Episode 5
· 47:45
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What about the myth that psychiatric
hospitals is only for crazy people,
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and only for those
that are extremely violent and dangerous?
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I think that's so unfortunate and sadly,
I hear that when sometimes
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families are calling to find a place
to put their loved one, that's not well.
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And I just tell them, you know, mental
health doesn't discriminate.
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It's from the park bench to park place
and everywhere in between.
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Mental health care
isn't about other people.
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It's about any of us who might need help.
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Yet Hollywood stereotypes
and outdated fears have created
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a dangerous misunderstanding
about psychiatric treatment facilities.
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On this episode of Beyond the Window.
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La Ventana’s Chief Clinical Officer
Sharon Volner sits down with Carla DiCandia
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Director of Business Development
at Oceanview Psychiatric
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Facility, to separate fact from fiction.
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We'll expose the truth
about forced medication.
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Walk you through a real day in treatment
and reveal
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what psychiatric care actually looks like
when the cameras aren't rolling.
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This is beyond the window.
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Welcome to Beyond the Window podcast.
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My name is Sharon.
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Volner,
Licensed Marriage and Family Therapist.
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And you are?
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I am Carla DiCandia.
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I'm the Director of Business
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Development at Oceanview
Psychiatric Health Facility in Long Beach.
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I am so excited to have you here.
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This has been a long time desire for me.
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Because I really want to look at this,
tackling
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this crucial topic of psychiatric
health care.
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What it is. What it's not.
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Psychiatric health care facilities
have been sensationalized in the media
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and glorified as these horrific,
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awful, locked up,
One Flew Over the Cuckoo's Nest type of,
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places.
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And I
really think that psychiatric health care
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really deserves a conversation
about what it is and what it's not.
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So thank you for joining us today.
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My pleasure. My pleasure.
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So what is your interest?
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Let's start.
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There is what what made you want to work
in psychiatric health care?
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I, I, I have to say, it was,
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not necessarily
something I knew was coming.
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I was,
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working in corporate health
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care, at a large Catholic health system,
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and then fell in love with an alcoholic
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and then thought, well,
this is interesting.
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And went to work for a rehab
as the director of clinical outreach
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and then got recruited to work
in a psychiatric hospital.
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I really didn't think twice about it.
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I didn't ever stop to be like.
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Oh, a psych hospital.
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You know what I mean?
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It just, for me,
it was like, it's health care.
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It's just it's, an opportunity in health
care.
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And so. And I love it.
And I've been there eight years.
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And I love that you say that
an opportunity in health care.
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Because most people when you say
psychiatric facility or psych hospital,
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people are automatically thinking
an insane asylum, the cuckoo house,
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people are wearing straight jackets.
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It's like girl interrupted
and other movies that have really put
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a different spin and stereotype
and created this fear based,
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ideal.
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That really isn't true.
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And so I really wanted to look at today
as to what is a health care facility
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or hospital like, like Oceanview
and what goes on in there.
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And I have some notes here,
because there are some really interesting
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myths out there that I want us to debunk
today for our viewers and listeners.
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Let's do it.
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Okay, so psychiatric
hospitals are like asylums
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from a horror movie dark, scary,
full of screaming and crazy people.
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We hear that a lot. Yes we do.
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What are they really?
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These
are just people who are experiencing acute
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psychiatric symptoms
and for a variety of reasons.
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Oh, so disclaimer I'm not a doctor.
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I'm not a therapist,
I'm not a medical professional.
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So all of my opinions and,
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things that I share with you
today are based on my life experiences
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with psychiatric patients.
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So it's all anecdotal. Yeah.
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But they're usually with us because
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they their symptoms
have overtaken their lives.
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And I'm much like,
I guess how an addiction
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would make someone's life unmanageable.
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All these symptoms do the same thing.
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And so now you have somebody
I mean, I have major depressive disorder,
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and I know there are days when I'm not
properly taking meds or whatever,
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or when I've been in depressive episodes
where if you ask me to get up
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and brush my teeth, it's like,
oh my God, that's like moving a mountain.
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The energy, the thought.
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And it's like, well,
my teeth won't fall out if I just take,
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you know, but it's just it's
it can just be.
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It can be anything.
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It can be the racing thoughts
that keep you awake at night.
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It can be,
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you know, walking down the street
and you've kind of crossed the line
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from being vigilant and aware of your
surroundings to hyper vigilant like,
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oh my God, it's like most people,
are they talking about me?
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I don't know them,
but what are they saying?
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You know, it just it's it's once
it's become unmanageable.
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So that's who's in psychiatric hospitals,
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I will say also in locked units.
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I don't work in a locked unit.
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I work in a voluntary unit.
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So we don't have police, officers
or ambulances dropping people off
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at my hospital.
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But in locked units
where they do 5150, they do have that.
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And so it might be somebody who is
in a psychosis and committed a crime.
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Does it mean they're criminal?
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Not necessarily.
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It means they're not.
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Well, and something went wrong.
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But but yeah,
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this whole concept of like,
there's screaming and
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I, I have heard loud persons on my unit,
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there's one woman who loves to sing,
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and so she'll be walking down the hallways
and singing joyfully.
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There's another woman who cries.
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And so you might hear her crying
very loudly,
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but it's their human beings.
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And you said a whole lot.
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And I want to kind of like, oh, sorry.
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No, no.
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First of all, I love your vulnerability
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that you're disclosing that you have also
and do struggle with depression.
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Yeah. And,
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have times
where you're struggling with basic stuff
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that we should all be doing right, getting
up, making our bed, brushing our teeth.
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But sometimes the struggle is real.
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And I always love to say that,
you know, everyone struggles.
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Everyone has mental health.
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Yes, everyone has mental health.
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It's how are we managing it?
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And it's okay to normalize
the conversation that sometimes
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we're having a little more symptoms
and others the racing thoughts.
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Or are those people talking about me
or depression?
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So mental health
shows up in a variety of ways
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and we becomes unmanageable
and an impairment.
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It earns, the title of a diagnosis
which I really believe,
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if we can name it, we containment.
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Kind of like what the seagull says.
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So that's what the name is for.
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It's for insurance. It's for medication.
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If I know the stars called peanut butter,
I know it goes with jelly.
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Yeah. So I'm not going to put it in
something else.
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But if we can name it, we can tame it.
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And if we can't tame it, it's
not that we're crazy.
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It's not that we're psychotic,
which is literally its own diagnosis
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of having auditory, visual, aural factory
hallucinations.
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It's something is off
and I need to manage it.
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And sometimes voluntary,
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hospitalizations can be a safe
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way as an early intervention
so that things don't become worse.
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So it's not the loony bin
in the crazy house.
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And and all the extremes
that we've seen in Hollywood and media.
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But it's really,
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and I've been to Oceanview,
so I can attest that
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it's a beautiful, clean,
very well-lit facility with single rooms
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and group rooms and windows
and so much light.
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And people are singing
and people are just learning
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how to manage their day to day struggles
with a ton of professionals,
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onsite
nurses, doctors, health care workers.
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And it's not this these images
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that we see on in Hollywood
now, sometimes those do exist.
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Those are generally
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for the locked facilities where people are
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in imminent danger
of hurting themselves or others.
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So and I will I will also add that
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even on on those locked units, yes.
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Generally they they separate
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the, the, the patient population
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into high high acuity and other acuity.
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Yeah.
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And they might
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if they have the space, they might even go
as far as to have a low acuity unit too.
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So I don't want people to be afraid.
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Like if you go voluntarily
and it happens to be at a locked unit,
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that you're going to be
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with the people that the cops are dropping
off, that that's not necessarily true.
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Yeah.
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So just I just wanted to clarify that.
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Absolutely.
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That they're not usually intermixed. Yeah.
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And those people also are people
that need treatment
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just showing up at a different
severity. Right. And
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yeah, they say thank.
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You for that.
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They wait for some people.
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Wait too long or just become,
you know, in a state of denial.
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I don't want to admit.
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I mean, how often do we get help
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when the red flag warnings are there?
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Or do we wait when it's a little too late
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and then we're like,
oh man, what do I do now?
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Right.
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Well, even when we look at the statistics
for people
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getting help for depression, yes,
I think it's,
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an average of suffering with the symptoms
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for five years before seeking treatment.
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And that's not even seeking
medical treatment.
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It could be there. Basic therapy.
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And then, you know how many years I did
I did two years
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of psychotherapy actively.
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And I still hold a slight resentment
that he didn't ever tell me, like,
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oh, hey, by the way, you, have
clinical depression, you know what I mean?
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But. And then finally get medicated.
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But it's it's on average,
just five years. Yeah.
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Well, it's nice
that today the conversation is
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being normalized with platforms like this
where we could talk about psychiatric
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care, mental health care, therapy,
medications, like, it's all okay.
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There are so many different options
to access help. Yeah.
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And if we talk about it and normalize
the conversation, more people
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are likely to get early intervention
and help. Yeah.
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Because what we don't want happen
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is we get to a state where we're isolated,
we're paranoid, our thoughts are racing,
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we're afraid to tell anyone
that we're not feeling ourselves.
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And then it ends up
being an emergency admission anywhere.
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Yeah. So that is very scary.
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Yeah.
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So another myth I want to run by you
is once you go to a psychiatric hospital,
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you're locked away, and you can't leave,
and they force you to stay indefinitely.
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Yes. I can't tell you how many times
patients,
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a loved one has called with them, and,
and wants them to get help.
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And aside from obviously my unit
being voluntary. So.
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No, you're not locked in.
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The doors are literally unlocked,
and you can walk out any time.
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But they say
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if I go in, they'll never let me out.
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Right?
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And I've heard that phrase so many times,
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and it's not true.
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I mean, the fact of the matter is,
even when there are people where I'm like,
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oh God, I wish we could keep them here
longer because it's not.
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Well, we can't, it's just that's
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just not the way the laws are written.
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They just can't.
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So legally, you know, there's a process
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and if you go in voluntarily,
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can they write a hold at my facility? No.
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In other facilities,
they can, it's usually for 72 hours.
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And it's usually if you're an imminent
risk of hurting yourself and others.
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And so that imminent part is very crucial
because,
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unless you are in immediate danger.
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Of. Hurting yourself with a plan, title
and intent, it's not going to happen.
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And it it patients do have rights.
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Patient can self discharge
and patients can come and patients can go.
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And so that 5150 code which
is the involuntary hold or for teens 5585
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sometimes it's voluntary.
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Yeah.
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It can be voluntary where they can
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come and go and seek the treatment
that they need and leave. Yes.
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And I'll tell you to your point,
when people self admit to a locked unit,
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but they're admitting voluntarily,
sometimes
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I'm of the opinion
that the hospital's right to hold merely
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for the sake of getting that state
authorized by the insurance,
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because the insurance companies
don't want to believe
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that people are checking themselves
into a psych unit for treatment.
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They still kind of view it as like
they're just taking a vacation.
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I will not comment on anything
about insurance. Yeah.
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But but so yes, I do get written. Yes.
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I don't know much about them.
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Yeah, but even if the doctor said,
hey, Sharon, you know what?
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You've been here three days
and your hold is up and you're not well,
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so I don't feel comfortable
discharging you.
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And I want to keep you longer.
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That's great that
00:13:22:10 - 00:13:25:11
he has that opinion,
and he has to present that to a judge
00:13:25:11 - 00:13:29:00
and a meet or a mediator,
whoever's, facilitating for that hospital.
00:13:29:15 - 00:13:34:02
And that judge has to give approval,
and the patient
00:13:34:02 - 00:13:38:06
has the opportunity to attend the hearing
and advocate on their own behalf.
00:13:38:17 - 00:13:41:04
And even then, the judge will say,
00:13:41:04 - 00:13:44:01
let's say the judge says, yes,
I agree with you, doctor.
00:13:44:01 - 00:13:46:19
I'm going to extend the hold
for up to 14 days.
00:13:46:19 - 00:13:49:13
That doesn't mean you're going to be there
the whole the whole time.
00:13:49:13 - 00:13:52:21
It's entirely up to the doctor
in terms of when you discharge.
00:13:53:16 - 00:13:56:15
And then if after the 14 days of,
say, doctor's like,
00:13:56:15 - 00:13:59:15
gosh, you're and you're still not well,
00:13:59:17 - 00:14:02:17
you know, I, I think we need to pursue
additional measures.
00:14:02:17 - 00:14:04:12
They can go back, but it does.
00:14:04:12 - 00:14:06:08
Nothing happens automatically.
00:14:06:08 - 00:14:08:20
The patient is involved in all of it.
00:14:08:20 - 00:14:11:00
The patient has a
right to have an advocate there with them.
00:14:11:00 - 00:14:14:00
So this whole, like,
you're going to be there forever.
00:14:14:01 - 00:14:17:01
It's it's it's literally
almost impossible.
00:14:17:10 - 00:14:19:18
If you're going to be there forever,
you'll know well in advance
00:14:20:19 - 00:14:22:01
that that's the plan.
00:14:22:01 - 00:14:24:15
Right? So it's not what we see on TV. Or.
00:14:24:15 - 00:14:25:15
People are coming
00:14:25:15 - 00:14:27:01
and they're taking you
in the middle of the night,
00:14:27:01 - 00:14:29:12
and you're in a straitjacket
and a padded room
00:14:29:12 - 00:14:31:18
and you're locked against your well
and forget about it.
00:14:31:18 - 00:14:34:21
Like there's an actual process
that the patient is a legal.
00:14:35:12 - 00:14:36:09
Yeah. An absolutely.
00:14:36:09 - 00:14:39:14
I love that you said that a legal process
that the patient is a part of.
00:14:39:21 - 00:14:42:16
And it's it's part of coordinated care.
00:14:42:16 - 00:14:44:02
Yeah.
00:14:44:02 - 00:14:47:02
And so thank you for debunking that one.
00:14:47:05 - 00:14:51:05
My other favorite
myth out there is that people get drugged.
00:14:51:12 - 00:14:54:12
So there's zombified and compliant.
00:14:54:19 - 00:14:58:11
Okay,
so here's the other interesting part.
00:14:59:07 - 00:15:01:03
Again, I work in a voluntary facility.
00:15:01:03 - 00:15:03:18
So if you're in the doctor, sit down.
00:15:03:18 - 00:15:06:22
You come up with a medication plan of yes,
00:15:06:22 - 00:15:10:04
doctor explains it to you
and you're like, yeah, no,
00:15:11:05 - 00:15:14:00
I don't I don't
actually like the side effects of that.
00:15:14:00 - 00:15:15:07
Is there something else?
00:15:15:07 - 00:15:17:18
So it's very collaborative.
00:15:17:18 - 00:15:21:07
And I know that because we've actually,
in our residential programs,
00:15:21:07 - 00:15:24:16
have assessed clients
to see if they're an appropriate fit
00:15:24:16 - 00:15:28:22
for our residential programs, because
we do believe that care is on a continuum.
00:15:28:22 - 00:15:31:22
So if you're in a psych hospital,
it is recommended that you seek outpatient
00:15:31:22 - 00:15:34:15
therapy
or therapy as a residential or outpatient.
00:15:34:15 - 00:15:38:04
So I know firsthand that we've interviewed
clients that are like,
00:15:38:04 - 00:15:41:04
I'm in a psych facility,
I'm receiving care.
00:15:41:05 - 00:15:44:23
I like the medications that I'm on, but
I would maybe like to try alternatives.
00:15:45:06 - 00:15:48:12
And I'm open to coming to your program
or I'm open to this.
00:15:48:12 - 00:15:52:23
And I'm so it's very collaborative
and it's a conversation between the doctor
00:15:52:23 - 00:15:53:13
and the patient.
00:15:53:13 - 00:15:56:22
It's not that the doctor is always right,
it's the doctors making medication.
00:15:56:22 - 00:15:58:23
Right. Suggestions.
00:15:58:23 - 00:16:01:03
And the patient is a part of that process,
too. Yes.
00:16:01:03 - 00:16:04:20
And then the absolutely the patients
and the clients do have a say
00:16:04:23 - 00:16:08:04
in their care when of course, it's
not an extreme situation.
00:16:08:04 - 00:16:11:09
But I also know
back to the previous point about holds
00:16:11:17 - 00:16:15:20
is if a client has a safe outpatient plan,
00:16:16:01 - 00:16:19:02
sometimes
the holds are kind of lifted early.
00:16:19:13 - 00:16:23:07
So but people are not overmedicated
they're not doing that shuffle.
00:16:23:07 - 00:16:25:16
Well they're not I. Mean there are
00:16:27:09 - 00:16:28:19
I think it's important to clarify.
00:16:28:19 - 00:16:32:15
Yes. This one point,
even if you're on a hold,
00:16:33:00 - 00:16:36:00
a 5150, a 5250.
00:16:36:00 - 00:16:38:08
Then that's the shorter
hold versus the. Yes.
00:16:38:08 - 00:16:38:21
Okay.
00:16:38:21 - 00:16:42:06
They cannot force you to take medication
00:16:43:08 - 00:16:46:08
period.
00:16:47:21 - 00:16:50:04
The only time that you can be
00:16:50:04 - 00:16:54:04
forcibly medicated, there's two times
00:16:54:17 - 00:16:59:01
one if you're on a hold
and you are out of control,
00:16:59:01 - 00:17:03:20
you are becoming a hazard
to the people around you or to yourself.
00:17:04:07 - 00:17:07:18
That's when you hear about people
getting taken down and injected
00:17:07:23 - 00:17:09:14
against their will.
00:17:09:14 - 00:17:13:09
That injection is a sedative,
and it's a strong one.
00:17:14:05 - 00:17:17:05
And it usually will take somebody out
for like a day.
00:17:17:05 - 00:17:18:18
Those are very extreme situations.
00:17:18:18 - 00:17:20:15
Those are very extreme situations.
00:17:20:15 - 00:17:25:02
And so, you know, I hear it a lot where
patients are like, oh, you know what?
00:17:25:02 - 00:17:28:10
I was at this unit
and they forcibly injected me.
00:17:28:16 - 00:17:30:21
And, you know, in the back of my head
I'm like,
00:17:30:21 - 00:17:33:13
you know, that all has to be documented
and justified.
00:17:33:13 - 00:17:36:17
So something happened.
And there's cameras.
00:17:36:17 - 00:17:39:16
And there's there's no,
you know, stops and it's.
00:17:39:16 - 00:17:41:04
Very few.
00:17:41:04 - 00:17:43:19
Oh yeah. Frequent.
00:17:43:19 - 00:17:45:16
Yeah. Not like what we see in Hollywood.
00:17:45:16 - 00:17:47:02
No, no.
00:17:47:02 - 00:17:49:19
And then the other time
that they can force you
00:17:49:19 - 00:17:53:04
to take medications again,
you have to be on a hold
00:17:53:20 - 00:17:58:11
and there's a legal proceeding
that is attached to the request.
00:17:58:11 - 00:18:02:17
So if the doctor's like Sharon, you're
if you've been refusing medications
00:18:02:17 - 00:18:04:20
the whole time you've been on the hold,
it's been three weeks now.
00:18:04:20 - 00:18:06:06
You're not getting better.
00:18:06:06 - 00:18:08:15
I'm going to petition the court.
00:18:08:15 - 00:18:11:06
It's called a hearing. And,
00:18:12:17 - 00:18:14:10
it's a whole process.
00:18:14:10 - 00:18:18:15
And the doctor and I, the patient again,
has the opportunity
00:18:18:15 - 00:18:22:02
to represent themselves,
but it requires a hearing
00:18:22:11 - 00:18:25:11
in order for the judge to say,
you know what?
00:18:25:17 - 00:18:27:20
The doctor's right, Sharon,
00:18:27:20 - 00:18:30:12
you're not making good decisions
for your health.
00:18:30:12 - 00:18:36:13
And so we're going to, take this matter
into our hands and medicate you.
00:18:36:16 - 00:18:37:10
Yeah.
00:18:37:10 - 00:18:40:09
That's the only way
you're going to be forcibly medicated.
00:18:40:15 - 00:18:42:18
So I'm glad you asked that. Yeah.
00:18:42:18 - 00:18:43:23
Because people really think that
00:18:43:23 - 00:18:45:16
they're like, well,
if I come, you're going to make me.
00:18:45:16 - 00:18:49:08
No, no, nobody can make you like you
no matter how badly we want to.
00:18:49:11 - 00:18:50:14
If you need it.
00:18:50:14 - 00:18:52:01
Because there are those times you're like,
00:18:52:01 - 00:18:53:18
oh my gosh,
this person would be so much better.
00:18:53:18 - 00:18:54:15
Their life would be so much better.
00:18:54:15 - 00:18:57:12
But no, there's no there's nothing.
00:18:57:12 - 00:18:59:07
We can't do it. Yeah.
00:18:59:07 - 00:19:03:03
So what about the myth that psychiatric
hospitals is only for crazy people,
00:19:03:14 - 00:19:06:21
and only for those
that are extremely violent and dangerous?
00:19:07:01 - 00:19:07:20
What do you say about that?
00:19:09:09 - 00:19:12:09
I think that's so unfortunate.
00:19:13:12 - 00:19:16:17
And I sadly,
I hear that when sometimes families
00:19:16:17 - 00:19:19:22
are calling to find a place
to put their loved one who's not.
00:19:19:22 - 00:19:22:21
Well, and
00:19:23:15 - 00:19:26:15
I just tell them, you know.
00:19:27:00 - 00:19:29:10
Mental health doesn't discriminate.
00:19:29:10 - 00:19:33:16
It's from the park bench to park place
and everywhere in between.
00:19:34:10 - 00:19:37:11
And I up over the eight years.
00:19:37:11 - 00:19:42:18
I can't tell you how many different
people, different races,
00:19:42:18 - 00:19:47:12
different ethnicities,
different sexual orientation, like,
00:19:48:23 - 00:19:50:18
different career paths,
00:19:50:18 - 00:19:53:18
different socioeconomic levels.
00:19:54:09 - 00:19:56:02
I've had
00:19:56:02 - 00:19:58:18
rheumatologists, I've had chiropractors,
00:19:58:18 - 00:20:02:12
I've had firefighters,
I've had, you name it, lawyers.
00:20:02:12 - 00:20:03:18
Like,
00:20:03:18 - 00:20:06:18
when it gets to be too much, it's
too much.
00:20:06:20 - 00:20:10:12
It doesn't matter who you are
or where you're at, it's just too much.
00:20:10:21 - 00:20:14:16
And it's just like people
also ask like, well,
00:20:14:16 - 00:20:15:20
what kind of people are there right now?
00:20:17:12 - 00:20:20:13
The humankind,
the human kind of psychiatric symptoms.
00:20:21:02 - 00:20:21:23
Does that help?
00:20:21:23 - 00:20:22:04
Yeah.
00:20:22:04 - 00:20:24:10
You know, it's like I, what do I tell you?
00:20:24:10 - 00:20:25:06
They're all ages.
00:20:25:06 - 00:20:29:04
We're 18 and over,
so it's across the spectrum.
00:20:29:05 - 00:20:30:01
Yeah.
00:20:30:01 - 00:20:31:15
And there's adolescent hospitals, too.
00:20:31:15 - 00:20:32:15
Specifically for adolescents.
00:20:32:15 - 00:20:36:05
We're talking about
symptoms, mental health symptoms
00:20:36:11 - 00:20:40:00
that are far beyond one's ability
to manage.
00:20:40:00 - 00:20:42:05
That just needs more intervention.
00:20:42:05 - 00:20:45:22
So when you talked about chiropractors
and other professionals,
00:20:45:22 - 00:20:49:13
that leads me to the next myth
that psychiatric hospitalizations,
00:20:49:20 - 00:20:53:01
just the idea of being in a psych
hospital will ruin your career.
00:20:53:04 - 00:20:55:11
It'll ruin your life,
ruin your reputation,
00:20:55:11 - 00:20:57:20
and it'll be something that you're going
to be ashamed of later on.
00:20:57:20 - 00:21:00:11
If you do it. How will they know?
00:21:00:11 - 00:21:01:02
That's my question.
00:21:01:02 - 00:21:03:19
How will they know
unless you tell them? Yeah.
00:21:03:19 - 00:21:05:06
And it's confidential.
00:21:05:06 - 00:21:07:02
Super confidential. And
00:21:08:04 - 00:21:09:02
every client, every
00:21:09:02 - 00:21:12:20
patient has a right to confidential care
at any level of care at any facility.
00:21:12:20 - 00:21:15:05
It doesn't follow you. It's
not on your resume, right?
00:21:15:05 - 00:21:19:23
It doesn't prevent you
from fulfilling your life and career path.
00:21:20:10 - 00:21:21:21
No, it's personal health information.
00:21:21:21 - 00:21:23:23
It's not. No, no protected
health information.
00:21:23:23 - 00:21:24:05
Yeah.
00:21:24:05 - 00:21:27:11
It's it's nobody has a right to it.
00:21:27:11 - 00:21:29:07
Yeah.
00:21:29:07 - 00:21:31:22
I know people sometimes
worry about like the bigger health
00:21:31:22 - 00:21:35:04
systems and,
you know, are all of those like,
00:21:36:00 - 00:21:39:10
hospitals have access to everybody
else's records and other hospitals,
00:21:39:10 - 00:21:41:21
and that's not usually the case. Yeah.
00:21:41:21 - 00:21:42:04
Yeah.
00:21:42:04 - 00:21:45:05
I, I that my, my answer to
that is how will they know.
00:21:45:11 - 00:21:46:18
Yeah.
00:21:46:18 - 00:21:48:07
So take me through the process.
00:21:48:07 - 00:21:53:05
If there are, there are someone out there
that is struggling with anxiety,
00:21:53:05 - 00:21:57:12
depression, trauma, paranoia, racing
thoughts just something isn't right.
00:21:57:12 - 00:22:00:00
Their level of functioning is impaired.
00:22:00:00 - 00:22:00:10
Somehow.
00:22:00:10 - 00:22:02:14
Relationships aren't going well,
00:22:02:14 - 00:22:05:18
they're not able to function
and they're afraid to come to a hospital.
00:22:05:18 - 00:22:10:07
What might they expect from the first
phone call to their last day there?
00:22:10:07 - 00:22:11:14
Take me through that process,
00:22:11:14 - 00:22:15:13
because I know as a health care
professional, you know, we've called you
00:22:15:17 - 00:22:21:09
we've had you personally sit on the phone
with clients for as long as they need it,
00:22:21:09 - 00:22:25:15
which is really impressive
seven days a week, any hour of the day.
00:22:25:15 - 00:22:28:16
You've been so accessible
to tell your story, share
00:22:28:16 - 00:22:32:12
your experience, strength and hope
with other people that are also struggling
00:22:32:16 - 00:22:36:12
and say, hey, as an ally, as a person
who doesn't just work
00:22:36:12 - 00:22:40:12
in a psych hospital or psych facility,
let me tell you about it.
00:22:40:12 - 00:22:42:02
Let me tell you what to expect.
00:22:42:02 - 00:22:43:15
And when you get there, I'll see you too.
00:22:43:15 - 00:22:45:03
Yeah. So like that. So.
00:22:45:03 - 00:22:47:12
So what happens after
they make that initial phone call?
00:22:47:12 - 00:22:50:22
So anytime you call a psych hospital
00:22:50:22 - 00:22:53:23
to find out about admitting,
they're going to ask you questions,
00:22:54:19 - 00:22:58:11
they're going to ask you a lot of times
they'll ask you, where where are you now?
00:22:58:22 - 00:23:00:11
What is the address you're at now?
00:23:01:13 - 00:23:03:02
And that's for the purpose of if,
00:23:03:02 - 00:23:08:03
if we need to send an emergency, my unit,
not ours.
00:23:08:03 - 00:23:09:13
But so let's just talk about it.
00:23:09:13 - 00:23:11:16
So I'm suicidal, right?
00:23:11:16 - 00:23:13:19
Yes. And I want to hurt myself.
00:23:13:19 - 00:23:16:20
I'm not going to
because I really want to get care.
00:23:17:09 - 00:23:20:21
So if I give you my address,
are you going to show up with police?
00:23:21:06 - 00:23:23:21
And, you know,
these big people that are going to, like,
00:23:23:21 - 00:23:27:20
put me in a, in a, in a straitjacket
and then like, take me away?
00:23:28:00 - 00:23:30:03
Or is it safe to have that conversation
00:23:30:03 - 00:23:33:22
like no one feels comfortable
and safe to say, I feel suicidal.
00:23:33:22 - 00:23:37:07
I want to hurt myself like,
these are super taboo conversations.
00:23:37:16 - 00:23:40:15
If somebody has picked up the phone,
that's
00:23:40:15 - 00:23:43:21
that's the indicator that they're open
to having that conversation.
00:23:43:21 - 00:23:44:09
Okay. Right.
00:23:44:09 - 00:23:49:00
So when they call us, we're having a talk
about what are you experiencing?
00:23:49:16 - 00:23:51:20
Okay. Well,
you know, I want to harm myself.
00:23:51:20 - 00:23:53:23
I don't have a plan,
but I hate feeling like this.
00:23:55:13 - 00:23:58:13
Then they're probably gonna ask you
for your assurance information
00:23:58:16 - 00:24:01:16
to make sure that you're not
getting yourself into a financial bind.
00:24:02:09 - 00:24:04:23
We like covered by insurance, too.
Yes. Wow.
00:24:04:23 - 00:24:05:21
Yes. And even.
00:24:05:21 - 00:24:08:21
And even Medicaid in California
as Medi-Cal,
00:24:09:17 - 00:24:10:12
covers it.
00:24:10:12 - 00:24:13:05
I mean, this is a health condition, right?
00:24:13:05 - 00:24:16:05
You need to be hospitalized. So,
00:24:16:11 - 00:24:19:11
they'll check your insurance
to verify that it's active and,
00:24:20:16 - 00:24:23:09
in network or has out of network benefits.
00:24:23:09 - 00:24:26:15
And for us, we do a phone assessment.
00:24:26:15 - 00:24:31:13
It's brief, maybe 15, 20 minutes, where
we just start asking about the symptoms
00:24:31:13 - 00:24:34:14
and we start asking
about your history of a
00:24:34:15 - 00:24:37:15
specifically for us, violence.
00:24:37:16 - 00:24:40:16
We ask,
do you have any legal cases pending?
00:24:40:17 - 00:24:44:00
And that's for the sake of like,
if you were to admit then what?
00:24:44:23 - 00:24:47:00
What what do
you have scheduled in the next seven days?
00:24:47:00 - 00:24:48:11
Are you supposed to be appearing in court?
00:24:48:11 - 00:24:50:06
You can you do it on zoom?
00:24:50:06 - 00:24:50:19
Can you know.
00:24:50:19 - 00:24:55:01
So so they might ask you that they are,
asked if you're taking medications.
00:24:55:17 - 00:24:58:18
If you are, they want to know which ones,
how much.
00:25:00:22 - 00:25:04:09
I think that's a, that's
that's going to be the phone call.
00:25:04:09 - 00:25:07:23
And then some hospitals will tell you,
okay, well, you know, come
00:25:08:04 - 00:25:09:22
you have to admit
through the emergency room.
00:25:09:22 - 00:25:12:15
So we'll go to the E.R., check in.
00:25:12:15 - 00:25:17:01
For us, we like to schedule the admission,
so we'll ask you like Sharon.
00:25:17:01 - 00:25:18:06
Well, what time would you like to come?
00:25:18:06 - 00:25:20:02
And what day
would you like to come? Today.
00:25:20:02 - 00:25:21:20
But you don't want to come until 10 p.m.?
00:25:21:20 - 00:25:23:02
No problem.
00:25:23:02 - 00:25:24:08
Do you have transportation?
00:25:24:08 - 00:25:28:18
Well, and and and I don't know,
I don't know which other hospitals
00:25:28:18 - 00:25:31:22
are for that, but for us, we would ask
you, do you need transportation?
00:25:31:22 - 00:25:32:14
Are you local?
00:25:32:14 - 00:25:35:00
If you're local,
we can send one of our drivers
00:25:35:00 - 00:25:36:05
and then we schedule the pickup.
00:25:36:05 - 00:25:39:20
And then because some people for them,
transportation is a barrier. Yes.
00:25:40:03 - 00:25:41:15
And you know, where am I going to park?
00:25:41:15 - 00:25:44:08
And what am I even safe to drive to?
So I'm not feeling like this.
00:25:44:08 - 00:25:47:15
I can't drive or
I can't because I'm paralyzed by my fear
00:25:47:15 - 00:25:50:18
or my anxiety or I've. I've had
00:25:51:17 - 00:25:52:15
cases like that.
00:25:52:15 - 00:25:55:15
So a 15 minute interview over the phone
00:25:56:05 - 00:25:58:05
and then you set up transportation. Yeah.
00:25:58:05 - 00:25:59:07
Well we in time we.
00:25:59:07 - 00:26:02:07
Do end up having to send all of those
notes through our clinical review
00:26:02:07 - 00:26:05:04
and it gets approved
and then we schedule the admission. Yeah.
00:26:05:04 - 00:26:09:22
And so the person arrives,
I arrive right on the patient I arrive
00:26:09:22 - 00:26:13:01
what should I expect as far as you know,
where am I sleeping.
00:26:13:01 - 00:26:13:22
What am I eating?
00:26:13:22 - 00:26:16:01
Who am I meeting with?
When do I see the doctor?
00:26:16:01 - 00:26:16:22
Yeah.
00:26:16:22 - 00:26:17:19
Who's there?
00:26:17:19 - 00:26:20:19
What other people are there? Yeah.
00:26:21:04 - 00:26:24:13
Most psych units
don't give tours to patients
00:26:24:19 - 00:26:27:19
ahead of time for privacy reasons.
00:26:27:20 - 00:26:30:20
So what I like to say is, you know what?
00:26:31:06 - 00:26:34:12
There are all ages and all kinds,
and you will find your tribe.
00:26:35:01 - 00:26:38:11
And inevitably, they do,
you know, just inevitably they do.
00:26:39:08 - 00:26:42:20
You will sit down with an admissions
or an intake person
00:26:43:05 - 00:26:46:08
and, do all of the formalities.
00:26:46:17 - 00:26:49:17
But I understand I'm here voluntarily,
I understand I can leave
00:26:49:17 - 00:26:52:16
and again,
this is just at my yes facility.
00:26:52:16 - 00:26:56:02
But like any hospital intake,
if you were checking in,
00:26:56:21 - 00:26:59:07
to Providence for a heart surgery,
00:26:59:07 - 00:27:03:11
you show up to the admissions office
and you fill out all your papers, right?
00:27:04:00 - 00:27:07:01
And you have a co-pay,
and you pay your co-pay, and
00:27:07:23 - 00:27:10:12
and then once the paperwork is complete,
00:27:12:04 - 00:27:14:20
the additional
steps we take in, in behavioral health
00:27:14:20 - 00:27:18:00
is they go through your belongings
to make sure that there's no contraband.
00:27:19:02 - 00:27:19:08
What would.
00:27:19:08 - 00:27:22:06
Be considered contraband, like.
00:27:22:06 - 00:27:25:07
Anything that can be used to hurt yourself
or someone else.
00:27:25:07 - 00:27:30:10
So that's why you hear of, like,
no shoelaces, no drawstrings, no belts.
00:27:31:05 - 00:27:32:07
Well, but I'm not suicidal.
00:27:32:07 - 00:27:34:13
I'm not sure. Yeah,
but we want to make sure.
00:27:34:13 - 00:27:37:12
Not that just you're safe,
but that everybody else is safe, too.
00:27:37:15 - 00:27:39:00
Right? Okay.
00:27:39:00 - 00:27:42:00
No razors, no scissors.
00:27:42:13 - 00:27:43:09
No mirrors.
00:27:43:09 - 00:27:47:05
So we do, every morning
there is a grooming session.
00:27:47:05 - 00:27:50:01
So then, like, if you wanted your makeup,
00:27:50:01 - 00:27:53:09
you'll get your makeup and you can do it,
and then we're going to take it back
00:27:53:09 - 00:27:55:23
and put it away. Okay.
00:27:55:23 - 00:27:57:01
What else is contraband?
00:27:57:01 - 00:27:59:04
What about activities and meal times?
00:27:59:04 - 00:28:00:12
What does that look like?
00:28:00:12 - 00:28:02:12
So are there activities?
00:28:02:12 - 00:28:04:13
Yes yes yes yes. And,
00:28:06:00 - 00:28:06:15
while I'm not
00:28:06:15 - 00:28:09:21
familiar with compliance
like and regulations to the tee,
00:28:10:02 - 00:28:13:12
I will say that the hospitals
are supposed to be providing
00:28:13:17 - 00:28:16:14
groups, psychoeducation groups.
00:28:16:14 - 00:28:19:15
They're supposed to be providing meals
and snacks.
00:28:21:07 - 00:28:24:07
They're supposed to be providing case
management.
00:28:24:23 - 00:28:28:03
So, like, for us, there's,
I think six groups a day.
00:28:28:16 - 00:28:31:16
So three are psycho educational
00:28:31:18 - 00:28:34:22
and three are therapeutic recreation. Wow.
00:28:35:03 - 00:28:37:21
And everything is led by clinical staff.
00:28:37:21 - 00:28:40:21
And that means everything has a purpose,
a goal.
00:28:41:16 - 00:28:44:00
Things get chart it it gives.
00:28:44:00 - 00:28:46:21
It gives the hospital or the facility
an opportunity
00:28:46:21 - 00:28:50:04
to see the patient
in, in, in their completeness.
00:28:50:04 - 00:28:53:04
Right. Because a lot of times
00:28:53:20 - 00:28:56:13
patients are smart, they're very smart.
00:28:56:13 - 00:28:59:17
And they know what the doctor wants
to hear in order to let them go.
00:29:00:01 - 00:29:03:17
So maybe Sharon tells the doctor,
no, doctor, I am not hearing voices
00:29:03:17 - 00:29:05:06
since you started me on medication.
00:29:05:06 - 00:29:07:02
I'm, I'm I'm ready to go home.
00:29:08:14 - 00:29:11:10
But then
00:29:11:10 - 00:29:14:13
the doctor looks through the chart
and sees that the rec therapist
00:29:14:13 - 00:29:18:08
has added that today in group, Sharon
00:29:18:08 - 00:29:21:20
was sitting next to an empty chair
and having a conversation.
00:29:22:09 - 00:29:25:23
So it also gives an opportunity
for different types of interventions. Yes.
00:29:25:23 - 00:29:29:16
And group offers an opportunity
for that common ground
00:29:29:16 - 00:29:33:15
where people are coming together
and sharing, which also normalizes
00:29:33:15 - 00:29:36:18
the conversation of I'm
not alone in the struggle and it's
00:29:36:18 - 00:29:39:19
okay if I am experiencing voices
00:29:39:21 - 00:29:43:19
or visuals and hallucinations,
and I can talk about it
00:29:43:19 - 00:29:47:02
and I can get treatment, and that's
actually not the criteria for a hold.
00:29:47:10 - 00:29:50:02
It's am I safe in my body? Yeah.
00:29:50:02 - 00:29:52:03
Am I safe in my in the world?
00:29:52:03 - 00:29:53:08
In the world, yes.
00:29:53:08 - 00:29:56:07
Big time.
Okay. Back to so groups and meals.
00:29:56:15 - 00:29:59:04
And what about meeting with the doctor.
00:29:59:04 - 00:30:03:04
So the goal of being in a psychiatric
facility
00:30:03:14 - 00:30:07:02
is to get the brain chemistry regulated.
00:30:07:14 - 00:30:10:09
Right? Like that's the goal.
00:30:10:09 - 00:30:12:13
Most places are not offering
00:30:12:13 - 00:30:15:15
individual therapy
because it's really just not indicated.
00:30:16:07 - 00:30:22:00
If somebody is really fragile
or really unstable, then it's not.
00:30:22:02 - 00:30:24:19
CBT is not going to help.
00:30:24:19 - 00:30:27:10
It's emergency
stabilization. Right? Right.
00:30:27:10 - 00:30:29:15
So they meet with the doctor every day.
00:30:29:15 - 00:30:31:11
And this is like standard in any hospital.
00:30:31:11 - 00:30:34:14
You're supposed to meet with the physician
within 24 hours of your arrival,
00:30:35:01 - 00:30:38:01
and they'll do a psychiatric evaluation.
00:30:38:03 - 00:30:40:18
And then the doctor will develop
00:30:40:18 - 00:30:44:16
their medication plan for you
and discuss it with you.
00:30:45:03 - 00:30:47:22
Once you guys are in agreement,
00:30:47:22 - 00:30:50:17
they'll put the order in and then,
00:30:50:17 - 00:30:54:00
you know, if it's an am mad, you'll get it
the next morning if it's a PM.
00:30:54:00 - 00:30:56:20
And it depends when you see the doctor,
obviously. And we'll consider this. But,
00:30:57:22 - 00:31:00:22
and then the doctor comes back
the next day
00:31:01:05 - 00:31:05:07
and, what's happening a lot of times
because of the shortage, in physicians
00:31:05:23 - 00:31:09:02
is they're using a lot
of what they call extenders.
00:31:09:08 - 00:31:12:17
So that could be a physician's assistant,
it could be a nurse practitioner,
00:31:12:22 - 00:31:16:05
but they're prescribers and they're
working under the doctor's supervision.
00:31:16:13 - 00:31:18:20
So the doctors develop the plan.
00:31:18:20 - 00:31:22:15
Or maybe, you know, maybe you showed up
and it's that doctor's day off.
00:31:22:15 - 00:31:25:02
And so you're actually meeting
with the extender.
00:31:25:02 - 00:31:28:05
That person will develop the plan and,
00:31:28:21 - 00:31:31:08
you know,
give it to the doctor and get you started.
00:31:31:08 - 00:31:33:21
So there's no waste of time
while you're with us.
00:31:33:21 - 00:31:34:17
Right.
00:31:34:17 - 00:31:37:16
And then the doctor comes back
the next day and is like,
00:31:37:16 - 00:31:40:20
hey, Sharon, you know, you came
in, you hadn't slept in four days.
00:31:40:20 - 00:31:43:14
We started you on Seroquel last night,
you know.
00:31:43:14 - 00:31:44:19
How did you sleep?
00:31:44:19 - 00:31:45:23
Oh, I slept really good.
00:31:45:23 - 00:31:48:00
But this morning I woke up.
I was really groggy.
00:31:48:00 - 00:31:49:18
I just I couldn't snap out of it.
00:31:49:18 - 00:31:51:11
Okay, well,
you know what? Let's make an adjustment.
00:31:51:11 - 00:31:52:03
Oh, wow.
00:31:52:03 - 00:31:54:23
Right. And so and and that's the advantage
00:31:56:09 - 00:31:57:09
I think
00:31:57:09 - 00:32:00:20
many people
who've been on the mental health journey,
00:32:01:19 - 00:32:06:04
specifically with medication,
you go as an outpatient person,
00:32:07:03 - 00:32:10:17
you go to your doctor and you're like,
I'm not sleeping.
00:32:10:17 - 00:32:14:01
I and when I am supposedly sleeping,
I wake up exhausted
00:32:14:01 - 00:32:17:13
ten hours later
and every day I come home and I'm sobbing.
00:32:17:13 - 00:32:20:02
I mean, this is my story.
And every day I come home
00:32:20:02 - 00:32:22:06
and I'm on the floor with my dog
sobbing and la la la.
00:32:22:06 - 00:32:25:14
And the doctor's like, okay,
it sounds like sounds like depression.
00:32:25:14 - 00:32:28:02
Let's let's start you on this medication.
00:32:28:02 - 00:32:30:16
And you know, it's going to take
a few weeks before it kicks in.
00:32:30:16 - 00:32:32:12
So I don't have very like,
00:32:32:12 - 00:32:36:04
you know, high expectations
of noticing at anything immediately
00:32:36:10 - 00:32:40:01
and then come back in three weeks and,
and let me know how it went.
00:32:41:16 - 00:32:44:16
And you're like, well, shoot,
00:32:45:00 - 00:32:46:03
that's okay. I'm in between.
00:32:46:03 - 00:32:48:07
So you're, you're getting to see a doctor
or a.
00:32:48:07 - 00:32:50:10
Free day every. Single day.
00:32:50:10 - 00:32:54:20
And so you said
hospitalizations are not indefinite stays.
00:32:54:20 - 00:32:58:08
So how long is a hospitalization
when we're talking about acute
00:32:58:16 - 00:33:01:10
stabilization triaging.
00:33:01:10 - 00:33:04:10
Yeah. What what what can a person expect.
00:33:04:10 - 00:33:07:08
For us it's about 7 to 10 days. Okay.
00:33:07:08 - 00:33:09:19
Can it be shorter.
It could be longer. Yes. Yeah.
00:33:09:19 - 00:33:11:16
So it's really individualized to
00:33:11:16 - 00:33:15:08
what does the person need if I'm coming in
and I haven't slept in four days
00:33:15:15 - 00:33:19:01
and I'm still not sleeping
in full in four additional days,
00:33:19:15 - 00:33:22:09
is there an opportunity to stay
until we find the right?
00:33:22:09 - 00:33:26:03
Yeah, because I know that
that is a huge concern with patient
00:33:26:03 - 00:33:28:21
care is I don't want to see my doctor
in three weeks.
00:33:28:21 - 00:33:30:06
I know that's so long.
00:33:30:06 - 00:33:32:23
It's so much suffering. It's
and it is so much suffering.
00:33:32:23 - 00:33:35:14
And what do we do
in the midst of suffering?
00:33:35:14 - 00:33:38:02
What other bad behaviors?
Or as TJ Woodward
00:33:38:02 - 00:33:41:19
says, brilliant strategies
do we come up with in the meantime?
00:33:42:02 - 00:33:44:05
So yeah, it is.
00:33:44:05 - 00:33:47:05
It sounds like
a really collaborative process
00:33:47:07 - 00:33:49:08
where I want to find the right man.
00:33:49:08 - 00:33:52:11
I don't want to leave
because the fear of I'm going to go home
00:33:52:11 - 00:33:55:16
and I can't do another night a week,
I just can't.
00:33:55:16 - 00:33:57:12
Yeah, yeah. No, absolutely.
00:33:57:12 - 00:33:59:08
And same thing
with when you're looking at,
00:33:59:08 - 00:34:02:10
for example, medications
that require blood tests.
00:34:02:10 - 00:34:02:19
Yeah.
00:34:02:19 - 00:34:05:19
To make sure that you're
reaching a therapeutic dose.
00:34:06:08 - 00:34:08:13
We do that all internally.
00:34:08:13 - 00:34:12:09
So it's not like,
oh, you're an outpatient start.
00:34:12:09 - 00:34:13:14
Start you on Depakote.
00:34:13:14 - 00:34:16:22
We're gonna start you on a low dose and
come back and then you know what I mean?
00:34:16:22 - 00:34:18:10
It's like that could take weeks.
00:34:18:10 - 00:34:20:23
This is like going to happen
like within a week or two.
00:34:20:23 - 00:34:25:09
Well and and when we hit that therapeutic
dose then we see how that goes.
00:34:25:09 - 00:34:26:20
If it's too much, you know what I mean?
00:34:26:20 - 00:34:30:05
It's like it's all happening
pretty immediately.
00:34:30:21 - 00:34:33:21
I mean, in the grand scheme of things,
it's like immediate, you know.
00:34:34:05 - 00:34:37:02
So let's say
a person checks in to a hospital.
00:34:37:02 - 00:34:40:02
Are they able to call or visit family?
00:34:40:04 - 00:34:45:02
Yes. So the law says that a person
in a psychiatric facility
00:34:45:07 - 00:34:48:12
must have access to a telephone 24 seven.
00:34:49:07 - 00:34:51:15
So there will be patient
00:34:51:15 - 00:34:55:18
phones on any psychiatric unit
because it is required by law.
00:34:57:08 - 00:35:00:08
And, you
know, you can't have your cell phone.
00:35:00:20 - 00:35:02:21
And that's kind of standard.
00:35:02:21 - 00:35:04:20
And there's a lot of reasons why.
00:35:04:20 - 00:35:08:10
But you can make calls 24 seven
and you can receive calls to,
00:35:09:03 - 00:35:12:03
if you have people, you know, on
consent and, and all that good stuff,
00:35:12:17 - 00:35:15:19
the visiting hours, you know,
don't know what the regulations are.
00:35:17:00 - 00:35:20:00
I know a lot of the locked
facilities have visiting hours
00:35:20:00 - 00:35:23:22
every day, at least for like two hours
in the nighttime for us.
00:35:23:22 - 00:35:27:10
We do visiting on Saturdays
and Sundays from 1 to 3.
00:35:27:10 - 00:35:30:02
So there is family control?
Yes there is. Engage. Absolutely.
00:35:30:02 - 00:35:30:17
Yeah.
00:35:30:17 - 00:35:33:15
I will also want to touch on
when you when you talk about
00:35:33:15 - 00:35:36:15
like accessibility to patients or staff.
00:35:37:12 - 00:35:40:21
I, I just heard this again this
morning from a family that
00:35:42:00 - 00:35:43:05
it was really hard to get
00:35:43:05 - 00:35:46:15
Ahold of the doctor
while my loved one was there.
00:35:47:11 - 00:35:50:11
And yes,
00:35:51:07 - 00:35:52:09
it's true.
00:35:52:09 - 00:35:55:12
And and I'm going to say that
that's the case pretty much
00:35:55:12 - 00:35:58:23
in any hospital and,
and really like, almost on any unit.
00:36:00:14 - 00:36:03:20
And it's
because the doctors are not our employees,
00:36:04:04 - 00:36:07:04
so they come on their own schedule.
00:36:07:07 - 00:36:12:02
Many of them are, are,
are privileged at a number of hospitals.
00:36:12:02 - 00:36:16:03
And so they're making rounds
at a couple of different places a day,
00:36:16:09 - 00:36:17:23
and then depending on
how long it takes them.
00:36:17:23 - 00:36:19:18
So but they're social workers in.
00:36:19:18 - 00:36:22:19
Case there are workers, there's case
managers.
00:36:22:19 - 00:36:24:05
There's the nursing department.
00:36:24:05 - 00:36:25:21
So there's always someone to talk to.
00:36:25:21 - 00:36:29:12
Yes. If you if you call the nursing unit
wherever your loved one
00:36:29:12 - 00:36:32:23
is and just say, you know,
can you check if I'm on consent?
00:36:33:09 - 00:36:36:03
And if you are ask, you know what, what?
00:36:36:03 - 00:36:36:11
Have there been
00:36:36:11 - 00:36:39:13
any medication changes like what are the
what are the notes saying?
00:36:39:13 - 00:36:41:19
What you know, how are they?
Are they attending groups?
00:36:41:19 - 00:36:42:13
Are they eating?
00:36:42:13 - 00:36:44:10
Are they you know,
you can ask all those questions.
00:36:44:10 - 00:36:45:18
It's all in the system.
00:36:45:18 - 00:36:51:02
And, and and if if it's not then there's
staff there who know your loved one.
00:36:51:14 - 00:36:54:14
You know, like we spend a lot of time
00:36:54:14 - 00:36:57:19
I mean, the nurses and all the staff at
the hospital are working 12 hour shifts.
00:36:57:19 - 00:36:58:06
Yeah.
00:36:58:06 - 00:37:02:22
So that's a long time with people
and they get to know them pretty well.
00:37:03:06 - 00:37:07:21
So, I know when I go to visit patients,
I, I try to like
00:37:08:09 - 00:37:10:00
I might, with their permission,
00:37:10:00 - 00:37:13:11
like, take a picture of us together
and send it to the family.
00:37:13:22 - 00:37:16:01
So they're like, you know, okay,
this is what he looks like.
00:37:16:01 - 00:37:17:07
He's here. He's okay.
00:37:17:07 - 00:37:19:06
Like, you know, but,
00:37:19:06 - 00:37:21:22
And you personally have a relationship
with patients and families.
00:37:21:22 - 00:37:23:08
I them I know. Yeah.
00:37:23:08 - 00:37:26:20
Yeah, I tend to it just because I for me,
00:37:27:19 - 00:37:30:06
I, I try to be who I would have needed.
00:37:30:06 - 00:37:30:17
Yeah.
00:37:30:17 - 00:37:34:09
You know
and and I recognize that they're sending
00:37:34:20 - 00:37:38:01
their child their wife, their mom,
00:37:39:02 - 00:37:39:21
their brother.
00:37:39:21 - 00:37:42:20
Like they're sending this person to what
00:37:42:23 - 00:37:46:01
you've identified
clearly as a very scary situation.
00:37:46:01 - 00:37:46:17
Yeah.
00:37:46:17 - 00:37:52:04
And, and nothing pleases me more
than hearing, like, for example, a mom
00:37:52:04 - 00:37:57:10
that I spoke to this morning, she told me,
you know, I'm so glad that we went
00:37:57:23 - 00:38:00:14
because she felt safe.
00:38:00:14 - 00:38:02:00
It did her so well.
00:38:02:00 - 00:38:04:14
The doctor, the medication like
00:38:04:14 - 00:38:06:11
to know that we can be that.
00:38:06:11 - 00:38:10:08
Please for someone at literally
00:38:10:08 - 00:38:14:14
one of the most vulnerable points
of their entire lives.
00:38:16:01 - 00:38:20:04
There's nothing,
I think, more sacred than that, you know?
00:38:20:04 - 00:38:23:04
So. So, yes,
I tried to be involved when I can.
00:38:23:18 - 00:38:27:17
So what would be your one piece of advice
for the listener out there,
00:38:27:17 - 00:38:31:01
the viewer out there that is concerned
about their mental health,
00:38:32:01 - 00:38:34:04
but they're so afraid of the stigma
00:38:34:04 - 00:38:37:04
because we, we,
we stigmatize what we fear and don't know
00:38:38:00 - 00:38:41:02
and have been recommended
to seek treatment
00:38:41:02 - 00:38:44:09
or seek care at a facility of any kind.
00:38:44:09 - 00:38:46:21
And just the idea of the facility,
a hospital.
00:38:46:21 - 00:38:48:16
And I mean,
00:38:48:16 - 00:38:50:14
what would be your piece of advice
to someone out there
00:38:50:14 - 00:38:54:17
listening that that is aware
that something is going on and,
00:38:54:21 - 00:38:57:21
and they might benefit
from accessing care?
00:38:58:14 - 00:39:01:00
I think
00:39:01:00 - 00:39:03:23
I would say
00:39:03:23 - 00:39:06:08
if you don't do anything,
00:39:06:08 - 00:39:09:07
it's not going to get better.
00:39:09:07 - 00:39:12:07
And with mental health
00:39:12:08 - 00:39:14:14
it tends to get worse.
00:39:14:14 - 00:39:17:14
So try it.
00:39:18:23 - 00:39:21:06
You can always leave,
00:39:21:06 - 00:39:24:22
but try it and I,
I feel the same way about medication.
00:39:24:22 - 00:39:26:21
You know, a lot of people are hesitant
about medication.
00:39:26:21 - 00:39:28:10
I don't want to be on medication.
00:39:28:10 - 00:39:30:16
Okay. Doesn't
mean you can be on it forever.
00:39:30:16 - 00:39:33:16
Maybe you just need to get through
this period of time, like this
00:39:33:19 - 00:39:37:08
difficult period at work,
or this difficult time of loss
00:39:37:08 - 00:39:42:07
or some something situational
and you just need help to get through it.
00:39:43:23 - 00:39:45:15
For now.
00:39:45:15 - 00:39:48:12
It's not it doesn't have to be forever,
right?
00:39:48:12 - 00:39:50:15
That that those would be my two things.
00:39:50:15 - 00:39:53:01
Just try it
because it's going to get worse
00:39:53:01 - 00:39:56:01
and it doesn't have to be forever.
00:39:58:05 - 00:40:00:05
That's it.
00:40:00:05 - 00:40:01:12
So what haven't we covered?
00:40:01:12 - 00:40:04:12
And as far as any stereotypes or
00:40:05:22 - 00:40:08:11
myths that need to be debunked.
00:40:08:11 - 00:40:10:07
We talked about medication.
00:40:10:07 - 00:40:12:15
We talked about.
00:40:12:15 - 00:40:14:03
Locations, halls.
00:40:14:03 - 00:40:17:14
Yeah. Scary dark screaming places.
00:40:17:15 - 00:40:21:17
I think the other thing people are afraid
of is use of force.
00:40:21:22 - 00:40:24:22
Yeah. Right. So,
00:40:25:06 - 00:40:28:05
it's kind of like any other situation
where
00:40:29:05 - 00:40:34:03
if you don't need to be restrained,
you won't be.
00:40:34:15 - 00:40:39:03
And there are always interventions first,
00:40:39:19 - 00:40:43:13
you know, if you, let's say,
are starting to ramp up,
00:40:44:15 - 00:40:48:08
you know, we have a whole protocol,
at the hospital in terms of,
00:40:49:12 - 00:40:50:04
observing
00:40:50:04 - 00:40:53:05
patients on the unit
when nothing is happening.
00:40:54:08 - 00:40:57:07
And then that way we can see,
oh, you know,
00:40:57:07 - 00:41:00:06
Sharon has started pacing.
00:41:00:06 - 00:41:00:14
Okay.
00:41:00:14 - 00:41:02:04
So that's a sign that's an alert for us.
00:41:02:04 - 00:41:04:04
Like Sharon is experiencing something.
00:41:04:04 - 00:41:04:10
Yeah.
00:41:04:10 - 00:41:07:15
So a social worker might go out
and be like hey Sharon.
00:41:07:16 - 00:41:10:16
You know, let came out to see
we want to chat,
00:41:11:21 - 00:41:13:04
check in with you.
00:41:13:04 - 00:41:16:04
You're like I'm fine, I'm fine. Okay.
00:41:16:15 - 00:41:19:14
And then you keep pacing
and now you're pacing faster.
00:41:19:14 - 00:41:22:14
And now your facial
00:41:23:08 - 00:41:24:21
expressions have changed.
00:41:24:21 - 00:41:27:17
So now we're more concerned
and somebody is going to come out,
00:41:27:17 - 00:41:31:21
probably the nurse and the social worker
and say, hey, Sharon, great about you.
00:41:31:23 - 00:41:33:20
You know,
00:41:33:20 - 00:41:37:17
can we give you something to help you
relax or feel better?
00:41:38:14 - 00:41:41:04
Do you want, you know,
you put on your form when you admitted
00:41:41:04 - 00:41:42:16
that music helps you to calm down.
00:41:42:16 - 00:41:45:01
Would you like a headset? Well.
00:41:45:01 - 00:41:49:09
You know, we offer these interventions
as Sharon has the right to say. No.
00:41:50:15 - 00:41:53:00
Okay, so now Sharon is pacing.
00:41:53:00 - 00:41:56:02
She's got the face,
and now she's starting to, like,
00:41:56:13 - 00:41:59:09
ramp up verbally.
00:41:59:09 - 00:42:01:07
Okay, then we're going to go.
00:42:01:07 - 00:42:04:07
Maybe we send the doctor if he's there.
00:42:04:08 - 00:42:05:04
What's that?
00:42:05:04 - 00:42:08:05
Someone's going to come to you
and be like, Sharon, we're very worried.
00:42:10:15 - 00:42:11:09
We've offered you
00:42:11:09 - 00:42:14:08
this, this and this,
and you've not wanted it.
00:42:14:20 - 00:42:17:08
And I'm just going to really strongly
00:42:17:08 - 00:42:20:08
encourage you to help us help you.
00:42:20:18 - 00:42:25:08
Because if this keeps going,
then we're going to have to call
00:42:25:08 - 00:42:28:11
for a third party evaluation,
which is a pet team.
00:42:28:11 - 00:42:29:20
It's a county.
00:42:29:20 - 00:42:32:09
Second unit evaluation team. Yes.
00:42:32:09 - 00:42:37:12
And if they come and they decide
that you're a danger to yourself
00:42:37:12 - 00:42:40:15
or to other people here,
they're going to take you on hold.
00:42:41:04 - 00:42:44:19
And when that happens,
I can't get you out.
00:42:45:02 - 00:42:47:14
I can't get you back. I mean, it's like
00:42:48:17 - 00:42:50:08
you're going to another hospital at that.
00:42:50:08 - 00:42:52:23
So we're going from the least intrusive
to the most intrusive.
00:42:52:23 - 00:42:54:07
But there's so many interventions.
00:42:54:07 - 00:42:57:18
You talk about music and social workers
and nurses and coping
00:42:57:18 - 00:43:00:21
skills and groups and just.
00:43:01:09 - 00:43:02:20
We try everything.
00:43:02:20 - 00:43:05:15
So much that is not common knowledge.
00:43:05:15 - 00:43:07:01
Yes, yes.
00:43:07:01 - 00:43:11:06
And then on the rare occasion
that Sharon's like,
00:43:11:06 - 00:43:14:08
you know what, if you have all of you,
I don't want any of that.
00:43:15:12 - 00:43:20:05
And and now like,
Sharon's like throwing chairs.
00:43:20:05 - 00:43:23:05
Okay.
That is like 100% unacceptable, right.
00:43:23:08 - 00:43:26:08
So let's say you
00:43:27:06 - 00:43:29:17
make some kind of gesture,
00:43:29:17 - 00:43:34:23
you do something that shows us
that you're trying to hurt yourself.
00:43:34:23 - 00:43:36:17
Someone else. Right?
00:43:36:17 - 00:43:40:02
That's when we have to
00:43:41:09 - 00:43:42:15
to intervene physically.
00:43:42:15 - 00:43:43:20
Right.
00:43:43:20 - 00:43:47:14
Again, we have a very strict protocol
because we are hands off.
00:43:47:14 - 00:43:51:15
So if and this and, you know, in
other facilities too, if we put hands on
00:43:51:15 - 00:43:55:11
somebody, it that is going to require
a whole bunch of paperwork,
00:43:55:11 - 00:43:59:10
a whole bunch of justification,
of why, right, why
00:44:00:09 - 00:44:01:12
we don't want to do that.
00:44:01:12 - 00:44:02:20
Because patients have rights.
00:44:02:20 - 00:44:05:18
We've gone from the least intrusive,
the most intrusive,
00:44:05:18 - 00:44:08:19
and really the most important is safety
and care. Yes.
00:44:08:19 - 00:44:10:23
And if we have to protect you
from yourself, we will.
00:44:10:23 - 00:44:11:20
Yeah.
00:44:11:20 - 00:44:12:15
You know. Yeah.
00:44:12:15 - 00:44:16:09
But there's always going to be
a whole bunch of stuff leading up to that.
00:44:16:12 - 00:44:17:02
Yeah.
00:44:17:02 - 00:44:21:00
Again, I've only worked at Oceanview,
so I'm speaking from my own perspective.
00:44:21:12 - 00:44:23:05
There might be people out there
who are like, that's not true,
00:44:23:05 - 00:44:23:15
that's not true.
00:44:23:15 - 00:44:26:06
And maybe, maybe in some sense it's. True
for all other hospitals.
00:44:26:06 - 00:44:29:12
And what I love about Oceanview
is that it's a private hospital.
00:44:29:20 - 00:44:31:12
It is voluntary.
00:44:31:12 - 00:44:34:13
There are many other hospitals
that we have worked with
00:44:34:13 - 00:44:38:04
and have wonderful relationships
with that have locked and voluntary,
00:44:38:04 - 00:44:41:22
and a lot of the
themes are very similar across the board.
00:44:41:22 - 00:44:42:04
Yeah.
00:44:43:12 - 00:44:45:06
Oh, everyone has a bad story.
00:44:45:06 - 00:44:47:03
Yeah. About a place.
00:44:47:03 - 00:44:50:05
Much like if we go to a coffeehouse and
someone didn't make our drink correctly,
00:44:50:10 - 00:44:52:06
that happens everywhere.
00:44:52:06 - 00:44:56:10
But it's not as common
as media sensationalize it.
00:44:57:08 - 00:45:00:11
It makes for great TV drama,
but it's not in real life.
00:45:00:13 - 00:45:00:21
Yeah.
00:45:00:21 - 00:45:03:22
And it's really wonderful
and a privilege to have this conversation
00:45:03:22 - 00:45:06:22
because so many people don't know
what to expect.
00:45:06:22 - 00:45:08:08
And the idea is so scary.
00:45:08:08 - 00:45:11:13
And for any of our viewers and listeners,
and I'm sure some of our clients
00:45:11:17 - 00:45:14:07
are going to be listening and saying,
I can attest to that.
00:45:14:07 - 00:45:17:07
And and I wish I knew,
00:45:17:13 - 00:45:23:01
and it's just so nice to have these taboo
conversations that no one talks about
00:45:23:01 - 00:45:26:02
in the world about,
you know, let's talk about suicidality.
00:45:26:06 - 00:45:28:23
Let's talk about mental
health. Let's talk about symptoms.
00:45:28:23 - 00:45:32:16
Let's talk about the impairment that does
take place that people don't talk about.
00:45:32:16 - 00:45:35:14
I know until it's too late,
and it's so secretive
00:45:35:14 - 00:45:38:14
and isolated and stigmatized,
and we don't need to do that.
00:45:38:14 - 00:45:41:16
We can access good health care,
00:45:42:02 - 00:45:45:02
good medical care without the stigma.
00:45:45:05 - 00:45:47:00
Yeah. And, you know, to,
00:45:48:07 - 00:45:49:03
kind of
00:45:49:03 - 00:45:53:09
I just had this afterthought
about when you asked, about privacy and,
00:45:53:09 - 00:45:57:21
well, people know another question
that comes up a lot is, what?
00:45:57:21 - 00:45:59:15
I can't miss work.
00:45:59:15 - 00:46:02:19
You know, I need the money
with all of us, right? So,
00:46:03:20 - 00:46:06:23
in those situations,
we can write a letter,
00:46:07:04 - 00:46:10:22
the doctor can write a letter,
you know, for your medical absence.
00:46:11:04 - 00:46:14:07
And it's not going to say from Oceanview.
00:46:14:11 - 00:46:17:05
It's not going to say I'm a psychiatrist.
00:46:17:05 - 00:46:20:08
It's going to say Sharon is under my care.
00:46:21:02 - 00:46:24:12
And it, you know, and he'll put in there
why you can't return.
00:46:24:21 - 00:46:28:23
Well, not why like in detail, but that
you cannot return to work based on his,
00:46:30:11 - 00:46:31:05
his treatment plan.
00:46:31:05 - 00:46:33:18
A very discreet letter,
unable to work at this time.
00:46:33:18 - 00:46:38:00
And it's an excused absence
from work, and it is 100%
00:46:39:03 - 00:46:39:19
real valid.
00:46:39:19 - 00:46:41:09
Yeah. Yeah, exactly.
00:46:41:09 - 00:46:44:07
So I just I know people are like, well,
I don't want my work to know.
00:46:44:07 - 00:46:45:19
And it's like, no, they won't know.
00:46:45:19 - 00:46:48:04
Yeah. Nobody has to know. Yeah.
00:46:48:04 - 00:46:48:11
Yeah.
00:46:48:11 - 00:46:51:17
We tried to try to remove
all the barriers.
00:46:51:17 - 00:46:54:15
Yeah. So final thoughts.
00:46:54:15 - 00:46:56:07
Thank you.
00:46:56:07 - 00:46:59:03
Thank you for thinking of this
00:46:59:03 - 00:47:02:20
topic and bringing light to it.
00:47:03:12 - 00:47:05:04
I'm sure people have other questions.
00:47:05:04 - 00:47:09:10
If you ever get any other questions
and you want to talk about them,
00:47:10:07 - 00:47:11:04
let me know.
00:47:11:04 - 00:47:15:12
Because the more yeah,
the more people know,
00:47:15:23 - 00:47:18:22
you know, the better off
we'll all be. Yeah.
00:47:19:03 - 00:47:20:12
Thank you so much for coming.
00:47:20:12 - 00:47:21:13
Thank you.
00:47:21:13 - 00:47:24:00
Thanks for joining us
for this important conversation.
00:47:24:00 - 00:47:24:22
If you want to learn more
00:47:24:22 - 00:47:28:10
about Oceanview Psychiatric Facility
or connect with Carla DiCandia visit
00:47:28:10 - 00:47:31:13
www.ovphf.com
00:47:31:13 - 00:47:34:07
And if this episode changed
how you think about mental health care
00:47:34:07 - 00:47:35:22
share it with
someone who needs to hear it.
00:47:35:22 - 00:47:38:22
For more raw, real conversations
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00:47:38:23 - 00:47:41:19
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