Being admitted to a psychiatric facility can occur in one of two ways. Either you admit yourself as a voluntary patient, or sign yourself in, as it is called; or you are being admitted as an involuntary patient, on some type of “order of protection” by police, doctors, or therapists. In some states, even a concerned family member can have you involuntarily admitted for evaluation.

As a voluntary patient, you are actively seeking help and realize that you are not acting responsibly. You may even fear that you will act rashly and possibly hurt yourself or others. In any case, you want to be in the psychiatric hospital and get help.

• What to expect as a “voluntary” patient-

1. You will be allowed to sign all admission paperwork.
2. You will work with your doctor and therapist and nurse to develop your plan of care
3. You will be expected to attend all groups and activities assigned for your treatment
4. You can ask to be released when you feel better

As an involuntary patient, someone else has made a petition to the legal community to have you evaluated for anywhere from 24 to 72 hours in a psychiatric facility based on specific behaviors and statements. You may or may not know what is going on; you may or may not want to be there but the fact is you will be held “against your will” until a doctor evaluates you and decides you no longer pose a threat to yourself or others.As an involuntary patient, someone else has made a petition to the legal community to have you evaluated for anywhere from 24 to 72 hours in a psychiatric facility based on specific behaviors and statements. You may or may not know what is going on; you may or may not want to be there but the fact is you will be held “against your will” until a doctor evaluates you and decides you no longer pose a threat to yourself or others.

• What to expect as an “involuntary” patient-

1. You may be allowed to sign some of the admission paperwork, but do not need to sign yourself in
2. You can work with your doctor, nurse and therapist to develop a plan of care, but may not be able to do so at the time of admission
3. You will be expected to attend all groups and activities assigned for your treatment, even if you do not want to or do not agree that you need to
4. You can not expect to be discharged just because you ask to leave

• What to expect as a patient in a psychiatric facility-

1. The first difference you will notice is that few rooms are private.
2. There are no telephones in the rooms. Family and friends will have to give some type of code # before being allowed in to visit or before being allowed to talk with you on the phone.
3. There are no televisions in the rooms. You will watch television in a day area and it will be a communal activity.
4. Your belongings will be gone through and several items you regularly use at home will not be allowed on the units. Some things will be allowed, but must be monitored when used.
5. You will not be allowed to stay in bed all day.
6. You will wear regular clothes instead of hospital gowns. Some of your favorite clothes will not be allowed on the unit due to the presence of some type of string/belt or due to the type of decoration on it (no tee-shirts with violence, drug or gang emblems). Your shoe strings will be removed as well as all belts.
7. You can expect staff to monitor your location every 15 minutes in a 24hour period, that includes during the night.
8. You will attend groups with people from all walks of life; some will not make much sense; some may not look very clean and nice.
9. If you lose control of your behavior – either you become so angry that you act out or you become disconnected from reality–the staff will intervene to assist you in regaining control.
10. You will be encouraged to talk about your thoughts and feelings with staff.
11. You will be asked questions regularly that pertain to your ability to maintain your safety. Staff will actively monitor you to provide for your safety and your security during your stay.
12. Staff will not be put off by anything you say or do, and will actively want to help you find solutions to your issues.

• What not to expect as a patient in a psychiatric facility-

1. You will not be allowed to break any of the numerous rules, no matter who you are.
2. You cannot behave aggressively and get your way.
3. You will not have the undivided attention of any of the staff. In this facility, staff act in unison as a team and all will be dealing with you at various times throughout the day.
4. Things you tell staff will not be kept “secret” from the rest of the treatment team. Your privacy will be monitored and your HIPPA rights will be guarded, but things said in treatment will be shared with the treatment team in its entirety to facilitate your improvement.
5. You will not engage in any personal relationships with staff during or after treatment as a patient.
6. You will not visit the unit after discharge to see “friends” made during your treatment. Most facilities restrict ex-patients from being allowed to return to visit current patients for several months.

• When will you be discharged-

1. Discharge will be decided by your behavior and your willingness to participate in treatment.
2. You may request to leave if you are a voluntary patient, but may not be allowed to do so based on the physicians concern for your continued safety or the safety of others.
3. As an involuntary patient, you may be allowed to sign yourself in if you agree to remain for treatment or you may have to go to court to have a judge hear both sides of the issue.
4. In either case, there is a definite process that must be followed and will be based on safety concerns and your ability to make safe decisions.

As you can see, there are similarities between medical and psychiatric hospitals–both are staffed by doctors, nurses, social workers, and clinical assistants. Both are involved with improving your condition – either physical(medical) or psychological(psychiatric) – and getting you back into your life as soon as possible. Both provide treatment to facilitate your improvement and offer some type of after-care plan.

But there are significant difference also. It is in the differences that you may become confused at an already trying time in your life. Hopefully, this will eliminate some of the confusion for you.