Note: names have been omitted/changed to protect patient and staff privacy.
After noticing the warning signs of severe depression, I became a part of Pennsylvania’s archaic and paternalistic mental health system. I signed what is affectionately referred to by patients as a 201 form, surrendering myself voluntarily to be cared for by mental health professionals in an inpatient setting. I started at a Crisis Response Center (CRC), a triage and intake facility for individuals suffering from severe mental health issues. At the CRC, I met an individual struggling from addiction and a broken life, desperate for help. I also met an elderly woman, clearly in pain and angry that her graham crackers were broken. After hours in an uncomfortable waiting room, I was transferred by ambulance, in a heavily medicated and confused state, to a sprawling psychiatric hospital far from where I lived.
Upon arriving, I was held in yet another CRC, evaluated by a triage team, and assigned to a ward. I was thoroughly searched, and surrendered my belt, my shoes, my phone, and my freedom. A friendly but cautious “mental health technician” escorted me up to my new home. My belongings were again searched and inventoried, and I was subject to a cursory physical examination by a physician’s assistant. The charge nurse informed me of the rules of the facility, showed me to my room, and gave me a chance to decompress. I was running on fumes.
Being a pre-med student, I immediately framed this as an opportunity to learn, focusing on evaluating the facility and its ailments instead of my own.
Over the course of a week, I got to know my fellow patients, including the good and bad, and the ugly. I was introduced to the “repeat offender” who hoarded food in her room to share with other patients, the schizophrenic with experience working for the UN who claimed to hold multiple PhDs, and the Guatemalan who in broken English reported receiving phone calls threatening her family. There was the ex-con with a hardened exterior and a warm heart, the heavily tattooed patient who was always there for me, and the quiet homeless man with an incredibly poetic (but quiet) voice. We came from different worlds, but had one thing in common – we were all in pain.
I also got to know the hospital’s staff. Dr. S was the psychiatrist in charge of my treatment team, and frequently told me that I should consider a career other than medicine. There was the med student, proudly donning his white coat, shepherding patients to and from consultations. There was the “tech” with wisdom and warmth far beyond that of anyone else in the hospital. We were introduced to a variety of therapists, social workers, activity coordinators, phlebotomists, finance professionals, and nurses. Some were kinder than others. Some spoke to us in that “sing-songy” preschool teacher’s voice, others addressed us as adults.
My experience was both unique and stereotypical. I was in a locked ward, on suicide watch, and spent most of my time either pacing the halls or staring into space in the day room. I held my general chemistry textbook close to my chest like the security blanket it was, clutching any last vestiges of the outside world. I was given 30-60 minutes a day in the yard, where I played hoops or read my book with the elderly Russian who never spoke.
It took me a few hours after I was admitted to truly understand where I was, and when it settled in the tears arrived. I pleaded with my parents on the phone, with Dr. S. and with anyone who would listen to let me out. I didn’t think I belonged in such a restrictive environment, and figured it was a waste of time to be in such a dull setting.
On my second-to-last day in the facility, I was given the opportunity, with a group of other patients, to eat lunch in the staff cafeteria. This was a welcome respite from the under-seasoned and over-fried food served to us for breakfast, lunch, and dinner. After getting my cheesesteak, salad, and pie, a feast fit for a king, waiting to be herded to our secluded dining area, I was asked by a higher up if I was an employee or family member waiting to pay. I responded, “No, I’m an inmate”, which caused the color to drain from her face. I needed to be the class clown, and found humor to be one of the few tools that brought patients and staff together, something that gave a human touch to this experience. At lunch, I met one of my peers in recovery who now worked at the hospital as its activities coordinator. This gentleman was one of the only staff members who spoke to us like we were adults, shared his personal experience with depression, anxiety, and addiction, and gave us valuable lessons on how to take our recovery into our own hands.
As I reflect on my experience, I see the value of it. I was desperately seeking a reset button, a safe environment, and recovery, and despite the many grievances I had with the facility and its policies, I learned a tremendous amount about myself and others. We all had something in common, despite a wide socioeconomic spectrum separating us.
I would not have been able to survive this experience without the support of my parents and dear friends who called and came to visit me. I treasured those 60 minutes granted to us every other day for in-person visits, and gained a new appreciation for how lucky I was to have such a strong support system.
I left the hospital similar to how I arrived. Early in the morning, somewhat confused about where to go next, with two bus tokens and a paper bag full of my belongings in my hands. But I also left with a new lease on life, an appreciation for unrestricted time outdoors, and gratitude towards those that helped me along the way.
While much of the work in my recovery remains to be accomplished, I gained some valuable tools from my experience. I now recognize the importance of unplugging, the joy that can come from being outside, and the importance of smiling. I will be forever grateful for this life-changing but difficult experience.