My father recently had surgery on his spine at one of the top hospitals in Boston. I brought my son to the hospital to visit his grandfather. This is the same hospital Ben spent four days at in the psychiatric emergency department waiting for a bed at a psychiatric hospital.
We walked past the emergency department towards the elevators. Ben paused as he looked through the doors. We entered the elevator to the seventh floor. We exited to a beautiful glass atrium with plants and inviting furniture.
Ben and I pressed the buzzer and the glass doors opened to the unit my father was on. My father’s room was bright with lots of windows and a view of the city. Under his breath Ben said “I never had windows.”
The nurses and staff popped in and out. They were friendly, engaging, and always asked “Mr. Rupp, is their anything I can get for you?”
The real kicker for Ben was when lunch was delivered. Ben said “wow, you get silverware. Not fair.”
As we were leaving my father’s room to head back downstairs, Ben expressed frustration that he was segregated against when he was at the hospital three months earlier. My initial response was no, you did not experience segregation.
I thought more about it … yes, he did experience segregation just like every other individual seeking acute psychiatric care.
At age 13, Ben experienced his 10th psychiatric hospitalization. Ben knew his thoughts were getting big and he asked for help. It was time for a medication adjustment. Based on past experience with similar symptoms, a psychiatric hospital was warranted.
I was so proud of Ben. He said “mom, let’s go and get the wait in the emergency department over with so that I can get to the hospital.” He knew the drill. We dreaded the process; however, it was part of the deal to get help and be back in school.
We have visited five emergency departments across four states to receive psychiatric care. Although there are some differences, in general, the punitive experience is the same.
If you have not experiences a psychiatric emergency department, then consider yourself lucky. The following is meant to highlight some of the stark differences between going to the emergency department for physical symptoms versus mental illness.
Security guards – upon entering the emergency department the experience is immediately different then if you brought your child in for a broken wrist; regardless of age and mental health symptoms, security guards are notified of your arrival and meet you at the registration area to escort you to your room or bed; there are more security guards in the psychiatric emergency department area that stand guard at the locked door
Electronics – cell phones, iPads, gaming devices, etc. are either limited or prevented from being in the room; at two different emergency departments, I had to go through security and lock all personal belongings in a locker prior to being with my child
The actual room – stripped down to a bed and maybe a plastic chair, the size of a shoe box, no windows, no TV, a camera in the corner, and a locked door from the outside … you have to buzz staff when you want to leave the room
The food – most of the time we could order off of the hospital menu; however, the food was delivered on a cardboard tray with very limited utensils, if any at all … we got smart and would order a bagel in the morning … you could tear off a piece and use it as a knife to spread butter or peanut butter
The nursing staff – let me start by saying I have incredible admiration for everyone working in the emergency department; and to clarify, when you are waiting in the emergency department for a psychiatric bed, you are not being treated … it is a “holding cell”; with that being said the main difference for me is staff proactively checking in on a regular basis verses responding only when called or if they see something on camera
Transferring to a psychiatric hospital – in our state, if your child was admitted under involuntary status, then when a bed is ready at a psychiatric hospital the sheriff transports your child, typically in handcuffs in the back of the cruiser … picture your 11-year-old in the back of a cruiser while you follow to the psychiatric hospital; your child is brought in through a separate entrance
Ben is right, he did experience segregation due to asking for help with his thoughts.
It petrifies me to think about my kids as adults if the mental health system does not evolve. Today you are treated like a criminal locked in a small room with limited comforts. I understand to some extent why the precautions are put in place.