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How Inpatient Mental Health Treatment Works

How Inpatient Mental Health Treatment Works

Have you ever wanted to learn about inpatient mental health treatment but were afraid to ask? Maybe you're wondered about it for yourself, or for a friend, or have been curious about how it connects to therapy in the mental healthcare continuum. Maybe you just want to know what to do in case of a mental health emergency. Regardless of why you wondered, we're here to help!


Inpatient mental health treatment is an essential, life-saving level of care that more people should know about and use, but that is still widely feared, stigmatized, and misunderstood. We think it's time to erase the stigma. Going to a hospital for mental health treatment is simply what you do to get the right level of care when you're in crisis. It's not that different from going to the hospital for short-term acute treatment of a medical crisis or condition.


In either case, it's only fair to acknowledge that no matter what kind of hospital we're talking about, no one really wants to go to a hospital, and when you have to go to the hospital, it's usually not the best time in your life. It's also true that psychiatric hospitals in particular come with some very real downsides. All that said, inpatient mental health treatment is not the Gothic horror it's often shown to be in movies or television.


Not everyone who needs or wants therapy will ever need inpatient treatment, but some will—and that's okay. It's a service that's there for exactly when you need it and for only as long as you need to be there. The goal of inpatient treatment is to get you stable enough to continue your treatment in the community. It's nothing more and nothing less than that: a short stop to get the help you need to get through a crisis. But this simple fact means it could be what saves your life.


You may never need inpatient mental health care. But will you know what to do or what to expect if you do need it—or if a loved one does? We want to shine a light on this vital service and bust the myths that keep people from getting it when it is what they need.


Who Is Inpatient Mental Health Treatment For? 

Like medical care, mental health care is a continuum designed to move you through it, not a sorting system that assigns care based on what kind of person you are. Anyone can experience a severe mental health episode, regardless of their history or current circumstances. And inpatient care is simply what you need when your mental health symptoms become too severe to safely manage on your own. Common reasons for getting inpatient mental health treatment include:


  • Bipolar mania
  • Severe depression
  • Self-harming behavior
  • Suicidal intent or a plan
  • Psychosis (delusions and hallucinations)
  • Escalating reckless or impulsive behavior
  • Altered mental status due to substance use


Sadly, inpatient mental health care can be hard to get, especially if you're seeking it voluntarily. Since there aren't enough inpatient beds to meet the need, inpatient facilities often have to limit care to the people with the most severe symptoms. And because many psychiatric hospitals have these restrictive admissions policies, people who qualify for voluntary admission often also meet the standard to be committed involuntarily.


We've written about this before, but in short, being committed is what happens when a police officer, doctor, care professional, or family member requests, and is then granted by a judge or magistrate, an order to have a person admitted to inpatient care against their will for the sake of their (and others') safety. To meet commitment criteria, you need to be:


  1. In danger of harming yourself because of mental illness;
  2. In danger of harming other people because of mental illness; or
  3. In danger of harm from being unable to care for yourself due to mental illness.


You can meet these criteria if you have a suicide plan, have stopped caring for yourself in a way that puts you in danger, or have physically attacked or threatened to attack someone. (Note that just being belligerent is not enough; your behavior has to be due to a mental health condition.)


It's important to understand that what determines if you need hospitalization is your symptoms, not your diagnosis or condition. Transient severe mental health episodes can have causes other than a chronic mental health condition, such as:


  • Reactions to prescribed medications,
  • Complications of medical conditions,
  • Severe emotional stress or trauma,
  • Extreme physical stress,
  • Head trauma, or
  • Substance use.


That said, the primary causes for psychiatric hospitalization are mental health conditions, and some conditions are more likely to require inpatient treatment than others. These are:


  • Mood disorders (which include major depressive disorder and bipolar disorder),
  • Psychotic disorders (which include schizophrenia and schizoaffective disorder), and
  • Substance-use-related disorders (including substance-induced psychosis or depression).


The reason these conditions are more likely to send you to the hospital is because the symptoms of these conditions are the ones that put you at the greatest risk of harm. Psychosis, bipolar mania, and severe depression all make it very hard to care for yourself or keep yourself safe.


While it's possible for transient psychosis (which can include delusions, hallucinations, or disordered thinking) to be triggered by anything that changes your mental status (see the list above), it's much more common to experience a psychotic episode in the course of a chronic psychotic disorder like schizophrenia. If you have a psychotic disorder, your road to recovery often begins with your first hospital admission and continued follow-up care in the community.


Mood disorders sometimes cause psychotic episodes, but they are more likely to put you in the hospital because of a severe depressive episode. What makes depression insidious is how quietly it can become severe. All too often, people suffer in silence with worsening depression until it reaches a crisis point. What starts as mild depression can expand over time, slowly sucking away your capacity to feel joy or hope. You might withdraw from life further and further until you're barely making it. And while you might learn how to function this way, you can sometimes get to a point where you just can't anymore. And that might be the point when you need inpatient care.


How Long Does Mental Health Treatment Last?

Let's say that your mental health symptoms have gotten to a dangerous level. You're at the point you feel like you can no longer take care of yourself, manage your normal everyday activities, or keep yourself safe. You've sought admission to an inpatient treatment facility, and you've been accepted. What should you expect when you arrive?


First, don't expect to be there too terribly long. A 2012 study found that for people with serious mental illness, the average length of stay was 7-13 days. A 2004 study found that the average length of stay was 15 days and that "absence of serious mental illness was significantly associated with shorter length of stay." Depending on why you're admitted and how quickly you respond to treatment, you might be in the hospital for as little as two or three days.


The reason psychiatric hospital stays are so much shorter than they used to be is because inpatient mental health care has a different purpose now. In the past, psychiatric hospitals were places where people went to get long-term care because it wasn't yet possible to manage their conditions outside of an institution. Now, psychiatric hospitals are for acute care, or intensive short-term treatment that improves your condition to the point you can be discharged and continue your treatment on an outpatient basis.


Where Exactly Do You Go for Inpatient Mental Health Care? 

State psychiatric hospitals still exist, but they're not where most people get inpatient treatment anymore, especially not the first time they go. These large facilities are often reserved for forensic patients—people who have been admitted through the criminal justice or corrections systems—or people with severe mental health conditions who did not respond to an initial episode of acute hospital care and who need longer-term treatment (often 30 to 90 days) to stabilize. Most states have separate facilities (or, at minimum, separate units) for forensic and non-forensic patients.


If it's your first time getting inpatient care, or if you've received short-term inpatient treatment before and responded well to it, you're more likely to be admitted to a general hospital with a psychiatric unit (or, less frequently, a standalone private psychiatric facility that is part of that hospital system). You may have a local hospital with a mental health unit, or you may need to travel to one that does. If you're involuntarily committed, you may need to be transported by law enforcement, depending on regulations in your state.


It's possible to call a psychiatric unit or hospital and ask to be admitted voluntarily. Depending on your symptoms and situation, the hospital may ask you to bring yourself or have a loved one bring you to the facility. Otherwise, you'll be admitted through a local emergency department (ED), where you'll wait under safe supervision until space becomes available at a mental health unit or facility. Unfortunately, due to demand, you can sometimes wait for a long time in an ED to get into an inpatient facility—sometimes for several days, though usually for one day or less.


Who Do I Call When I Need Inpatient Mental Health Care? 

If you're in crisis, and not sure where to go or who to call, we recommend calling either:



The National Suicide Prevention Hotline, local mental health crisis lines, and many other mental health hotlines can identify and connect you with local crisis resources. They can then guide you through the process of getting where you need to go to get the care you need.


What Is Inpatient Mental Health Treatment Like? 

What do hospitals do to help you get better? First, they may prescribe psychiatric medication. The clinical staff may recommend that you start taking medication on a long-term basis, or they may simply want you to take medication on a short-term basis to help you stabilize in the hospital. They may not recommend medication at all. It depends on your condition, your preferences, and your history. Whether you receive medication or not, you'll usually also participate in the following during your stay:


  • Group therapy sessions
  • Individual therapy sessions
  • Therapeutic activities like art, exercise, and yoga


Group therapy sessions can be educational, therapeutic, or both. They often focus on topics that will help you understand your symptoms and condition and how to manage them. They are also designed to help you and others in the group feel seen and understood, which can help you start to accept yourself and your condition and to heal.


Individual therapy in an inpatient unit usually focuses on analyzing the conditions that led to your mental health crisis and hospital admission. These sessions can help you gain insight into what happened and how you can recover. They will also help you and your clinical team put together an effective discharge plan and identify goals for ongoing therapy in the community.


Therapeutic activities are usually designed to help you feel calm. During a mental health crisis, your nervous system is overwhelmed. Soothing activities can help you heal your nerves, regain your ability to focus on the present, and become better able to participate in and benefit from other therapeutic interventions.


What Are the Downsides of Inpatient Mental Health Treatment?


While psychiatric hospitals and units have moved past many of the horrors we once associated with them, it's fair to say they can still sometimes be scary places to be, especially if you've never been to one before.


Psychiatric units and facilities treat a wide range of patients. This means a severely depressed person who cringes at how loud a shuffling newspaper sounds can be put on the same unit as a person experiencing a psychotic episode who is screaming at the top of their lungs. The fact that psychiatric units gather people together who are having some of the worst times of their lives in the same place can make them stressful places to be.


Another issue is that psychiatric facilities sometimes still use restraints—though sparingly. Use of restraints is highly regulated and hospitals can lose their licenses if they use them inappropriately or too much. So they are only used when someone poses an immediate threat to themselves or others, and they are only used for as long as is needed to calm someone down. Still, it's scary and demoralizing to be restrained or see someone else be restrained. (Note that this isn't all that different from medical hospitals, which also sometimes use restraints for similar reasons.)


At any kind of hospital, you might be around people who are crying, yelling, or in distress, and might feel a certain sense of sadness or claustrophobia. Remembering why you're at the hospital can go a long way to allay your discomfort with the unfamiliar setting. You might actually enjoy your experience on a psychiatric unit, or you might not. But whether you enjoy your experience, remember that your team is working hard to help you get better and get you back home.


What Happens After You Leave the Hospital?


From the moment you're admitted to the hospital, your clinical team starts preparing your discharge plan. In a way, the hospital is just a way station that gets you from the crisis point that brought you there to a place where you can get the treatment you need in the community.


In rare cases, psychiatric hospitalization is all that is needed to fully resolve a mental health crisis. However, it's much more likely that you'll need ongoing outpatient care after leaving the hospital so you can manage the condition that brought you there and so you don't need to go back later.


For example, if you went to the hospital to get treatment for a major depressive crisis, your clinical team might recommend that you start taking an antidepressant medication and follow up with a physician at a community mental health center or primary care clinic. Instead, or in addition, they may recommend therapy and give you a referral to a private practitioner or a therapist at a local counseling agency.


Depending on your circumstances, your team may recommend additional treatments, such as case management, psychosocial rehabilitation, or support groups. They will also make referrals to help you address any co-occurring conditions you may have (such as medical or substance use disorders). They may also recommend nutrition and exercise plans that can help with both your physical and mental health.


The important thing to keep in mind is that your discharge plan is designed to keep you stable so you don't have to come back to the hospital or go through another mental health crisis. So take the advice on it! Your new outpatient mental health team might tweak and update your plan as they learn more about you, but they will start with what's on your discharge plan. Following that plan and getting good follow-up care is essential for getting on the road to recovery.


We hope the information that we've provided in this article will help you recognize if you ever need to go to the hospital, understand what you'll experience there, and be ready to reach out for the care you need if you're ever in crisis. Going to the hospital when you're having a mental health emergency might help you get better faster than you otherwise would have—and it might even save your life.

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Stephanie Hairston, MSW
Posted on 03/22/2021 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.