Choosing a Mental Healthcare Facility before You Need One

By Candida Fink MD
January 13, 2009

Bipolar disorder often involves bouts of depression or mania that require hospitalization, which can be particularly stressful for both the person being hospitalized and his or her loved ones. Most stressful, perhaps, is the idea of going to an unfamiliar place, particularly if you’re being hospitalized for mania accompanied by paranoia. In addition, you may be worried about whether your insurance will cover the hospitalization and for how long and how this facility stacks up to other available facilities in your area.

One way to reduce some of this anxiety is to choose a mental healthcare facility before you need one. Ask your doctor for a list of facilities in your area or call your local hospital or your County’s health or mental health department and obtain a list of options. Once you have a list in hand, you can start to whittle it down:

Which mental healthcare facility does your doctor recommend? He or she may “do rounds” at only one or two facilities on your list.The inpatient doctor model varies regionally; in many areas you will always be treated by a doctor on staff at the hospital, who will consult with your outpatient doctor. In other parts of the country, psychiatrists admit their own patients to a local hospital and function as the primary doctor while you are inpatient.
Which facility does your therapist recommend?
Which facility(ies) does your insurance policy cover?
If you belong to a support group, ask your fellow members which facilities are best and worst.

After you have trimmed your list to two or three possible candidates, schedule a visit to the facility. If you are the person with bipolar, consider inviting one or more close friends or family members (people in your support group) to go with you, so they can provide additional input and are well aware of which facility you want to go to in the event that you are in no condition to decide for yourself.

Note: Many psychiatric hospitals will not allow you to tour the facility in advance due to privacy regulations. If that is the case you can still inspect the facility overall and ask specific questions like those listed below about the unit itself. You may also ask to speak to the Head Nurse or Medical Director of the specific unit to obtain more information.

When you arrive at the facility, try your best to obtain answers to the following questions:

Does the facility seem clean and well organized? (Check the bedrooms, bathrooms, and any common areas, such as the cafeteria and the group therapy room.)
Does the staff seem to treat the patients with respect and empathy?
Does each patient have his or her own bedroom?
Does the facility provide access to the outdoors? For how much time each day?
Will you be able to see your doctor, or does the facility have its own doctor who will manage your inpatient care?
How often will you see your doctor or the doctor on staff?
How long is an average stay?
What is the phone call policy for patients?
What can I bring with me, and what is prohibited?
If you smoke, find out whether the facility allows smoking – where and when?
Which days and times are visitors allowed? Be wary of visiting hours that are highly restrictive.
What types of therapy are offered?
How much time each day can I expect to be in therapy sessions?
What is the policy on “Seclusion and Restraint”? If possible you would like to know how frequently these interventions are used and what policies are in place to reduce them, because they are always undesirable, although occasionally necessary.

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2 Comments to
“Choosing a Mental Healthcare Facility before You Need One”

Dano MacNamarrah at 1:52 am on January 20th, 2009

This is a lovely idea. I was visiting a friend of mine in hospital, and I was jealous! There was fresh fruit, private rooms, caring staff, etc. Trust me, I looked into it!

That said, I am on SSDI for Bipolar II. When I go in, a lot depends on available beds, as well as participating hospitals. I tend to stay about three months at a time.

Most of the time, I have a hard time just brushing my teeth, let alone going to the dentist. I cannot imagine visiting mental wards. It would be too much.

Sort of like shopping for a coffin. How would you know what you need, if you are not there yet?!

Carole at 11:36 pm on March 7th, 2009

Overall I have been in good hospitals when I needed to be hospitalized for bipolar. The worst was when I was sent to a mental hospital after a suicide attempt. However, at one of the good hospitals, I was brought in for lithium toxicity that was NOT caused by a suicide attempt. Initially I was placed in a medical ward. But was then transferred to the psych ward. It wouldn’t have bothered me but there was no call button so I couldn’t get help to go to the bathroom. If my mother hadn’t been there to help me walk, I would have had to wet the bed. Also, in the psych ward there were no T.V.s in the room so I just laid there all day and night staring at the ceiling. This says to me that once you are labeled as having bipolar your medical problems are likely to be attributed to a psychiatric problem. An upsetting thing to say the least.