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Plan for Your Next Breakdown





Hospital shopping. Interviewing doctors. Researching therapies.


All things that people with depression don’t want to do. It’s exhausting. But the truth is this: Not all hospitals are alike; not all doctors are empathetic and not all therapies work.


Although we don’t want to believe it, some of us are receiving better care than others, and some of us are better at advocating for ourselves than others. If we are going to receive mental health care on par with other types of health care, we have to speak out and be more proactive in demanding that the level of care we receive is on par with that of other life-threatening illnesses.


My dad was just diagnosed with prostate cancer. While this is a common disease for men in their 80’s, our family doctor helped us choose the best oncologist, radiologist and facility for his tests that his insurance could provide. It makes sense then for me to likewise do some shopping for my own health care.

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I’ve been with my current psychiatrist for more than nine years. But he wasn’t the first one I saw. Four others came before him. There was the Psychiatrist whose office staff kept me sitting in the waiting room for over two hours when the pdoc had a crisis. What if I had been in crisis? No one did an evaluation of the clients waiting to make sure we were safe and give us an offer to reschedule our appointments, or told us what was going on. I never went back.


Then there was the psychiatrist whose lifeless expression kept me wondering if he had heard a word I said. And there was the one whose flat out denial of my symptoms had me running for the door. My point is this: It’s time to shop for well care for our psychiatric illness just as we would if we had cancer or needed surgery.


It’s clear that not all hospitals are the same either. My last article on making the most of your hospital stay certainly garnered a few critics. My experience of the mental health hospital near me was a far cry from what others have experienced. After talking with others who are in an online support group with me, I fear for those who do not have the so-called luxury of a hospital near them with actual therapeutic services and collaboration/consultation going on, and whose health care is relegated to the county services.




So before you are in a place that you are no longer safe, visit the hospitals near you and ask about their doctors in attendance. Make an agreement with your psychiatrist for where you will receive treatment and how he or she will consult and collaborate with the attending psychiatrist. Read about your meds and research what types of psychotherapies have the best evidence for success. Demand a treatment plan from your psychiatrist and therapist.


Interview them and ask them some key questions:

  • How will you collaborate with the therapist/psychiatrist treating me?
  • What is your policy about consulting with the doctors on staff at “Acme” Behavioral Health Hospital?
  • How do you feel about treating Bipolar Disorder with third generation antipsychotics versus other mood stabilizers and anti-epileptics?
  • Do you have an agreement with any other psychiatrists who can see me when you are unavailable due to vacations, etc.?
  • What is your policy with regards to termination of a therapeutic relationship?



Shut Up, Shut In and Shut Down


These and other questions must be asked if you have the luck to be able to choose your physician and clinician. We must stand as a community and demand appropriate care. We cannot go back to the days of being shut up, shut in and shut down. I encourage you to take control of your health – especially your mental health and advocate for yourself now so that when you can’t, you know you have measures in place to provide the best care possible. Talk to friends and family members as much as you can about your wishes for your own health care. Write up an agreement and make sure everyone has a copy. I know this is extremely difficult and draining, but it’s important especially if you’ve had one hospital stay, to plan for the possibility of the next. You can do this. You’ve got to do this.







Plan for Your Next Breakdown

Lisa Keith, Psy.D.

September 29, 2014 Lisa Keith,Lisa.Keith Psy.D. is a 20-plus year veteran special education teacher who has taught grades K-12 and now teaches graduate students who want to grow up to be special ed. teachers. When she’s not teaching or academically engaged, she is completely engrossed in 49er football or the art of Zentangle. A typical day for Lisa begins at 4 a.m. to check email, Pinterest and journal, followed by a hefty dose of coffee and hours of study. You can learn more about her here: http://grad.fresno.edu/faculty/lisa-keith-psyd

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APA Reference
, . (2014). Plan for Your Next Breakdown. Psych Central. Retrieved on July 19, 2018, from https://blogs.psychcentral.com/bipolar-lifehacks/2014/10/plan-for-your-next-breakdown/


Last updated: 30 Oct 2014
Last reviewed: By John M. Grohol, Psy.D. on 30 Oct 2014
Published on PsychCentral.com. All rights reserved.