I work on a psych ward...ask me anything

[Anonymous]

A question about voluntary admission:
Someone suffering from PTSD psychosis (hallucinations and dissociation due to trauma) considers voluntary admission, just to feel safe and cared-for for a while, to try to get extra insight and fine-tuning of meds and coping strategies that the regular psychiatrist isn't offering.

What is the environment in a psych ward, and would be it be more traumatic to be away from one's carefully-created safe space and routine? Are patients relatively well isolated from each other, so as not to further traumatize one another? Can it be a calm, safe, productive space, or is it more incarceration, just to get ill people away from the general population while the meds are doing their work, with med adjustment and therapy happening afterwards?

[Anonymous]

Anonymous wrote:When my son had an extremely violent manic episode (in the grocery store) I had to call an ambulance and a neighbor to collect my other child.

I have come to hate the word crazy and wish people would stop using it. Mental illness isn't anything to poke fun at. My son will have to deal with this his entire life and I don't want him to have to worry about the stigma that's still associated with mental illness. He's a great kid and my goal is to make sure he has years of therapy under his belt before the turmoil of adolescence. I don't want him to self medicate or refuse to take his meds. Without all this prevention he could be a child who gets out of control and hurts himself or someone else. With all the care he has received his mania is no longer violent but he buzzes around like a bee, can't stop talking, has to touch everything, and he now cycles through it and doesn't crash into depression.

I am sure that someone will recognize who I am because of all the details I provided and I don't care. I want everyone to know what we have gone through and how helpful the psych ward was. I am sure there are more visits in our future and I appreciate everything that has been accomplished.

I think the onset of mental illness during childhood is not at all understand by the general public. There is greater understanding of autism and ADHD and other childhood disorders but for more psychiatric illnesses, there is little public awareness. Part of this is because childhood onset of psychiatric illness isn't that common (a good reason) and partly because of stigma and misunderstanding (the parents must have done SOMETHING). The reality is that parenting behavior is tied to some mental health problems that kids experience so it is hard for people to not assume it happens in all cases. Poor parenting can also lead to behavior that looks very similar to signs of mental illness - similar behavior with very different causes but as a public observer, you wouldn't know which it was.

I feel for you. It is very challenging to have a child with a chronic illness of any kind and a mental illness adds a psychological component that few understand. Childhood bipolar disorder isn't that common and has been a controversial diagnosis at times making the stigma worse. I've seen many kids with childhood bipolar who had improvement of symptoms as they age so hopefully your early intervention will pay off down the road. Have you found any parent support groups? They can be an invaluable resource. This is a pretty active discussion forum for parents of kids with bipolar you may find useful. http://www.mdjunction.com/forums/parents-of-bipolar-children-discussions

[Anonymous]

Anonymous wrote:A question about voluntary admission:
Someone suffering from PTSD psychosis (hallucinations and dissociation due to trauma) considers voluntary admission, just to feel safe and cared-for for a while, to try to get extra insight and fine-tuning of meds and coping strategies that the regular psychiatrist isn't offering.

What is the environment in a psych ward, and would be it be more traumatic to be away from one's carefully-created safe space and routine? Are patients relatively well isolated from each other, so as not to further traumatize one another? Can it be a calm, safe, productive space, or is it more incarceration, just to get ill people away from the general population while the meds are doing their work, with med adjustment and therapy happening afterwards?

On a general admit unit like I work on, you probably wouldn't like it. It depends on the culture and philosophy of each ward and also on the mix of patients. Occasionally there is a mix of patients where you would find what you are looking for but the majority of the time there are people who are manic, people who are hallucinating, people who are very irritable, people who are disinhibited, people who are delusional, people who are obsessive compulsive ....that doesn't lead to a calm environment. It can get noisy, people can get in your space and while my ward isn't at all like incarceration, it is rarely quiet or calm! Despite that, there definitely are people who are dealing with depression/anxiety/ptsd who still do find it very beneficial as it gets them services and supports they can't get somewhere else and it gives them a break from the routine of life. The other caution I would say is that not all psychiatrists on general units are specialists in PTSD and you might not get what you went in looking for.

You really need a program that is specific to PTSD. I've heard good things about The Center at the Psychiatric Institute of Washington http://www.psychinstitute.com/inpatient_services/the_center.htm Sheppard Pratt in Baltimore also has a good program People report good and bad experiences from the same units so it is hard to say any one is the one. A good idea is to call the Sidran Foundation hep desk. They are experts and know of pretty much every unit in the country for trauma! If you tel them a bit about what you would be looking for they could probably advise you best. http://www.sidran.org/sub.cfm?sectionID=5

[Anonymous]

Hi, I'm 15 and I was wondering if I would be aloud to do my work experiance in a psych ward, even if I was just able to observe.

[Anonymous]

Hope you're still reading this OP - I missed it first time round, but enjoyed reading it just now (thanks to the 15yo for bringing it back!).

My question is:
Are some of the staff in the psych ward a bit strange or mentally ill themselves?

My mom was in a psych ward a couple of times. On one of my visits, my mom's nurse asked me if I had been some particular famous figure in a past life (I think it was a Roman Emperor or something) because she knows she met me by looking in my eyes. After feeling freaked out, I was then really mad that my mom was being taken care of by someone more mentally ill than her!!

[Anonymous]

Anonymous wrote:We also see a lot of teens from families who have focused too much on making their kids happy/self-esteem, and in doing so kept their kids from feeling and learning to cope healthily with sadness, disappointment, hurt feelings, being in trouble and taking responsibility etc.. When those kids grow into the teenage years, they really struggle to cope with life and teen pressures.

I have an infant. Our goal is to keep her happy. I watch my brother not let his son have his own feelings. My brother in constantly telling him what to do and what to feel. I thought I was doing pretty good at letting her feel her feelings, but I'm not sure. I want her to be able to cope with her feelings, to learn how to deal with sadness, disappointment, etc. in a healthy way. What are these parents doing that leads to this?

[Anonymous]

Anonymous wrote:

Anonymous wrote:We also see a lot of teens from families who have focused too much on making their kids happy/self-esteem, and in doing so kept their kids from feeling and learning to cope healthily with sadness, disappointment, hurt feelings, being in trouble and taking responsibility etc.. When those kids grow into the teenage years, they really struggle to cope with life and teen pressures.

I have an infant. Our goal is to keep her happy. I watch my brother not let his son have his own feelings. My brother in constantly telling him what to do and what to feel. I thought I was doing pretty good at letting her feel her feelings, but I'm not sure. I want her to be able to cope with her feelings, to learn how to deal with sadness, disappointment, etc. in a healthy way. What are these parents doing that leads to this?

Not the OP but here are examples of manipulating feelings:

Child is scared to cross the street and cries. Instead of encouraging them, reviewing how to do it safely, you don't make them do it.
Child is being taken to toy store only to arrive and find toy store is closed. Instead of saying that stinks, but we'll try again tomorrow, earlier, the parent takes the child for an ice cream or drives all over trying to find another toy store open later.
Child hits random stranger, stranger yells at child, child starts to feel shame. Instead of parent telling child it was wrong to hit, parent yells at stranger for yelling at child.

Here are examples of teaching child to own and manage their feelings properly:
Child falls off bed and is unhurt but crying. You cuddle child, and say "That was scary, wasn't it? You didn't expect to fall. Are you okay?"
Child comes home announcing they weren't invited to birthday party everyone else is going to. Cries at being left out. "It really hurts to be the only one left out, huh? Can you think of any reason why you weren't invited? [child mumbles about being mean to party kid] Ohhh, well if someone had done that to you would you want to invite them to your party?"

[Anonymous]

Am I able to work as an employee in a psych ward without a degree? Are there positions available outside of being a psychiatrist?

[Anonymous]

Do you hear what I hear?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Have you ever dated one of the crazies?

God this is nasty and hurtful. I bet you wouldn't be speaking like this if you had a loved one with mental illness.

I understand your thoughts very well and completely agree with you. Hopefully, that poster has a job that doesn't require kindness, empathy, and tactfulness.

[Anonymous]

Anonymous wrote:Hi, I'm 15 and I was wondering if I would be aloud to do my work experiance in a psych ward, even if I was just able to observe.

Op here - just saw that this had been revived!

Unfortunately you usually can't do work experience on the psych ward due to confidentiality and safety. I think that rule is in place partly due to psych being a specialty area. Psych patients can be very unpredictable and irritable at times and there could be safety issues. You can often get work (when you are a little older) as a psych tech or as a patient assistant or orderly and get a feel that way for psych. I would encourage you to look into working as a camp counselor or CIT at a camp for kids with ADHD, autism, or emotional / behavior problems. That is a great way to get a little experience with a population that struggles with mental health. Also if you can't get into a specialized are just working with the general public will introduce you to mental health. People with mental illness and mental health problems are your friends, your neighbors, everywhere - just getting good at communicating, listening, respecting others, being assertive, being inclusive...all is good practice for working in psych.

[Anonymous]

Anonymous wrote:Hope you're still reading this OP - I missed it first time round, but enjoyed reading it just now (thanks to the 15yo for bringing it back!).

My question is:
Are some of the staff in the psych ward a bit strange or mentally ill themselves?

My mom was in a psych ward a couple of times. On one of my visits, my mom's nurse asked me if I had been some particular famous figure in a past life (I think it was a Roman Emperor or something) because she knows she met me by looking in my eyes. After feeling freaked out, I was then really mad that my mom was being taken care of by someone more mentally ill than her!!

HI PP, OP here. The psych field definitely draws in people with their own mental health issues. Often people go into psych thinking it will give them more knowledge, insight and tools to understand themselves or their family members. Some want to to give back to a system that supported them, others are just very caring and wanting to help others where they couldn't help their own families members. Sometimes this is an asset and other times it can definitely present a problem - if staff over identify or project or transfer or overstep boundaries. If their own illness gets worse or if their mental health is interfering with patient care then they shouldn't be working.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We also see a lot of teens from families who have focused too much on making their kids happy/self-esteem, and in doing so kept their kids from feeling and learning to cope healthily with sadness, disappointment, hurt feelings, being in trouble and taking responsibility etc.. When those kids grow into the teenage years, they really struggle to cope with life and teen pressures.

I have an infant. Our goal is to keep her happy. I watch my brother not let his son have his own feelings. My brother in constantly telling him what to do and what to feel. I thought I was doing pretty good at letting her feel her feelings, but I'm not sure. I want her to be able to cope with her feelings, to learn how to deal with sadness, disappointment, etc. in a healthy way. What are these parents doing that leads to this?

As an infant likely you are not so much focused on keeping her happy but on doing the things that make her happy (sleeping, fed, bathed, entertained, attached)etc... the same principle applies as she grows. Your goal should not be to keep her happy. It should be to focus on the things that will ultimately lead to her being happy, healthy and responsible. Those are things like developing confidence, mastery of skills, building strong attachments, competency, coping skills, social skills, self-regulation - emotional regulation and behavioral regulation, reflection and introspection, connecting feelings, thoughts and actions etc.

As she grows let her experience the feelings that she has naturally related to a situation - talk about identifying the feeling and how to cope with it, rather than how to take it away and make her happy. Adversity (not trauma) is good for kids. Life is stressful and age appropriate stress helps them to develop the skills they need to manage it. It is okay to not be good at things, it is okay to fail, it is okay to be sad, mad, frustrated, angry, scared, excited, etc... but there are healthy and appropriate ways to manage these feelings and situations so you learn from them and it leads to growth. Structure, boundaries, limits, expectations, consequences are all good for kids to learn - this is how life works and being unable to understand those connections and when to stop is really important. Developing a strong sense of self is also key - not feeling like you need to be like everyone else or being a chameleon who changes to those around you. Also self-responsibility - no externalizing blame onto others or taking on a victim role, teach them it is okay to make mistakes but you own up to it and take responsibility for it. It is also important they learn to advocate for themselves and have a voice. All of this needs to happen in the context of a family and home (s) where there is a sense of belonging, of being loved and appreciated, of parents who believe in them, of support and attachment.

[Anonymous]

Anonymous wrote:Am I able to work as an employee in a psych ward without a degree? Are there positions available outside of being a psychiatrist?

Yes many! The psych team where I work consists of psychiatrist, psychologists, nurses, occupational therapists, recreation therapist, social workers, spiritual support worker, a pharmacist, patient care attendants and I am probably forgetting someone. There are also child youth workers and teachers on the pediatric unit. Most of the jobs do require a degree. Some places you can work as a tech without a degree.

[Anonymous]

Anonymous wrote:How is my family doing?

thanks for the laugh!