**This week’s blog posts are dedicated to advocating for effective mental health treatment and educating patients, family, and friends in all areas of inpatient psychiatric care. The perspectives shared here are not that of a mental health professional, but rather someone with lived experience. Information shared may not align with every circumstance or viewpoint of readers, but is meant to offer guidance in an area that is often confusing and holds little resources.**

One of the thoroughly confusing things the first times I was hospitalized in inpatient psychiatric care was who all the people who were not patients were and what their role was. For a while, I didn’t even know they had different jobs and would get frustrated when I would ask one person a question and they told me to ask someone else. It left me feeling as though I was an afterthought and they didn’t want to deal with my problems. At first, I just stopped asking questions. Eventually, a kind mental health tech explained the entire structure to me one late night and my stays were so much smoother from then on out. So here they are, in no particular order:

#1 – Mental health technicians – Sometimes just referred to as a “tech,” these are sometimes the hardest working, least appreciated employees in a hospital. You will find techs spending all of their time in the general population area, amongst the patients. They handle all practical requests such as needing an extra blanket, wanting to get into your room (if rooms are locked during the day), requests to take a shower or sharpen colored pencils, really anything you can think of. Their actual job is maintaining a safe environment, observing behavior, taking vitals in the morning and when needed, doing safety checks for individuals on suicide watch, and providing physical security if the need arises. They likely will be asking you questions throughout the day regarding your mood, level of depression/anxiety/suicidal thoughts, and charting the information for the nurses and doctors. They will lead group sessions with or without curriculum to teach coping skills, address concerns, or bring up morale.

#2 – Nurses – Nurses are usually stationed behind a desk or even a wall with a glass window that opens and shuts. They are there to monitor physiological and medical wellbeing and are rarely the right resource for general questions. They administer medications several times through the day to the appropriate individuals and chart any medical concerns. Occasionally, personal hygiene items will be held behind the nurses desk for check-out, but first ask the tech what the procedure is for receiving this at morning/evening/shower times. If you are not feeling well, aren’t sleeping well, feeling extremely anxious, or have any need for medical attention, you can go directly to the nurses’ station. They are not usually up for chatting or keeping company as their jobs are demanding and require every minute of their shift to complete.

#3 – Psychiatrists – The doctors will come in once a day, usually at different times. Some will come the same time every day (always the morning, or even late at night). You will be assigned to one doctor you will see throughout your stay and your first visit will be with them within 24 hours from arriving on the floor. From then, you will see them once every weekday and once over the weekend. They typically will meet with you for a brief time (can range from 2 minutes – 15 minutes). Any requests for items that have been restricted from you should go through your doctor. For example, if you brought a personal item like a stuffed animal that didn’t make it to your room, you can ask if they can write an order for you to have that comfort item. Be sure you know before-hand what questions you need to ask because you won’t have contact with your doctor for another 24 hours. Their role is to assess your mental state, prescribe medication and treatments, and determine readiness for discharge.

#4 – Therapists – There are several types of therapists you may encounter in a psychiatric hospital. The most common will be licensed counselors or psychologists. They, like the doctors, will come in throughout the week. Typically, they will only come once or twice a week. You may have a chance to meet one-on-one with a therapist for a 30-60 minute session, but these do not happen often. For the most part, therapists will come in to lead group therapy sessions or even educational groups about mental health. Another common type of therapist you could see, depending on the facility, is an occupational/recreational therapist. They will come to lead low-impact exercise group sessions or recreational game sessions. You can ask the nurses’ station if you would like to speak with a therapist to get put on their schedule.

#5 – Social Workers – This person is the main connection to the outside world for the patient. Along with updating authorized family members about inpatient treatment, they work to find resources for the patient after discharge from the hospital. Closer to the discharge date, they will meet more often with you to go over your plan for care in the days and weeks following discharge. Typically, protocol is to have an appointment scheduled with an outside psychiatrist within 48 hours of discharge and have first therapy (whether individual or outpatient group therapy) appointment scheduled to happen within 1-4 weeks of discharge. For people who are in need of other resources, such as housing, occupational, food assistance, healthcare, etc, the social worker will handle this as well.

It definitely takes a village to bring mental health to someone in crisis. In my experience, even the other patients can play a process in your journey to wellness. The key thing to keep in mind is these people are really here for you only for this season. You very likely will never encounter the patients, the techs, the nurses, the doctors, or the therapists again in your lifetime. Some will make the biggest impact on your life and you will never know their last name. Be sure to show your gratitude while you can and thank them for what they do.