What It's Like to be Held in a Psych Ward Against Your Will
I couldn’t leave until they told me I could. That loss of control felt intensely threatening.
Nick Keppler/aydinmutlu/Getty Images
When they decided to lock me in the psych ward, they did not tell me it was for my own good.
The hospital social worker—a suburban dad-looking guy with salt-and-pepper hair—came into the room carrying a binder. It was the room closest to the emergency room intake desk and the nurse always left the door open after she checked in, which she did every 1 minutes. I was sitting on the edge of the bed with a blanket covering my legs. The hospital gown was tissue-thin and it was February.
“We can’t find Dr. Cyanic,” he said, “so we’re transferring you.”
“Against my will,” I said. I don’t know if I meant it to be a question or a statement. He nodded and left.
I gulped down hard, trying to contain panic and anger. The lights in the room felt brighter and the air more stale. It was Saturday. What would I tell my boss if I wasn’t out by Monday?
I admit blame in getting myself to where I was that night, but I thought when they reached Dr. Cyanic, it would be over and I would go home.
Seven hours earlier, I called one of those hotlines. “Crisis line” has replaced “suicide hotline” as the preferred term, and with that redefinition came some ambiguity, to me, what they were for. I called when I reached peak anxiety, which happened a lot back then. I was in my early 20s and had moved for a newspaper job. I was fine at work but everything else—making friends, furnishing an apartment, finding a gym, talking to my new neighbors, checking my bank account—paralyzed me. It was like I had to build a life from scratch, and the enormity of that caused my system to overload. I’d spent weekend mornings in bed, not sure what I needed to do, but certain if I didn’t do it everything would erode and collapse.
The people on these lines were volunteers and the results varied. If I was lucky, I got someone who just listened. The obstacles immediately in front of me, practical or emotional, felt smaller and more manageable when I recounted them aloud, and the act of speaking gave me focus. An occasional, “That seems hard” was nice. Some of these faceless voices managed the minimalist comfort offered by bartenders, and that helped.
Then there were the ones who repeated self-help maxims, the ones who tried to get me off the line, and the ones with stupid suggestions like “go for a walk” or “take a warm bath.” (If something so small and obvious would help, I’d be doing it.) Whatever. It was one resource for an emotional clog-up between therapy appointments and I used it.
That Saturday morning in February was typical for me in that it was horrible. I had an interview with a South African rock band to write up for the paper. I often left myself work to complete over weekend. It was easier than facing life tasks. I froze, staring at a blank Microsoft Word document. And the anxiety built up.
So I called. I said I was having an anxiety attack. She asked if I wanted her to call an ambulance. I said no. She asked if I was suicidal. I didn’t answer. I talked about how hard things had been recently—with the job and the move. I just didn’t want the call to end.
She asked, “Can you promise to keep yourself safe?” I said, “I don’t know.” If this call stopped, I would be alone with the anxiety again, and the anxiety would be redoubled by the exhaustion of another resource. I was probably rambling to keep the call going when a pair of police officers and two paramedics arrived at my door.
I put down the phone. I walked out into the hallway of the building. I was fine, I told them. The person on the line overreacted. Cops in Bridgeport, Connecticut, are like the movie version of Boston cops: haggard-faced, pushy, and always involved in some internal drama that’s in the papers. An officer said, “You are going to the hospital.”
I said I wasn’t. They said I could go voluntarily or they would put a 72-hour hold on me. There was some back and forth, but they were resolute. I thought I could convince a clinician to let me go before 72 hours. I said fine; if those were the two options, I would go “voluntarily.”
The two paramedics had arrived with a rolling stretcher and asked me to sit in it. I was fine to walk, but clearly regulations had taken over the situation. They wheeled me down the hallway, into the elevator and into the back of the ambulance parked in front.
It was a five-minute ride to Bridgeport Hospital. Nobody spoke. I was wheeled through a series of doors. Once we were in the ER, the first thing that happened was a nurse asked for my insurance card. The ambulance ride itself probably cost hundreds of dollars. Someone had to start paying.
After I fished my insurance card out of my wallet and handed it over, the paramedics told me I could stand. A nurse gave me a plastic bracelet with my name on it, marking a clear transition into a patient. A fat security guard whose nametag read “Carl” walked up with a hospital gown.
“I’m gonna need you to change into this, boss,” Carl said.
I took it and said, “Please, I’m nobody’s boss.” I gave a faint smile. The goal was to not seem emotionally distressed, even though everything that was happening was emotionally distressing.
Carl led me to that room, the one next to the intake desk. I deduced that’s where they kept psychiatric patients—in close view of the most populated staff station, where even a sleepy-eyed resident could spot someone trying to hang themselves with bedsheets before it happened. Carl closed the door behind him and I stripped down to my boxers and put on the gown. It didn’t go below my knees and left a huge V exposed on my back. Carl left with my clothes. He did not close the door.
A middle-aged nurse came by and introduced herself. I don't remember her name, but it was probably something like Martha or Betty. “I’ll be taking care of you,” she said. “Tell me if you need anything.”
“Okay, thanks,” I said, thinking how weird it was that she sounded like a stewardess.
Next, the hospital social worker came by and told me to follow him to his office. “So let’s talk about what brought you in here tonight,” he said. I told him. I repeated what I had told the police. “I think the person on the line overreacted.”
“What would you do if we let you go home tonight?” he asked.
“I’d take the anxiety medication my doctor gave me, at the prescribed dose, and go to sleep.”
“I think that sounds good,” he said. “Watch what you say to the people on those lines. They’re not professionals.”
“Yeah,” I said. “Good call.”
He told me they needed to do some additional paperwork before I was discharged. He led me back to the designated psych patient room. In the ER were a few scrub-wearing staffers behind desks and computer stations. Some average Bridgeporters were sitting in plastic chairs, waiting on friends and family. They were in their jackets because of the influx of February air from the periodic whooshing of doors. I felt like everyone knew. Why else would someone who was able to walk unassisted through this room be in a hospital gown and a plastic bracelet?
Betty/Martha brought me a tuna fish sandwich. I let it sit beside me on the bed untouched; I’m a vegetarian. Time passed. Betty/Martha took the tray away. I got in the bed and put the covers over my head. I thought about why I wanted to go home, to not be hospitalized. I had been through months of paralyzing anxiety. Maybe I needed an intensive timeout.
When I was 17, I broke a lightbulb in my bedroom and lodged the broken glass into my wrists. It was probably a cry for help. My mom drove me to the ER, which transferred me to a psych ward in Buttfuck, Pennsylvania. The person working the nightshift forgot to mark down my arrival for the morning crew, so I slumped in a chair for 12 hours with a bandage on my wrist. No one realized I was there until my parents came back for visiting hours. My mom pulled me out, signing a paper stating that it was against medical advice (as if we received any). In the days after, she kept calling until someone was fired. So I didn’t trust psych wards.
And while this was all voluntary on paper, I was coerced here. And I couldn’t leave until they told me I could. That loss of control felt intensely threatening. I laid under the covers, listening in for the noise of bureaucratic mechanisms. They were looking for some psychiatrist who had to sign off on psych releases. Dr. Cyanic. Another hour passed.
When the social worker told me I was going to a psychiatric hospital two towns away, I panicked. True, I wasn’t a normal, mentally healthy person but I believe that if you take a normal, mentally healthy person—raised on due process and the usual expectations of Western democracy—and tell him that he’s being detained, arbitrarily, because of some Kafkaesque snag (a doctor wasn’t answering his pager), he would probably get agitated, paranoid, and incensed—all the TV attributes of a mental patient.
Martha/Betty came in, on her ten-minute mark, and said, “So we need to get you ready for Hall-Brooke.”
“Go fuck yourself,” I said.
She instantly craned her head to look out the room and walked out slowly. The staffer behind the intake desk looked over at me. I gave him the finger. When the social worker walked by the room again, I screamed, “fascist scum!” I wanted to turn the visibility of the room against them.
Carl came back with my clothes. “You got to calm down,” he said. “I’m telling you because you were nice to me when you came in and I want to be nice to you.”
“Okay. Thanks,” I said, zipping up my jeans. I wanted to like him. He was the only person whose demeanor seemed determined by something other than procedure and I'd started to despise procedure.
Two new paramedics came. We went through the routine again. I got into the stretcher, was wheeled through the ER and loaded into an ambulance. One of them, a 20-something little shit with nerd glasses, sat in the back with me. “So what happened today?” he said.
“I’m getting detained against my will,” I said. I hated him. He had just met me. We were destined to spend only 15 minutes together and he was so cavalier asking about one of the most humiliating experiences I had ever been through. “I think I’ll hunger-strike until I’m out,” I said.
“That’s just going to make them keep you longer,” he said. It was an empty threat, a thought struck up on the spot. I wanted to say something to acknowledge how fucked this was.
I don’t remember seeing the outside of the psychiatric facility. I just remember being loaded out of the ambulance and through some hallways. Again. It was about 2 AM. There were a few staffers at a front desk. The place was dead silent.
At about 2:30 AM, I did my intake interview with an Australian-accented social worker with shoulder-length hair. I sat opposite him at a small conference table in some room. We went over the day’s events and then through a questionnaire. (“Are you suicidal?” he asked. “Once again, no,” I said.)
“When can I get out of here?” I asked.
“The doctors won’t be able to see you until Tuesday,” he said. “Monday is Presidents Day.”
Seriously?, I thought. They get Presidents Day off.
“I really want to get out of here,” I said. “I have a job to get back to.”
“You have one thing working in your favor,” he said. “Do you know what it is?”
“Will and determination?” I asked.
“I’m obviously sane?”
“I give up. What?”
“An American insurance company,” he said. “They’re going to be calling on Monday, asking, ‘Can he get up? Is speaking? Then why is he still there? Why are we paying for this?’ They’ll keep calling every day.”
I was shown to my room. The facility seemed to be X-shaped with a men’s wing, a women’s wing, a wing for a lounge with tables and a TV and a wing that acted as an entrance, separated from the locked ward.
In my room, there was someone already sleeping in one of the beds. I slept from about 3 to 6. In the morning, I met my roommate, Chester, a thin man with long white hair, in for a severe case of agoraphobia. He explained he was here until his wife and adult kids found a more long-term solution. “We’ve been talking about a therapeutic farm in Ohio when the planting season starts,” he said.
Chester seemed nice enough, so I followed him through the med line (the staff confiscated the bottles of Cymbalta and Klonapine to feed them back to me at designated times) and the breakfast line.
The depressives in a psych ward tend to form a group, as if they want confirmation they are of a separate type than the guy in a bathrobe rambling about Jesus or the cross-eyed girl in the corner. There was Lisa, the alcoholic who checked herself in to prevent herself from taking another drink; Sarah, the overwhelmed college student who attempted suicide a few days earlier by swallowing all her antidepressants; and Amanda, the affluent housewife who’d recently lost both her husband and brother and felt too world-weary to go on herself. I liked her the most. We played cards for a few hours. Sunday was mostly an exercise in passing time. I also read old issues of Time and US News and World Report and tried to nap, but the nurse checking in put me on edge.
I left a voicemail for my boss. I laid it out for him and decided we would deal with it whenever I got out of there. I shouldn’t have been so worried, really. I worked for an alt-weekly newspaper. Each one is staffed by neurotics, casual drug users, and short-fused curmudgeons. (My own boss, a musician, was once in the national spotlight for making a parody album passed off as a secret punk demo recorded by Chelsea Clinton.) It was not an atmosphere where psychological convention, or even stability, were overly valued. Still, I worried about how the staff would see me from then on.
On Monday, the doctors and key medical staff were off marking their appreciation for the nation’s commanders-in-chief or whatever, but some routines resumed. In the morning, a nurse gathered every patient in a room and had us state goals for the day. This struck me as ridiculous. What was there to even do here?
Most people said, “Try to relax.” Someone said, “I’d like to see the doctor about going home.” The nurse interjected the doctor was not there today. I said I’d like to meet with someone from food service and clear up the whole vegetarian thing. I’d eaten only a bagel, a salad, and a side of macaroni and cheese in the last 36 hours.
The day passed. I waited through a few group therapy sessions. I hadn’t brought a change of clothes and mine started to stink.
I had gotten close enough to people that they started to relay their discontent with the system to me. “I didn’t know that you couldn’t check yourself out when you checked yourself in,” Lisa told me. “I wished I would have known that.”
Chester warned me to start throwing my uneaten meat products in the trash. “They check every plate,” he said. “It’s going to look like you’re not eating because you’re depressed.” I didn’t tell either of them how I got in there. I was worried I was the only one whose initial commitment was not really voluntarily.
Tuesday. At the morning goals meeting, nearly every patient said their goal for the day was to meet with the doctor and get released. Supposedly, all these people needed to be here, but their only goal was to leave. Despite their desperate situations on the outside, the psych ward was—after a few days—determined to be worse. I suppose for some of them a day or two of space from their dysfunctional routines had calmed their nerves and they were ready to leave. In any case, we all wanted out.
That morning, I finally met with the doctor, who looked a little like Nelson Mandela in a white coat. A young blonde social worker sat in to listen. So did a 20-something medical student with oversized glasses. I relayed the story of how I got there again.
“I seriously think I’m fine to go,” I said. “I’ll get an appointment with my doc this week and we’ll go over a long-term treatment plan.” The doctor took out papers from the Bridgeport Hospital ER, and told me it had been passed along that I had told a few staffers to go fuck themselves.
“I guess I was pretty upset that the whole transfer here was because they couldn’t find a doctor,” I said.
“We’d like to keep you here for one more day.” he said, “just so we can observe you.”
I went back and sat in the lounge area. Part of me wanted to just gun it. Run for the doors. I had some self-image as a person who didn’t do what he was told. I was a smart-assed teenager and then a campus liberal and then a journalist. But cold rationalism took over. They were “observing” me. I just had to hold it together for 24 more hours. So I went back to reading three-year-old Newsweeks. I started to feel a pent-up, lagging feeling in my muscles from lack of exercise. And fuck, my clothes stank.
On Wednesday morning, they called my doctor, made sure I had an appointment, and gave me $1.50 for the bus. It had been more than 72 hours. Maybe the police-ordered involuntary commitment would have been quicker.
I walked out of the door and breathed fresh air for the first time in four days. It felt like I had passed through the bowels of a great beast.
Things changed in the next few weeks. My boss offered me slack. He insisted on it, actually. He always made sure I went home at 5. Dealing with my anxiety became a task, not a thing that gets in the way of other tasks. I hiked more and started meditating with these Buddhist monks stationed out in a farmhouse in a rural patch north of Bridgeport.
Being committed was not therapeutically helpful, but it was a moment of clarity, the way skidding off the road is for a drunk driver or losing two months’ mortgage is for a gambler. If I didn’t handle my shit, I would get into a mess like that again and it might be worse next time.
Did I need to be committed? Maybe. But I was not committed because someone made that determination fairly and considerately. I was committed because I had started a chain reaction that swallows people. It was my fault that I ended up in the ER. Everything after that was because of procedure, or lapses in it.
In 1972, a Stanford University psychologist sent ten psychologically healthy fakers to mental hospitals. They lied about hearing voices to be admitted, but afterwards acted normally. No staffers detected them as frauds, though several patients did. All were forced to admit to having a mental illness, mostly schizophrenia, and agree to take antipsychotic drugs as a condition of their release. They were detained for an average of 19 days. The researcher, David Rosenhan, concluded that “it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.”
I wonder if anyone even tries to distinguish anyone. In the attitudes of all the staffers and patients I encountered, I saw such resignation, an acceptance that the system would play it, fairly or unfairly. Questions about who was sane and insane, as Rosenhan had defined them, were kicked up to another person or just kicked aside completely.
There was a final, absurd step in the process for me: A week after I left the facility, I got a $500 bill. I was enraged, because this seemed like a jail charging you room and board, because no services were rendered (I spent 20 minutes with a doctor, only to plead to be let out) and because the social worker who sat in on the meetings told me I wouldn’t get a bill.
I called the number for financial assistance and reached an administrator named Carrie Caspirino. (That’s not her name, but it was something equally alliterative.)
“The entire time I was pleading to get out of there and they told me I wouldn’t get a bill,” I said.
“I don’t know why they told you that,” she said.
“This is like that movie Brazil where they torture people with electric shock and then charge them by the voltage,” I said.
“I don’t go to the movies,” Carrie said. “I can send you some financial assistance applications.”
She sounded scared, which I guess was because she was talking to an irate mental patient. I wondered why she thought it was important to say she didn’t go to the movies.
A few days later, the financial assistance applications came. They asked questions about “net income” and “income-yielding investments.” As a 20-something who had filed taxes twice, Idid not understand these terms. I called Carrie again and asked a few questions.
“I can’t answer questions,” she said. “This has gone on for too long and I will send it to collection.”
“How can this have gone on for too long? I just got these forms today.”
“Tomorrow, it goes to collection.”
It never went to collection. My therapist connected me with a disability rights advocate. Together, we crafted a letter and sent it to the hospital network’s president. He responded with a letter cancelling the charge.
At that moment, on the phone with Carrie, I made a sigh. She didn’t go to the movies, but I am sure she had some life away from the desk where she was presently sitting, with a home and friends and family, who didn’t consider her anything like torture-happy bureaucrats of Brazil. This was just her part in the hospital system. But at that moment, being part of the system just made her seem worse to me.
“You know what, Carrie,” I said. “You’re a real bitch.”
She gasped and hung up.
I was sitting on a bench outside the newspaper’s office. It was an unusually warm, early spring day. I knew it was wrong and pointless to lash out at Carrie, but deep down, it also felt good—good to be free, and good to lose my temper in the face of absurdity again, without fear of being detained for it.
*All names and places were changed.
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