Writing Psychiatric Hospitalization with Accuracy and Care
Photo by Annie Spratt on Unsplash
Writing about a patient in a psychiatric hospital needs a lot of critical care. Before you get started, there are some details that you should consider, such as who your character is and what happens to them at the end of the story.
It’s important to start by saying it’s your responsibility to thoroughly research what life circumstances and mental health conditions lead to your character being hospitalized. (People only enter a psych hospital if they are an immediate danger to themselves or others.) No matter what story you want to tell, please remember fictional portrayals impact real people.
What It Feels Like to Be In One
I spent almost my entire senior year of high school in a psych hospital. Although I was familiar with the process, it was still a scary experience. I felt overwhelming guilt for not being able to take care of my little sister at home. I hadn’t applied to any colleges. I felt that I didn’t deserve to be alive, much less have multiple people watching me. I hated myself for losing control and “allowing” this to happen. It’s important to consider your character's circumstances, personality, and arch when you write about their hospitalization. Consider all of the things they may feel.
How Psychiatric Hospitals Differ from Regular Hospitals
Different hospitals have different rules but here are some guidelines about how they function:
Patients may not be able to sign themselves out, depending on how they came in. If they are detained by court order a psychiatrist must sign them out. If they signed themselves in, there is a possibility that they can sign themselves out as well, but this can introduce a new set of problems including insurance issues.
Visitors are only allowed at certain times - if they are allowed at all. Most facilities allow visitation once per week.
Individual rooms don’t have TVs. They usually are in common areas and are turned off at a certain point at nighttime.
Unless there is a special reason why someone needs a room to themselves, your patient will have a roommate of the same assigned birth sex.
No phones allowed, including visitors. The only method of communication is through cord phones in the common area that the nurse’s station monitors.
Upon intake, everything brought in is searched. This includes a strip search, though nowadays, the staff don’t (usually) put their hands on you. Certain items are not allowed for safety reasons.
Psychiatric patients are not allowed to refuse medication they are prescribed in the hospital.
Important Details to Remember When Writing a Psych Patient
Writing an authentic narrative about mental illness or addiction includes not demonizing the person suffering from it. Your character is not in a psychiatric hospital due to a moral failure.
If ableism is a theme in your story, who is perpetrating it? What consequences do they face as a result of their actions, if any?
Does the character exhibit internalized ableism by judging themselves or others? How does this impact their internal or external conflicts?
Just like me, your character(s) will have a wide range of feelings about being hospitalized and conflicts that they experience from internal and external factors.
Possible Conflicts for Your Character
Internal
Often, people feel ashamed when they are in a psych hospital. Many people have jobs and/or children to take care of, and they are unable to fulfill those duties while they’re hospitalized.
Is this your character’s first time in a psychiatric hospital? Are they being hospitalized again after some time has passed? This will affect the emotional experiences of the character.
External
Does your character get into altercations with other patients or staff?
Does the character’s family support them while they’re hospitalized? What does that support look like?
A Note on Humor
It is possible to tastefully add humor to a story about a psychiatric facility. The most important thing to remember is to humanize the patients. One book that did this well in my opinion is It’s Kind of a Funny Story by Ned Vizzini (cw: transphobia)