Demystifying mental health inpatient stays

I am one of the 68 million Americans living with a mental illness and one of the over 10 million Americans who have been diagnosed with bipolar disorder. Living with these diseases and seeking treatment is highly stigmatized — and newly precarious under the policies of the current federal administration. The best way to break stigma and advocate for better care is to share personal experiences.

In my youth, there was minimal mental health education in school. Any that was taught focused on depression only. I learned more details of how my great-grandfather died on his farmstead from my family than any insights on why he was never treated for depression and post-traumatic stress disorder by the Department of Veterans Affairs.

Mental health diagnoses are as complicated and diverse as our own brains and environments. Everybody deserves to feel well, and modern medications, support groups and therapy treatments have vastly improved over the past few decades. It is also true that feelings like anxiety helped us survive in a dangerous world before modern medicine, but we don’t have to accept those stressful symptoms as an everyday fact of life.

We are very lucky to live in 2026 for the abundance of mental health medications, community peer support groups and therapy options, often covered by health insurance. Less than a century ago, the regular course of action was to be locked in an asylum and not actively treated with any currently-prescribed medication.

Lithium carbonate (a salt that improves brain activity) was first federally approved to treat bipolar disorder in 1970, just 56 years ago. The first selective serotonin reuptake inhibitors (often known by their acronym, SSRIs, which treat depression) arrived a decade later. There are millions of Americans who could benefit from these prescribed medications that have been proven to be safe and effective in clinical trials, even going years into ongoing treatment. Taking medication, attending a peer support group, benefiting from therapy and prioritizing healthy habits like sleep are never something to be ashamed of. Caring for your mental health helps you and everybody you care about.

I have been diagnosed with bipolar depression since 2013. I have also been diagnosed with PTSD since 2020. Past trauma was rekindled by the early pandemic. Now with medication, those PTSD symptoms have been effectively treated for six years. If you or your loved ones have noticed ongoing depression, swings in mood or productivity, or the night terrors of PTSD, all of those can be treated by a provider with prescribed medication, peer support groups like those at the VA and therapy that is covered by health insurance.

The experience of an in-hospital stay has remained hidden from the general public, except in often inaccurate depictions in film and television. By the nature of these places, the media does not take photographs or interview patients when they are in a mental health unit, which can give them an undeserved, negative aura.

Getting admitted isn’t easy. People must exhibit suicidal thoughts or threatening behaviors, be experiencing psychosis (false thoughts or beliefs), or be unable to take care of themselves. Depending on their insight into their illness, they can be admitted voluntarily or under a “72-hour hold” that can lead to a civil commitment, where a court requires treatment under state law.

A psychiatric unit is different from other medical units. There are locked doors and restrictions on what clothing can be worn or gifts brought in. There are often limited visiting hours. It’s hard to stay connected because patients are separated from their devices and common-area phones have limited hours.

Inpatient mental health units are the safest place for a patient. There are separate units for children and adults. Depending on the size of the hospital, there may be different levels of care, or separate units for young adults and older adults. If a loved one is clinically lucid (with clear, rational thoughts), then the hospital can be boring. Television is restricted to certain channels and content. You may spend a whole afternoon watching reruns of “Roseanne,” which had its last season (aside from a brief reboot) nearly three decades ago. There may also be a nature slideshow channel during quiet hour (shift change). There often are newspapers or old magazines.

These can be a good test of how patients are able to read and function. If you see a patient reading the entire A section over their morning coffee, they are probably being medicated just fine and are waiting to discharge. Many units also feature individual and group therapy, occupational therapy, art therapy and medication management.

The most fun part of the day are the meal times. In my experiences at the University of Minnesota, we marked our paper menus with a stub pencil and turned them in for the next day. You learn the secret menu from other patients, like asking for hot sauce or having your provider prescribe double portions. One patient tried to trade me his second hamburger for a single chocolate chip cookie. I lost 30 pounds in three months instead.

While hospitals are required by law to limit the use of restraints, seclusion and sedatives, these are employed at times when a patient is lashing out and in danger of hurting themselves or others. I have been restrained and sedated several times, which is traumatic and humiliating. Avoiding this experience is one of the reasons why I have always taken my medication as prescribed. I have also marked “allergies” on my chart for medications that did not work, leading to my inpatient stay being extended by weeks when these were prescribed by accident.

When you are ready to be discharged, it’s important to be connected to the services you will need to continue to heal and recover. For some it may be therapy, support in the community or specialized housing.

The best way to continue your recovery is to start with self-care like regular exercise, eating healthy, making sleep a priority and other healthy habits. Taking medication and working with your prescriber to address side effects can help. Engaging in other therapies often makes a significant improvement. Joining a peer support group with other people living with a mental illness helps ease the isolation many feel. Finally, follow up and chart progress. 

People with mental illness are able to live more healthy and fulfilling lives today because of the sacrifices of patients and advocates. From Nellie Bly to the Affordable Care Act, we have made progress. But there is a retrenchment underway that is increasing stigma and denying care.

Medicaid is the single largest payer of mental health services in the United States and Minnesota, and it’s under threat after the Republican trifecta cut nearly $1 trillion from the program for low-income Americans and people with disabilities. Congress introduced new bureaucratic hurdles with the express intent of reducing the Medicaid rolls, which could be especially difficult for people suffering from mental illness. 

Under Trump-appointed U.S. Health and Human Services Secretary Robert F. Kennedy Jr. the administration has worked to reduce funding for federal agencies that publicly subsidize mental health research, including the National Institute of Mental Health, the Substance Abuse and Mental Health Services Administration and Health Resources and Services Administration. 

Under Kennedy’s leadership, SAMHSA also announced a Make America Healthy Again initiative this past May to wean patients — both adults and youth — off of prescribed mental health medication in favor of nonmedication treatment options. Patient advocacy groups and medical professionals have pushed back. They highlight the “robust” depth of clinical research showing safety and efficacy, and the need for more patients to have access to professional, evidence-based care. Using words like “overprescribing” only stigmatizes medication treatments that in most cases are not habit-forming.

Despite these policy headwinds, there is hope. Many mental health symptoms are treatable. And no matter how people lived in the past, we all deserve to live happy, healthy and fulfilling lives.

To learn more, NAMI Minnesota has a booklet explaining inpatient hospitalizations and how families can help. If you or somebody you know is experiencing a mental health crisis, call or text the suicide and crisis lifeline at 988. Caring counselors are here for you. You are not alone. In life-threatening situations, call 911.