Q & A with a Psychiatrist #1

Navigating mental healthcare can be a difficult and confusing process. In our new monthly column, we take your questions for a psychiatrist and ask the professionals on your behalf.

Please note that this article is for educational purposes only. The following does not constitute official medical advice, and no treatment relationship has been established. You should consult your own doctors to best understand the needs of your unique situation. If you or someone you know is in crisis, please visit the nearest emergency room or call the National Suicide Prevention Hotline at 1-800-273-TALK(8255), which is a 24/7 toll-free number. For non-crisis situations and non-U.S. resources, check out the resources on our Find Support page.

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This month's question:

In what situations can I admit myself into a psychiatric ward?

Dr. Wang says:

There are different levels of treatment in the mental health system, and finding the right level of care may seem a daunting task at first. Fortunately, you don't have to navigate the system alone - there are mental health professionals in various settings that can help you figure out where to go.

For now, let’s focus on when it is the right time to go to a psych ward, aka, inpatient psychiatric hospitalization. I will start by introducing you to what we, in the field, call admission criteria, or the conditions that must be met for someone to be “inpatient level of care”. To satisfy admission criteria, one must exhibit one of the following due to their mental condition:

1. Potential for harm to self, as demonstrated by active suicidal thoughts with intent to follow through

2. Potential for harm to others, as in thoughts / plan of hurting others OR

3. Severe impairment in one’s ability to function on a day-to-day basis (i.e. not eating, not taking care of personal hygiene, ongoing negligence of work or school due to a mental condition).

At times, patients are also admitted to the psych ward to make medication changes that may be too risky to take on outside of a medically monitored setting (i.e. risk of side effects or potential complicated withdrawal symptoms from certain medications or substances). These criteria are essentially a measure of the severity of one’s illness.

All of that basically says: if you feel so distraught that you worry about your own safety, or worry that you might hurt someone else, you should definitely go to a psychiatric hospital. If you feel that day-to-day living is a challenge – you can’t manage to eat, shower and dress yourself, or you can’t manage to leave your house or dorm, you should go to a psychiatric hospital.

Again, keep in mind that you do not have to make this determination alone. If you have a psychiatrist or a therapist, you could discuss hospitalization with them. Often, your treater can help facilitate the hospitalization process by giving the hospital admission team a call or sending in a referral. If you don’t yet have a mental health treater, you could go to a local crises center or an emergency room, where mental health professionals on staff who will evaluate you and determine an appropriate level of care and get you started on that path (we call this “triaging”). So while it helps to know what admission criteria are, you don’t have to make that decision on your own.

The most important thing is – tell someone, get help.

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Got questions you want to ask Dr. Wang? Submit them to our social media @L2Smentalhealth or email them to us by the 15th of each month for a chance to see your question answered!

ABOUT DR. WANG

Dr. Ying Wang is a psychiatrist in Pennsylvania, USA. She received her medical degree from Yale University School of Medicine and completed her residency at Harvard Medical School’s Massachusetts General Hospital/McLean Hospital adult psychiatry program.