PES (Psychiatric Emergency Services)

INEWS101A-MentalHealthHolds

I’d been in the psychiatric emergency rooms at South Street hospital more times than I could count.  But that was an old hospital. The rooms were basically just regular rooms, except the chairs were bolted to the ground.  One of them had an ugly green tiled floor.  One of them had a stretcher in it.  There were chairs just outside for the security guards to sit.

In July 2011, I was in a different hospital emergency room.  This hospital was newer and had an updated PES (Psychiatric Emergency Services) department.  The door to the department was locked at all times.  There were 4 small rooms, similar to the one in the picture above except the chairs were bolted down, and one washroom.  In the washroom the toilet was metal and had no seat.  The sink was metal and attached to the wall.  In the central area between the 4 rooms there was a water fountain and two telephones attached to the wall.  In the central area there was also a stretcher with restraints on it. Separated by another locked door was the nursing station.  Each of the rooms had cameras in them (except the washroom).  The nursing station had a window which looked into the department.  The washroom reminded me of what I imagine a jail looks like.  In fact the whole experience was like being in jail.

My family was out of town visiting my ex-husband’s extended family.  I was in my last weeks of the practical placement that would complete my Masters degree.  Ironically my placement was in a psychiatric hospital.  The depression that had crept back into my life in the Fall of 2009 had worsened.  There were many reasons for this.  I felt desperate and I had tried all the medications that were available.  I began to seriously consider ECT (electroconvulsive therapy aka shock treatments).  This had been suggested to me in the past around 2004, fairly early on in my psychiatric survivorship story.  At that time I felt it was too soon, I hadn’t tried a whole class of medications.

In 2011 I felt like my options were suicide or ECT and I preferred the ECT.

I wasn’t coerced, I wasn’t pressured into it.  I sought out the treatment myself with the support of my outpatient psychiatrist.  Since he has no privileges at the local hospitals my best bet was to go to the ER and ask for a consult.

My plan was to do this as an outpatient.  But things went awry.   When I told the psychiatric resident how much I was struggling and how suicidal I was she wouldn’t let me leave.  The doctor on call told me I had to be admitted to the hospital and that if I didn’t agree to stay she would admit me on a Form, involuntarily.  At this point, locked in PES, I decided my best option was to cooperate.   I hadn’t brought anything with me, and there were no beds open on the Mental Health Unit, so I was forced to spend 24 hours locked in PES.

I can’t remember exactly when I cracked, but I phoned a friend.  I told him where I was and that I wasn’t allowed to leave.  I cried to him on the phone. He was a friend from school and I was so embarrassed to be calling him from the hospital.  I felt like it was my one call to the outside world after being arrested.   I didn’t want to tell my parents, but the next day I finally did, so they could bring me some clothes and items.

Staying overnight in PES was not a pleasant experience.  The lights were always partially dimmed in the center hallway.  There were no windows to the outside world.  This place was literally a prison.

The white sheet on the bed left lint and little pills all over my lululemon yoga jacket.  They are still there to this day!  Also to this day the smell of the soaps and sheets in hospitals triggers me.  Hospitals have this very specific smell, a mix of bleach and antibacterial soap (the cheapest kind).

Meals arrived on a tray, but there was nothing I wanted to eat.  Somehow in the morning, after almost no sleep and nothing to eat, I convinced the nurse to let me go to the cafeteria to buy a snack.  I argued that since I was a voluntary patient I should be allowed and for whatever reason they reluctantly agreed.  I ate a muffin and drank some hot coffee.

The doctors came back the next day, and eventually I was moved up to the 4th floor.  I stayed for one night on the unit.  I told the doctors what I wanted: outpatient ECT.  We called my ex-husband and discussed this with him.   Everything was agreed upon and I was given an appointment to meet the doctor the next week.  I convinced them that I would be safe at home and they discharged me.  They wanted me to stay but I wanted to leave.

The hospital always seems like a good idea from the desperation of home.  But once you are there you realize that it isn’t a very safe place either.  A good part of this is because you are at the mercy of others and have very little control over your own life.  That and the doctors have the power to hold you against your will at any time.

I wonder…why do they make PES look like a prison?

Why are psychiatric patients treated like criminals?

Surely someone could design a safe and secure section of the hospital that actually looked and felt healing.  I’m willing to bet the person that designed PES had previous experience designing prisons.

I’m not a criminal.  I would heal and relax more quickly if I was in a hospital environment that felt welcoming and relaxing.  The very environment of PES conveys a lack of respect and a perspective on the status of the patients/prisoners.  PES brings up a deep sense of shame in me.  I begin to feel crazy because I am trapped and forced to comply with the orders of the staff.  In PES, you feel you have hit rock bottom.

“You are crazy.  You can’t be trusted.  We think you are going to hurt us.  You need to be locked up for our safety and for your own.  Behave or you will be locked up here indefinitely. We couldn’t be bothered to make this place welcoming or comfortable.  Because you are crazy your comfort is not our priority.  Get used to it”

This is what mental health stigma looks like.

 

2 thoughts on “PES (Psychiatric Emergency Services)

  1. “Why are psychiatric patients treated like criminals?, this is what mental stigma looks like” – a fabulous read, and I couldn’t agree more. The world really, really needs to change their perception about psychological disorders.

    Like

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