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Recovery isn’t just about stepping through the window—it’s about what lies beyond it. Join clinicians, staff, and special guests as we explore addiction recovery, mental health, trauma, and breaking stigmas with honesty, hope, and expert insight. Through raw conversations and transformative stories, we shed light on the journey of healing—because every voice matters, and no one walks this path alone.
La Ventana means "The Window" in Spanish—and this podcast is your invitation to look beyond it.
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What about the myth that psychiatric
hospitals is only for crazy people,
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and only for those
that are extremely violent and dangerous?
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I think that's so unfortunate and sadly,
I hear that when sometimes
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families are calling to find a place
to put their loved one, that's not well.
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And I just tell them, you know, mental
health doesn't discriminate.
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It's from the park bench to park place
and everywhere in between.
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Mental health care
isn't about other people.
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It's about any of us who might need help.
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Yet Hollywood stereotypes
and outdated fears have created
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a dangerous misunderstanding
about psychiatric treatment facilities.
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On this episode of Beyond the Window.
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La Ventana’s Chief Clinical Officer
Sharon Volner sits down with Carla DiCandia
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Director of Business Development
at Oceanview Psychiatric
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Facility, to separate fact from fiction.
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We'll expose the truth
about forced medication.
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Walk you through a real day in treatment
and reveal
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what psychiatric care actually looks like
when the cameras aren't rolling.
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This is beyond the window.
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Welcome to Beyond the Window podcast.
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My name is Sharon.
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Volner,
Licensed Marriage and Family Therapist.
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And you are?
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I am Carla DiCandia.
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I'm the Director of Business
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Development at Oceanview
Psychiatric Health Facility in Long Beach.
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I am so excited to have you here.
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This has been a long time desire for me.
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Because I really want to look at this,
tackling
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this crucial topic of psychiatric
health care.
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What it is. What it's not.
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Psychiatric health care facilities
have been sensationalized in the media
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and glorified as these horrific,
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awful, locked up,
One Flew Over the Cuckoo's Nest type of,
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places.
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And I
really think that psychiatric health care
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really deserves a conversation
about what it is and what it's not.
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So thank you for joining us today.
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My pleasure. My pleasure.
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So what is your interest?
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Let's start.
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There is what what made you want to work
in psychiatric health care?
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I, I, I have to say, it was,
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not necessarily
something I knew was coming.
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I was,
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working in corporate health
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care, at a large Catholic health system,
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and then fell in love with an alcoholic
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and then thought, well,
this is interesting.
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And went to work for a rehab
as the director of clinical outreach
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and then got recruited to work
in a psychiatric hospital.
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I really didn't think twice about it.
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I didn't ever stop to be like.
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Oh, a psych hospital.
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You know what I mean?
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It just, for me,
it was like, it's health care.
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It's just it's, an opportunity in health
care.
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And so. And I love it.
And I've been there eight years.
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And I love that you say that
an opportunity in health care.
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Because most people when you say
psychiatric facility or psych hospital,
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people are automatically thinking
an insane asylum, the cuckoo house,
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people are wearing straight jackets.
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It's like girl interrupted
and other movies that have really put
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a different spin and stereotype
and created this fear based,
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ideal.
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That really isn't true.
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And so I really wanted to look at today
as to what is a health care facility
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or hospital like, like Oceanview
and what goes on in there.
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And I have some notes here,
because there are some really interesting
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myths out there that I want us to debunk
today for our viewers and listeners.
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Let's do it.
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Okay, so psychiatric
hospitals are like asylums
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from a horror movie dark, scary,
full of screaming and crazy people.
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We hear that a lot. Yes we do.
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What are they really?
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These
are just people who are experiencing acute
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psychiatric symptoms
and for a variety of reasons.
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Oh, so disclaimer I'm not a doctor.
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I'm not a therapist,
I'm not a medical professional.
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So all of my opinions and,
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things that I share with you
today are based on my life experiences
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with psychiatric patients.
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So it's all anecdotal. Yeah.
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But they're usually with us because
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they their symptoms
have overtaken their lives.
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And I'm much like,
I guess how an addiction
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would make someone's life unmanageable.
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All these symptoms do the same thing.
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And so now you have somebody
I mean, I have major depressive disorder,
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and I know there are days when I'm not
properly taking meds or whatever,
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or when I've been in depressive episodes
where if you ask me to get up
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and brush my teeth, it's like,
oh my God, that's like moving a mountain.
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The energy, the thought.
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And it's like, well,
my teeth won't fall out if I just take,
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you know, but it's just it's
it can just be.
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It can be anything.
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It can be the racing thoughts
that keep you awake at night.
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It can be,
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you know, walking down the street
and you've kind of crossed the line
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from being vigilant and aware of your
surroundings to hyper vigilant like,
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oh my God, it's like most people,
are they talking about me?
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I don't know them,
but what are they saying?
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You know, it just it's it's once
it's become unmanageable.
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So that's who's in psychiatric hospitals,
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I will say also in locked units.
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I don't work in a locked unit.
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I work in a voluntary unit.
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So we don't have police, officers
or ambulances dropping people off
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at my hospital.
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But in locked units
where they do 5150, they do have that.
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And so it might be somebody who is
in a psychosis and committed a crime.
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Does it mean they're criminal?
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Not necessarily.
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It means they're not.
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Well, and something went wrong.
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But but yeah,
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this whole concept of like,
there's screaming and
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I, I have heard loud persons on my unit,
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there's one woman who loves to sing,
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and so she'll be walking down the hallways
and singing joyfully.
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There's another woman who cries.
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And so you might hear her crying
very loudly,
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but it's their human beings.
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And you said a whole lot.
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And I want to kind of like, oh, sorry.
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No, no.
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First of all, I love your vulnerability
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that you're disclosing that you have also
and do struggle with depression.
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Yeah. And,
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have times
where you're struggling with basic stuff
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that we should all be doing right, getting
up, making our bed, brushing our teeth.
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But sometimes the struggle is real.
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And I always love to say that,
you know, everyone struggles.
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Everyone has mental health.
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Yes, everyone has mental health.
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It's how are we managing it?
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And it's okay to normalize
the conversation that sometimes
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we're having a little more symptoms
and others the racing thoughts.
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Or are those people talking about me
or depression?
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So mental health
shows up in a variety of ways
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and we becomes unmanageable
and an impairment.
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It earns, the title of a diagnosis
which I really believe,
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if we can name it, we containment.
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Kind of like what the seagull says.
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So that's what the name is for.
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It's for insurance. It's for medication.
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If I know the stars called peanut butter,
I know it goes with jelly.
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Yeah. So I'm not going to put it in
something else.
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But if we can name it, we can tame it.
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And if we can't tame it, it's
not that we're crazy.
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It's not that we're psychotic,
which is literally its own diagnosis
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of having auditory, visual, aural factory
hallucinations.
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It's something is off
and I need to manage it.
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And sometimes voluntary,
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hospitalizations can be a safe
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way as an early intervention
so that things don't become worse.
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So it's not the loony bin
in the crazy house.
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And and all the extremes
that we've seen in Hollywood and media.
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But it's really,
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and I've been to Oceanview,
so I can attest that
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it's a beautiful, clean,
very well-lit facility with single rooms
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and group rooms and windows
and so much light.
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And people are singing
and people are just learning
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how to manage their day to day struggles
with a ton of professionals,
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onsite
nurses, doctors, health care workers.
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And it's not this these images
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that we see on in Hollywood
now, sometimes those do exist.
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Those are generally
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for the locked facilities where people are
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in imminent danger
of hurting themselves or others.
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So and I will I will also add that
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even on on those locked units, yes.
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Generally they they separate
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the, the, the patient population
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into high high acuity and other acuity.
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Yeah.
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And they might
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if they have the space, they might even go
as far as to have a low acuity unit too.
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So I don't want people to be afraid.
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Like if you go voluntarily
and it happens to be at a locked unit,
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that you're going to be
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with the people that the cops are dropping
off, that that's not necessarily true.
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Yeah.
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So just I just wanted to clarify that.
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Absolutely.
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That they're not usually intermixed. Yeah.
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And those people also are people
that need treatment
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just showing up at a different
severity. Right. And
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yeah, they say thank.
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You for that.
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They wait for some people.
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Wait too long or just become,
you know, in a state of denial.
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I don't want to admit.
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I mean, how often do we get help
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when the red flag warnings are there?
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Or do we wait when it's a little too late
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and then we're like,
oh man, what do I do now?
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Right.
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Well, even when we look at the statistics
for people
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getting help for depression, yes,
I think it's,
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an average of suffering with the symptoms
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for five years before seeking treatment.
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And that's not even seeking
medical treatment.
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It could be there. Basic therapy.
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And then, you know how many years I did
I did two years
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of psychotherapy actively.
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And I still hold a slight resentment
that he didn't ever tell me, like,
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oh, hey, by the way, you, have
clinical depression, you know what I mean?
00:10:05:12 - 00:10:07:13
But. And then finally get medicated.
00:10:07:13 - 00:10:09:18
But it's it's on average,
just five years. Yeah.
00:10:09:18 - 00:10:11:19
Well, it's nice
that today the conversation is
00:10:11:19 - 00:10:16:06
being normalized with platforms like this
where we could talk about psychiatric
00:10:16:06 - 00:10:20:18
care, mental health care, therapy,
medications, like, it's all okay.
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There are so many different options
to access help. Yeah.
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And if we talk about it and normalize
the conversation, more people
00:10:26:07 - 00:10:28:19
are likely to get early intervention
and help. Yeah.
00:10:28:19 - 00:10:30:12
Because what we don't want happen
00:10:30:12 - 00:10:34:19
is we get to a state where we're isolated,
we're paranoid, our thoughts are racing,
00:10:34:22 - 00:10:37:22
we're afraid to tell anyone
that we're not feeling ourselves.
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And then it ends up
being an emergency admission anywhere.
00:10:42:02 - 00:10:43:19
Yeah. So that is very scary.
00:10:43:19 - 00:10:44:03
Yeah.
00:10:44:03 - 00:10:49:06
So another myth I want to run by you
is once you go to a psychiatric hospital,
00:10:49:06 - 00:10:53:07
you're locked away, and you can't leave,
and they force you to stay indefinitely.
00:10:53:15 - 00:10:57:23
Yes. I can't tell you how many times
patients,
00:10:58:18 - 00:11:02:04
a loved one has called with them, and,
and wants them to get help.
00:11:02:14 - 00:11:06:00
And aside from obviously my unit
being voluntary. So.
00:11:06:00 - 00:11:06:23
No, you're not locked in.
00:11:06:23 - 00:11:09:23
The doors are literally unlocked,
and you can walk out any time.
00:11:11:00 - 00:11:11:18
But they say
00:11:11:18 - 00:11:14:21
if I go in, they'll never let me out.
00:11:14:21 - 00:11:15:19
Right?
00:11:15:19 - 00:11:18:19
And I've heard that phrase so many times,
00:11:20:10 - 00:11:21:15
and it's not true.
00:11:21:15 - 00:11:24:19
I mean, the fact of the matter is,
even when there are people where I'm like,
00:11:25:06 - 00:11:27:11
oh God, I wish we could keep them here
longer because it's not.
00:11:27:11 - 00:11:30:15
Well, we can't, it's just that's
00:11:30:15 - 00:11:33:15
just not the way the laws are written.
00:11:34:10 - 00:11:35:11
They just can't.
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So legally, you know, there's a process
00:11:38:14 - 00:11:42:13
and if you go in voluntarily,
00:11:42:20 - 00:11:46:01
can they write a hold at my facility? No.
00:11:46:07 - 00:11:50:08
In other facilities,
they can, it's usually for 72 hours.
00:11:50:18 - 00:11:54:15
And it's usually if you're an imminent
risk of hurting yourself and others.
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And so that imminent part is very crucial
because,
00:11:58:23 - 00:12:01:22
unless you are in immediate danger.
00:12:01:22 - 00:12:06:16
Of. Hurting yourself with a plan, title
and intent, it's not going to happen.
00:12:06:16 - 00:12:09:10
And it it patients do have rights.
00:12:09:10 - 00:12:13:19
Patient can self discharge
and patients can come and patients can go.
00:12:14:01 - 00:12:20:21
And so that 5150 code which
is the involuntary hold or for teens 5585
00:12:22:03 - 00:12:23:13
sometimes it's voluntary.
00:12:23:13 - 00:12:23:18
Yeah.
00:12:23:18 - 00:12:25:06
It can be voluntary where they can
00:12:25:06 - 00:12:29:01
come and go and seek the treatment
that they need and leave. Yes.
00:12:29:01 - 00:12:34:16
And I'll tell you to your point,
when people self admit to a locked unit,
00:12:34:16 - 00:12:37:23
but they're admitting voluntarily,
sometimes
00:12:38:11 - 00:12:44:08
I'm of the opinion
that the hospital's right to hold merely
00:12:44:08 - 00:12:48:07
for the sake of getting that state
authorized by the insurance,
00:12:49:02 - 00:12:51:21
because the insurance companies
don't want to believe
00:12:51:21 - 00:12:55:11
that people are checking themselves
into a psych unit for treatment.
00:12:55:11 - 00:12:58:12
They still kind of view it as like
they're just taking a vacation.
00:12:59:00 - 00:13:01:05
I will not comment on anything
about insurance. Yeah.
00:13:01:05 - 00:13:05:00
But but so yes, I do get written. Yes.
00:13:06:07 - 00:13:07:13
I don't know much about them.
00:13:07:13 - 00:13:11:18
Yeah, but even if the doctor said,
hey, Sharon, you know what?
00:13:11:18 - 00:13:15:16
You've been here three days
and your hold is up and you're not well,
00:13:16:01 - 00:13:18:02
so I don't feel comfortable
discharging you.
00:13:18:02 - 00:13:20:07
And I want to keep you longer.
00:13:21:20 - 00:13:22:10
That's great that
00:13:22:10 - 00:13:25:11
he has that opinion,
and he has to present that to a judge
00:13:25:11 - 00:13:29:00
and a meet or a mediator,
whoever's, facilitating for that hospital.
00:13:29:15 - 00:13:34:02
And that judge has to give approval,
and the patient
00:13:34:02 - 00:13:38:06
has the opportunity to attend the hearing
and advocate on their own behalf.
00:13:38:17 - 00:13:41:04
And even then, the judge will say,
00:13:41:04 - 00:13:44:01
let's say the judge says, yes,
I agree with you, doctor.
00:13:44:01 - 00:13:46:19
I'm going to extend the hold
for up to 14 days.
00:13:46:19 - 00:13:49:13
That doesn't mean you're going to be there
the whole the whole time.
00:13:49:13 - 00:13:52:21
It's entirely up to the doctor
in terms of when you discharge.
00:13:53:16 - 00:13:56:15
And then if after the 14 days of,
say, doctor's like,
00:13:56:15 - 00:13:59:15
gosh, you're and you're still not well,
00:13:59:17 - 00:14:02:17
you know, I, I think we need to pursue
additional measures.
00:14:02:17 - 00:14:04:12
They can go back, but it does.
00:14:04:12 - 00:14:06:08
Nothing happens automatically.
00:14:06:08 - 00:14:08:20
The patient is involved in all of it.
00:14:08:20 - 00:14:11:00
The patient has a
right to have an advocate there with them.
00:14:11:00 - 00:14:14:00
So this whole, like,
you're going to be there forever.
00:14:14:01 - 00:14:17:01
It's it's it's literally
almost impossible.
00:14:17:10 - 00:14:19:18
If you're going to be there forever,
you'll know well in advance
00:14:20:19 - 00:14:22:01
that that's the plan.
00:14:22:01 - 00:14:24:15
Right? So it's not what we see on TV. Or.
00:14:24:15 - 00:14:25:15
People are coming
00:14:25:15 - 00:14:27:01
and they're taking you
in the middle of the night,
00:14:27:01 - 00:14:29:12
and you're in a straitjacket
and a padded room
00:14:29:12 - 00:14:31:18
and you're locked against your well
and forget about it.
00:14:31:18 - 00:14:34:21
Like there's an actual process
that the patient is a legal.
00:14:35:12 - 00:14:36:09
Yeah. An absolutely.
00:14:36:09 - 00:14:39:14
I love that you said that a legal process
that the patient is a part of.
00:14:39:21 - 00:14:42:16
And it's it's part of coordinated care.
00:14:42:16 - 00:14:44:02
Yeah.
00:14:44:02 - 00:14:47:02
And so thank you for debunking that one.
00:14:47:05 - 00:14:51:05
My other favorite
myth out there is that people get drugged.
00:14:51:12 - 00:14:54:12
So there's zombified and compliant.
00:14:54:19 - 00:14:58:11
Okay,
so here's the other interesting part.
00:14:59:07 - 00:15:01:03
Again, I work in a voluntary facility.
00:15:01:03 - 00:15:03:18
So if you're in the doctor, sit down.
00:15:03:18 - 00:15:06:22
You come up with a medication plan of yes,
00:15:06:22 - 00:15:10:04
doctor explains it to you
and you're like, yeah, no,
00:15:11:05 - 00:15:14:00
I don't I don't
actually like the side effects of that.
00:15:14:00 - 00:15:15:07
Is there something else?
00:15:15:07 - 00:15:17:18
So it's very collaborative.
00:15:17:18 - 00:15:21:07
And I know that because we've actually,
in our residential programs,
00:15:21:07 - 00:15:24:16
have assessed clients
to see if they're an appropriate fit
00:15:24:16 - 00:15:28:22
for our residential programs, because
we do believe that care is on a continuum.
00:15:28:22 - 00:15:31:22
So if you're in a psych hospital,
it is recommended that you seek outpatient
00:15:31:22 - 00:15:34:15
therapy
or therapy as a residential or outpatient.
00:15:34:15 - 00:15:38:04
So I know firsthand that we've interviewed
clients that are like,
00:15:38:04 - 00:15:41:04
I'm in a psych facility,
I'm receiving care.
00:15:41:05 - 00:15:44:23
I like the medications that I'm on, but
I would maybe like to try alternatives.
00:15:45:06 - 00:15:48:12
And I'm open to coming to your program
or I'm open to this.
00:15:48:12 - 00:15:52:23
And I'm so it's very collaborative
and it's a conversation between the doctor
00:15:52:23 - 00:15:53:13
and the patient.
00:15:53:13 - 00:15:56:22
It's not that the doctor is always right,
it's the doctors making medication.
00:15:56:22 - 00:15:58:23
Right. Suggestions.
00:15:58:23 - 00:16:01:03
And the patient is a part of that process,
too. Yes.
00:16:01:03 - 00:16:04:20
And then the absolutely the patients
and the clients do have a say
00:16:04:23 - 00:16:08:04
in their care when of course, it's
not an extreme situation.
00:16:08:04 - 00:16:11:09
But I also know
back to the previous point about holds
00:16:11:17 - 00:16:15:20
is if a client has a safe outpatient plan,
00:16:16:01 - 00:16:19:02
sometimes
the holds are kind of lifted early.
00:16:19:13 - 00:16:23:07
So but people are not overmedicated
they're not doing that shuffle.
00:16:23:07 - 00:16:25:16
Well they're not I. Mean there are
00:16:27:09 - 00:16:28:19
I think it's important to clarify.
00:16:28:19 - 00:16:32:15
Yes. This one point,
even if you're on a hold,
00:16:33:00 - 00:16:36:00
a 5150, a 5250.
00:16:36:00 - 00:16:38:08
Then that's the shorter
hold versus the. Yes.
00:16:38:08 - 00:16:38:21
Okay.
00:16:38:21 - 00:16:42:06
They cannot force you to take medication
00:16:43:08 - 00:16:46:08
period.
00:16:47:21 - 00:16:50:04
The only time that you can be
00:16:50:04 - 00:16:54:04
forcibly medicated, there's two times
00:16:54:17 - 00:16:59:01
one if you're on a hold
and you are out of control,
00:16:59:01 - 00:17:03:20
you are becoming a hazard
to the people around you or to yourself.
00:17:04:07 - 00:17:07:18
That's when you hear about people
getting taken down and injected
00:17:07:23 - 00:17:09:14
against their will.
00:17:09:14 - 00:17:13:09
That injection is a sedative,
and it's a strong one.
00:17:14:05 - 00:17:17:05
And it usually will take somebody out
for like a day.
00:17:17:05 - 00:17:18:18
Those are very extreme situations.
00:17:18:18 - 00:17:20:15
Those are very extreme situations.
00:17:20:15 - 00:17:25:02
And so, you know, I hear it a lot where
patients are like, oh, you know what?
00:17:25:02 - 00:17:28:10
I was at this unit
and they forcibly injected me.
00:17:28:16 - 00:17:30:21
And, you know, in the back of my head
I'm like,
00:17:30:21 - 00:17:33:13
you know, that all has to be documented
and justified.
00:17:33:13 - 00:17:36:17
So something happened.
And there's cameras.
00:17:36:17 - 00:17:39:16
And there's there's no,
you know, stops and it's.
00:17:39:16 - 00:17:41:04
Very few.
00:17:41:04 - 00:17:43:19
Oh yeah. Frequent.
00:17:43:19 - 00:17:45:16
Yeah. Not like what we see in Hollywood.
00:17:45:16 - 00:17:47:02
No, no.
00:17:47:02 - 00:17:49:19
And then the other time
that they can force you
00:17:49:19 - 00:17:53:04
to take medications again,
you have to be on a hold
00:17:53:20 - 00:17:58:11
and there's a legal proceeding
that is attached to the request.
00:17:58:11 - 00:18:02:17
So if the doctor's like Sharon, you're
if you've been refusing medications
00:18:02:17 - 00:18:04:20
the whole time you've been on the hold,
it's been three weeks now.
00:18:04:20 - 00:18:06:06
You're not getting better.
00:18:06:06 - 00:18:08:15
I'm going to petition the court.
00:18:08:15 - 00:18:11:06
It's called a hearing. And,
00:18:12:17 - 00:18:14:10
it's a whole process.
00:18:14:10 - 00:18:18:15
And the doctor and I, the patient again,
has the opportunity
00:18:18:15 - 00:18:22:02
to represent themselves,
but it requires a hearing
00:18:22:11 - 00:18:25:11
in order for the judge to say,
you know what?
00:18:25:17 - 00:18:27:20
The doctor's right, Sharon,
00:18:27:20 - 00:18:30:12
you're not making good decisions
for your health.
00:18:30:12 - 00:18:36:13
And so we're going to, take this matter
into our hands and medicate you.
00:18:36:16 - 00:18:37:10
Yeah.
00:18:37:10 - 00:18:40:09
That's the only way
you're going to be forcibly medicated.
00:18:40:15 - 00:18:42:18
So I'm glad you asked that. Yeah.
00:18:42:18 - 00:18:43:23
Because people really think that
00:18:43:23 - 00:18:45:16
they're like, well,
if I come, you're going to make me.
00:18:45:16 - 00:18:49:08
No, no, nobody can make you like you
no matter how badly we want to.
00:18:49:11 - 00:18:50:14
If you need it.
00:18:50:14 - 00:18:52:01
Because there are those times you're like,
00:18:52:01 - 00:18:53:18
oh my gosh,
this person would be so much better.
00:18:53:18 - 00:18:54:15
Their life would be so much better.
00:18:54:15 - 00:18:57:12
But no, there's no there's nothing.
00:18:57:12 - 00:18:59:07
We can't do it. Yeah.
00:18:59:07 - 00:19:03:03
So what about the myth that psychiatric
hospitals is only for crazy people,
00:19:03:14 - 00:19:06:21
and only for those
that are extremely violent and dangerous?
00:19:07:01 - 00:19:07:20
What do you say about that?
00:19:09:09 - 00:19:12:09
I think that's so unfortunate.
00:19:13:12 - 00:19:16:17
And I sadly,
I hear that when sometimes families
00:19:16:17 - 00:19:19:22
are calling to find a place
to put their loved one who's not.
00:19:19:22 - 00:19:22:21
Well, and
00:19:23:15 - 00:19:26:15
I just tell them, you know.
00:19:27:00 - 00:19:29:10
Mental health doesn't discriminate.
00:19:29:10 - 00:19:33:16
It's from the park bench to park place
and everywhere in between.
00:19:34:10 - 00:19:37:11
And I up over the eight years.
00:19:37:11 - 00:19:42:18
I can't tell you how many different
people, different races,
00:19:42:18 - 00:19:47:12
different ethnicities,
different sexual orientation, like,
00:19:48:23 - 00:19:50:18
different career paths,
00:19:50:18 - 00:19:53:18
different socioeconomic levels.
00:19:54:09 - 00:19:56:02
I've had
00:19:56:02 - 00:19:58:18
rheumatologists, I've had chiropractors,
00:19:58:18 - 00:20:02:12
I've had firefighters,
I've had, you name it, lawyers.
00:20:02:12 - 00:20:03:18
Like,
00:20:03:18 - 00:20:06:18
when it gets to be too much, it's
too much.
00:20:06:20 - 00:20:10:12
It doesn't matter who you are
or where you're at, it's just too much.
00:20:10:21 - 00:20:14:16
And it's just like people
also ask like, well,
00:20:14:16 - 00:20:15:20
what kind of people are there right now?
00:20:17:12 - 00:20:20:13
The humankind,
the human kind of psychiatric symptoms.
00:20:21:02 - 00:20:21:23
Does that help?
00:20:21:23 - 00:20:22:04
Yeah.
00:20:22:04 - 00:20:24:10
You know, it's like I, what do I tell you?
00:20:24:10 - 00:20:25:06
They're all ages.
00:20:25:06 - 00:20:29:04
We're 18 and over,
so it's across the spectrum.
00:20:29:05 - 00:20:30:01
Yeah.
00:20:30:01 - 00:20:31:15
And there's adolescent hospitals, too.
00:20:31:15 - 00:20:32:15
Specifically for adolescents.
00:20:32:15 - 00:20:36:05
We're talking about
symptoms, mental health symptoms
00:20:36:11 - 00:20:40:00
that are far beyond one's ability
to manage.
00:20:40:00 - 00:20:42:05
That just needs more intervention.
00:20:42:05 - 00:20:45:22
So when you talked about chiropractors
and other professionals,
00:20:45:22 - 00:20:49:13
that leads me to the next myth
that psychiatric hospitalizations,
00:20:49:20 - 00:20:53:01
just the idea of being in a psych
hospital will ruin your career.
00:20:53:04 - 00:20:55:11
It'll ruin your life,
ruin your reputation,
00:20:55:11 - 00:20:57:20
and it'll be something that you're going
to be ashamed of later on.
00:20:57:20 - 00:21:00:11
If you do it. How will they know?
00:21:00:11 - 00:21:01:02
That's my question.
00:21:01:02 - 00:21:03:19
How will they know
unless you tell them? Yeah.
00:21:03:19 - 00:21:05:06
And it's confidential.
00:21:05:06 - 00:21:07:02
Super confidential. And
00:21:08:04 - 00:21:09:02
every client, every
00:21:09:02 - 00:21:12:20
patient has a right to confidential care
at any level of care at any facility.
00:21:12:20 - 00:21:15:05
It doesn't follow you. It's
not on your resume, right?
00:21:15:05 - 00:21:19:23
It doesn't prevent you
from fulfilling your life and career path.
00:21:20:10 - 00:21:21:21
No, it's personal health information.
00:21:21:21 - 00:21:23:23
It's not. No, no protected
health information.
00:21:23:23 - 00:21:24:05
Yeah.
00:21:24:05 - 00:21:27:11
It's it's nobody has a right to it.
00:21:27:11 - 00:21:29:07
Yeah.
00:21:29:07 - 00:21:31:22
I know people sometimes
worry about like the bigger health
00:21:31:22 - 00:21:35:04
systems and,
you know, are all of those like,
00:21:36:00 - 00:21:39:10
hospitals have access to everybody
else's records and other hospitals,
00:21:39:10 - 00:21:41:21
and that's not usually the case. Yeah.
00:21:41:21 - 00:21:42:04
Yeah.
00:21:42:04 - 00:21:45:05
I, I that my, my answer to
that is how will they know.
00:21:45:11 - 00:21:46:18
Yeah.
00:21:46:18 - 00:21:48:07
So take me through the process.
00:21:48:07 - 00:21:53:05
If there are, there are someone out there
that is struggling with anxiety,
00:21:53:05 - 00:21:57:12
depression, trauma, paranoia, racing
thoughts just something isn't right.
00:21:57:12 - 00:22:00:00
Their level of functioning is impaired.
00:22:00:00 - 00:22:00:10
Somehow.
00:22:00:10 - 00:22:02:14
Relationships aren't going well,
00:22:02:14 - 00:22:05:18
they're not able to function
and they're afraid to come to a hospital.
00:22:05:18 - 00:22:10:07
What might they expect from the first
phone call to their last day there?
00:22:10:07 - 00:22:11:14
Take me through that process,
00:22:11:14 - 00:22:15:13
because I know as a health care
professional, you know, we've called you
00:22:15:17 - 00:22:21:09
we've had you personally sit on the phone
with clients for as long as they need it,
00:22:21:09 - 00:22:25:15
which is really impressive
seven days a week, any hour of the day.
00:22:25:15 - 00:22:28:16
You've been so accessible
to tell your story, share
00:22:28:16 - 00:22:32:12
your experience, strength and hope
with other people that are also struggling
00:22:32:16 - 00:22:36:12
and say, hey, as an ally, as a person
who doesn't just work
00:22:36:12 - 00:22:40:12
in a psych hospital or psych facility,
let me tell you about it.
00:22:40:12 - 00:22:42:02
Let me tell you what to expect.
00:22:42:02 - 00:22:43:15
And when you get there, I'll see you too.
00:22:43:15 - 00:22:45:03
Yeah. So like that. So.
00:22:45:03 - 00:22:47:12
So what happens after
they make that initial phone call?
00:22:47:12 - 00:22:50:22
So anytime you call a psych hospital
00:22:50:22 - 00:22:53:23
to find out about admitting,
they're going to ask you questions,
00:22:54:19 - 00:22:58:11
they're going to ask you a lot of times
they'll ask you, where where are you now?
00:22:58:22 - 00:23:00:11
What is the address you're at now?
00:23:01:13 - 00:23:03:02
And that's for the purpose of if,
00:23:03:02 - 00:23:08:03
if we need to send an emergency, my unit,
not ours.
00:23:08:03 - 00:23:09:13
But so let's just talk about it.
00:23:09:13 - 00:23:11:16
So I'm suicidal, right?
00:23:11:16 - 00:23:13:19
Yes. And I want to hurt myself.
00:23:13:19 - 00:23:16:20
I'm not going to
because I really want to get care.
00:23:17:09 - 00:23:20:21
So if I give you my address,
are you going to show up with police?
00:23:21:06 - 00:23:23:21
And, you know,
these big people that are going to, like,
00:23:23:21 - 00:23:27:20
put me in a, in a, in a straitjacket
and then like, take me away?
00:23:28:00 - 00:23:30:03
Or is it safe to have that conversation
00:23:30:03 - 00:23:33:22
like no one feels comfortable
and safe to say, I feel suicidal.
00:23:33:22 - 00:23:37:07
I want to hurt myself like,
these are super taboo conversations.
00:23:37:16 - 00:23:40:15
If somebody has picked up the phone,
that's
00:23:40:15 - 00:23:43:21
that's the indicator that they're open
to having that conversation.
00:23:43:21 - 00:23:44:09
Okay. Right.
00:23:44:09 - 00:23:49:00
So when they call us, we're having a talk
about what are you experiencing?
00:23:49:16 - 00:23:51:20
Okay. Well,
you know, I want to harm myself.
00:23:51:20 - 00:23:53:23
I don't have a plan,
but I hate feeling like this.
00:23:55:13 - 00:23:58:13
Then they're probably gonna ask you
for your assurance information
00:23:58:16 - 00:24:01:16
to make sure that you're not
getting yourself into a financial bind.
00:24:02:09 - 00:24:04:23
We like covered by insurance, too.
Yes. Wow.
00:24:04:23 - 00:24:05:21
Yes. And even.
00:24:05:21 - 00:24:08:21
And even Medicaid in California
as Medi-Cal,
00:24:09:17 - 00:24:10:12
covers it.
00:24:10:12 - 00:24:13:05
I mean, this is a health condition, right?
00:24:13:05 - 00:24:16:05
You need to be hospitalized. So,
00:24:16:11 - 00:24:19:11
they'll check your insurance
to verify that it's active and,
00:24:20:16 - 00:24:23:09
in network or has out of network benefits.
00:24:23:09 - 00:24:26:15
And for us, we do a phone assessment.
00:24:26:15 - 00:24:31:13
It's brief, maybe 15, 20 minutes, where
we just start asking about the symptoms
00:24:31:13 - 00:24:34:14
and we start asking
about your history of a
00:24:34:15 - 00:24:37:15
specifically for us, violence.
00:24:37:16 - 00:24:40:16
We ask,
do you have any legal cases pending?
00:24:40:17 - 00:24:44:00
And that's for the sake of like,
if you were to admit then what?
00:24:44:23 - 00:24:47:00
What what do
you have scheduled in the next seven days?
00:24:47:00 - 00:24:48:11
Are you supposed to be appearing in court?
00:24:48:11 - 00:24:50:06
You can you do it on zoom?
00:24:50:06 - 00:24:50:19
Can you know.
00:24:50:19 - 00:24:55:01
So so they might ask you that they are,
asked if you're taking medications.
00:24:55:17 - 00:24:58:18
If you are, they want to know which ones,
how much.
00:25:00:22 - 00:25:04:09
I think that's a, that's
that's going to be the phone call.
00:25:04:09 - 00:25:07:23
And then some hospitals will tell you,
okay, well, you know, come
00:25:08:04 - 00:25:09:22
you have to admit
through the emergency room.
00:25:09:22 - 00:25:12:15
So we'll go to the E.R., check in.
00:25:12:15 - 00:25:17:01
For us, we like to schedule the admission,
so we'll ask you like Sharon.
00:25:17:01 - 00:25:18:06
Well, what time would you like to come?
00:25:18:06 - 00:25:20:02
And what day
would you like to come? Today.
00:25:20:02 - 00:25:21:20
But you don't want to come until 10 p.m.?
00:25:21:20 - 00:25:23:02
No problem.
00:25:23:02 - 00:25:24:08
Do you have transportation?
00:25:24:08 - 00:25:28:18
Well, and and and I don't know,
I don't know which other hospitals
00:25:28:18 - 00:25:31:22
are for that, but for us, we would ask
you, do you need transportation?
00:25:31:22 - 00:25:32:14
Are you local?
00:25:32:14 - 00:25:35:00
If you're local,
we can send one of our drivers
00:25:35:00 - 00:25:36:05
and then we schedule the pickup.
00:25:36:05 - 00:25:39:20
And then because some people for them,
transportation is a barrier. Yes.
00:25:40:03 - 00:25:41:15
And you know, where am I going to park?
00:25:41:15 - 00:25:44:08
And what am I even safe to drive to?
So I'm not feeling like this.
00:25:44:08 - 00:25:47:15
I can't drive or
I can't because I'm paralyzed by my fear
00:25:47:15 - 00:25:50:18
or my anxiety or I've. I've had
00:25:51:17 - 00:25:52:15
cases like that.
00:25:52:15 - 00:25:55:15
So a 15 minute interview over the phone
00:25:56:05 - 00:25:58:05
and then you set up transportation. Yeah.
00:25:58:05 - 00:25:59:07
Well we in time we.
00:25:59:07 - 00:26:02:07
Do end up having to send all of those
notes through our clinical review
00:26:02:07 - 00:26:05:04
and it gets approved
and then we schedule the admission. Yeah.
00:26:05:04 - 00:26:09:22
And so the person arrives,
I arrive right on the patient I arrive
00:26:09:22 - 00:26:13:01
what should I expect as far as you know,
where am I sleeping.
00:26:13:01 - 00:26:13:22
What am I eating?
00:26:13:22 - 00:26:16:01
Who am I meeting with?
When do I see the doctor?
00:26:16:01 - 00:26:16:22
Yeah.
00:26:16:22 - 00:26:17:19
Who's there?
00:26:17:19 - 00:26:20:19
What other people are there? Yeah.
00:26:21:04 - 00:26:24:13
Most psych units
don't give tours to patients
00:26:24:19 - 00:26:27:19
ahead of time for privacy reasons.
00:26:27:20 - 00:26:30:20
So what I like to say is, you know what?
00:26:31:06 - 00:26:34:12
There are all ages and all kinds,
and you will find your tribe.
00:26:35:01 - 00:26:38:11
And inevitably, they do,
you know, just inevitably they do.
00:26:39:08 - 00:26:42:20
You will sit down with an admissions
or an intake person
00:26:43:05 - 00:26:46:08
and, do all of the formalities.
00:26:46:17 - 00:26:49:17
But I understand I'm here voluntarily,
I understand I can leave
00:26:49:17 - 00:26:52:16
and again,
this is just at my yes facility.
00:26:52:16 - 00:26:56:02
But like any hospital intake,
if you were checking in,
00:26:56:21 - 00:26:59:07
to Providence for a heart surgery,
00:26:59:07 - 00:27:03:11
you show up to the admissions office
and you fill out all your papers, right?
00:27:04:00 - 00:27:07:01
And you have a co-pay,
and you pay your co-pay, and
00:27:07:23 - 00:27:10:12
and then once the paperwork is complete,
00:27:12:04 - 00:27:14:20
the additional
steps we take in, in behavioral health
00:27:14:20 - 00:27:18:00
is they go through your belongings
to make sure that there's no contraband.
00:27:19:02 - 00:27:19:08
What would.
00:27:19:08 - 00:27:22:06
Be considered contraband, like.
00:27:22:06 - 00:27:25:07
Anything that can be used to hurt yourself
or someone else.
00:27:25:07 - 00:27:30:10
So that's why you hear of, like,
no shoelaces, no drawstrings, no belts.
00:27:31:05 - 00:27:32:07
Well, but I'm not suicidal.
00:27:32:07 - 00:27:34:13
I'm not sure. Yeah,
but we want to make sure.
00:27:34:13 - 00:27:37:12
Not that just you're safe,
but that everybody else is safe, too.
00:27:37:15 - 00:27:39:00
Right? Okay.
00:27:39:00 - 00:27:42:00
No razors, no scissors.
00:27:42:13 - 00:27:43:09
No mirrors.
00:27:43:09 - 00:27:47:05
So we do, every morning
there is a grooming session.
00:27:47:05 - 00:27:50:01
So then, like, if you wanted your makeup,
00:27:50:01 - 00:27:53:09
you'll get your makeup and you can do it,
and then we're going to take it back
00:27:53:09 - 00:27:55:23
and put it away. Okay.
00:27:55:23 - 00:27:57:01
What else is contraband?
00:27:57:01 - 00:27:59:04
What about activities and meal times?
00:27:59:04 - 00:28:00:12
What does that look like?
00:28:00:12 - 00:28:02:12
So are there activities?
00:28:02:12 - 00:28:04:13
Yes yes yes yes. And,
00:28:06:00 - 00:28:06:15
while I'm not
00:28:06:15 - 00:28:09:21
familiar with compliance
like and regulations to the tee,
00:28:10:02 - 00:28:13:12
I will say that the hospitals
are supposed to be providing
00:28:13:17 - 00:28:16:14
groups, psychoeducation groups.
00:28:16:14 - 00:28:19:15
They're supposed to be providing meals
and snacks.
00:28:21:07 - 00:28:24:07
They're supposed to be providing case
management.
00:28:24:23 - 00:28:28:03
So, like, for us, there's,
I think six groups a day.
00:28:28:16 - 00:28:31:16
So three are psycho educational
00:28:31:18 - 00:28:34:22
and three are therapeutic recreation. Wow.
00:28:35:03 - 00:28:37:21
And everything is led by clinical staff.
00:28:37:21 - 00:28:40:21
And that means everything has a purpose,
a goal.
00:28:41:16 - 00:28:44:00
Things get chart it it gives.
00:28:44:00 - 00:28:46:21
It gives the hospital or the facility
an opportunity
00:28:46:21 - 00:28:50:04
to see the patient
in, in, in their completeness.
00:28:50:04 - 00:28:53:04
Right. Because a lot of times
00:28:53:20 - 00:28:56:13
patients are smart, they're very smart.
00:28:56:13 - 00:28:59:17
And they know what the doctor wants
to hear in order to let them go.
00:29:00:01 - 00:29:03:17
So maybe Sharon tells the doctor,
no, doctor, I am not hearing voices
00:29:03:17 - 00:29:05:06
since you started me on medication.
00:29:05:06 - 00:29:07:02
I'm, I'm I'm ready to go home.
00:29:08:14 - 00:29:11:10
But then
00:29:11:10 - 00:29:14:13
the doctor looks through the chart
and sees that the rec therapist
00:29:14:13 - 00:29:18:08
has added that today in group, Sharon
00:29:18:08 - 00:29:21:20
was sitting next to an empty chair
and having a conversation.
00:29:22:09 - 00:29:25:23
So it also gives an opportunity
for different types of interventions. Yes.
00:29:25:23 - 00:29:29:16
And group offers an opportunity
for that common ground
00:29:29:16 - 00:29:33:15
where people are coming together
and sharing, which also normalizes
00:29:33:15 - 00:29:36:18
the conversation of I'm
not alone in the struggle and it's
00:29:36:18 - 00:29:39:19
okay if I am experiencing voices
00:29:39:21 - 00:29:43:19
or visuals and hallucinations,
and I can talk about it
00:29:43:19 - 00:29:47:02
and I can get treatment, and that's
actually not the criteria for a hold.
00:29:47:10 - 00:29:50:02
It's am I safe in my body? Yeah.
00:29:50:02 - 00:29:52:03
Am I safe in my in the world?
00:29:52:03 - 00:29:53:08
In the world, yes.
00:29:53:08 - 00:29:56:07
Big time.
Okay. Back to so groups and meals.
00:29:56:15 - 00:29:59:04
And what about meeting with the doctor.
00:29:59:04 - 00:30:03:04
So the goal of being in a psychiatric
facility
00:30:03:14 - 00:30:07:02
is to get the brain chemistry regulated.
00:30:07:14 - 00:30:10:09
Right? Like that's the goal.
00:30:10:09 - 00:30:12:13
Most places are not offering
00:30:12:13 - 00:30:15:15
individual therapy
because it's really just not indicated.
00:30:16:07 - 00:30:22:00
If somebody is really fragile
or really unstable, then it's not.
00:30:22:02 - 00:30:24:19
CBT is not going to help.
00:30:24:19 - 00:30:27:10
It's emergency
stabilization. Right? Right.
00:30:27:10 - 00:30:29:15
So they meet with the doctor every day.
00:30:29:15 - 00:30:31:11
And this is like standard in any hospital.
00:30:31:11 - 00:30:34:14
You're supposed to meet with the physician
within 24 hours of your arrival,
00:30:35:01 - 00:30:38:01
and they'll do a psychiatric evaluation.
00:30:38:03 - 00:30:40:18
And then the doctor will develop
00:30:40:18 - 00:30:44:16
their medication plan for you
and discuss it with you.
00:30:45:03 - 00:30:47:22
Once you guys are in agreement,
00:30:47:22 - 00:30:50:17
they'll put the order in and then,
00:30:50:17 - 00:30:54:00
you know, if it's an am mad, you'll get it
the next morning if it's a PM.
00:30:54:00 - 00:30:56:20
And it depends when you see the doctor,
obviously. And we'll consider this. But,
00:30:57:22 - 00:31:00:22
and then the doctor comes back
the next day
00:31:01:05 - 00:31:05:07
and, what's happening a lot of times
because of the shortage, in physicians
00:31:05:23 - 00:31:09:02
is they're using a lot
of what they call extenders.
00:31:09:08 - 00:31:12:17
So that could be a physician's assistant,
it could be a nurse practitioner,
00:31:12:22 - 00:31:16:05
but they're prescribers and they're
working under the doctor's supervision.
00:31:16:13 - 00:31:18:20
So the doctors develop the plan.
00:31:18:20 - 00:31:22:15
Or maybe, you know, maybe you showed up
and it's that doctor's day off.
00:31:22:15 - 00:31:25:02
And so you're actually meeting
with the extender.
00:31:25:02 - 00:31:28:05
That person will develop the plan and,
00:31:28:21 - 00:31:31:08
you know,
give it to the doctor and get you started.
00:31:31:08 - 00:31:33:21
So there's no waste of time
while you're with us.
00:31:33:21 - 00:31:34:17
Right.
00:31:34:17 - 00:31:37:16
And then the doctor comes back
the next day and is like,
00:31:37:16 - 00:31:40:20
hey, Sharon, you know, you came
in, you hadn't slept in four days.
00:31:40:20 - 00:31:43:14
We started you on Seroquel last night,
you know.
00:31:43:14 - 00:31:44:19
How did you sleep?
00:31:44:19 - 00:31:45:23
Oh, I slept really good.
00:31:45:23 - 00:31:48:00
But this morning I woke up.
I was really groggy.
00:31:48:00 - 00:31:49:18
I just I couldn't snap out of it.
00:31:49:18 - 00:31:51:11
Okay, well,
you know what? Let's make an adjustment.
00:31:51:11 - 00:31:52:03
Oh, wow.
00:31:52:03 - 00:31:54:23
Right. And so and and that's the advantage
00:31:56:09 - 00:31:57:09
I think
00:31:57:09 - 00:32:00:20
many people
who've been on the mental health journey,
00:32:01:19 - 00:32:06:04
specifically with medication,
you go as an outpatient person,
00:32:07:03 - 00:32:10:17
you go to your doctor and you're like,
I'm not sleeping.
00:32:10:17 - 00:32:14:01
I and when I am supposedly sleeping,
I wake up exhausted
00:32:14:01 - 00:32:17:13
ten hours later
and every day I come home and I'm sobbing.
00:32:17:13 - 00:32:20:02
I mean, this is my story.
And every day I come home
00:32:20:02 - 00:32:22:06
and I'm on the floor with my dog
sobbing and la la la.
00:32:22:06 - 00:32:25:14
And the doctor's like, okay,
it sounds like sounds like depression.
00:32:25:14 - 00:32:28:02
Let's let's start you on this medication.
00:32:28:02 - 00:32:30:16
And you know, it's going to take
a few weeks before it kicks in.
00:32:30:16 - 00:32:32:12
So I don't have very like,
00:32:32:12 - 00:32:36:04
you know, high expectations
of noticing at anything immediately
00:32:36:10 - 00:32:40:01
and then come back in three weeks and,
and let me know how it went.
00:32:41:16 - 00:32:44:16
And you're like, well, shoot,
00:32:45:00 - 00:32:46:03
that's okay. I'm in between.
00:32:46:03 - 00:32:48:07
So you're, you're getting to see a doctor
or a.
00:32:48:07 - 00:32:50:10
Free day every. Single day.
00:32:50:10 - 00:32:54:20
And so you said
hospitalizations are not indefinite stays.
00:32:54:20 - 00:32:58:08
So how long is a hospitalization
when we're talking about acute
00:32:58:16 - 00:33:01:10
stabilization triaging.
00:33:01:10 - 00:33:04:10
Yeah. What what what can a person expect.
00:33:04:10 - 00:33:07:08
For us it's about 7 to 10 days. Okay.
00:33:07:08 - 00:33:09:19
Can it be shorter.
It could be longer. Yes. Yeah.
00:33:09:19 - 00:33:11:16
So it's really individualized to
00:33:11:16 - 00:33:15:08
what does the person need if I'm coming in
and I haven't slept in four days
00:33:15:15 - 00:33:19:01
and I'm still not sleeping
in full in four additional days,
00:33:19:15 - 00:33:22:09
is there an opportunity to stay
until we find the right?
00:33:22:09 - 00:33:26:03
Yeah, because I know that
that is a huge concern with patient
00:33:26:03 - 00:33:28:21
care is I don't want to see my doctor
in three weeks.
00:33:28:21 - 00:33:30:06
I know that's so long.
00:33:30:06 - 00:33:32:23
It's so much suffering. It's
and it is so much suffering.
00:33:32:23 - 00:33:35:14
And what do we do
in the midst of suffering?
00:33:35:14 - 00:33:38:02
What other bad behaviors?
Or as TJ Woodward
00:33:38:02 - 00:33:41:19
says, brilliant strategies
do we come up with in the meantime?
00:33:42:02 - 00:33:44:05
So yeah, it is.
00:33:44:05 - 00:33:47:05
It sounds like
a really collaborative process
00:33:47:07 - 00:33:49:08
where I want to find the right man.
00:33:49:08 - 00:33:52:11
I don't want to leave
because the fear of I'm going to go home
00:33:52:11 - 00:33:55:16
and I can't do another night a week,
I just can't.
00:33:55:16 - 00:33:57:12
Yeah, yeah. No, absolutely.
00:33:57:12 - 00:33:59:08
And same thing
with when you're looking at,
00:33:59:08 - 00:34:02:10
for example, medications
that require blood tests.
00:34:02:10 - 00:34:02:19
Yeah.
00:34:02:19 - 00:34:05:19
To make sure that you're
reaching a therapeutic dose.
00:34:06:08 - 00:34:08:13
We do that all internally.
00:34:08:13 - 00:34:12:09
So it's not like,
oh, you're an outpatient start.
00:34:12:09 - 00:34:13:14
Start you on Depakote.
00:34:13:14 - 00:34:16:22
We're gonna start you on a low dose and
come back and then you know what I mean?
00:34:16:22 - 00:34:18:10
It's like that could take weeks.
00:34:18:10 - 00:34:20:23
This is like going to happen
like within a week or two.
00:34:20:23 - 00:34:25:09
Well and and when we hit that therapeutic
dose then we see how that goes.
00:34:25:09 - 00:34:26:20
If it's too much, you know what I mean?
00:34:26:20 - 00:34:30:05
It's like it's all happening
pretty immediately.
00:34:30:21 - 00:34:33:21
I mean, in the grand scheme of things,
it's like immediate, you know.
00:34:34:05 - 00:34:37:02
So let's say
a person checks in to a hospital.
00:34:37:02 - 00:34:40:02
Are they able to call or visit family?
00:34:40:04 - 00:34:45:02
Yes. So the law says that a person
in a psychiatric facility
00:34:45:07 - 00:34:48:12
must have access to a telephone 24 seven.
00:34:49:07 - 00:34:51:15
So there will be patient
00:34:51:15 - 00:34:55:18
phones on any psychiatric unit
because it is required by law.
00:34:57:08 - 00:35:00:08
And, you
know, you can't have your cell phone.
00:35:00:20 - 00:35:02:21
And that's kind of standard.
00:35:02:21 - 00:35:04:20
And there's a lot of reasons why.
00:35:04:20 - 00:35:08:10
But you can make calls 24 seven
and you can receive calls to,
00:35:09:03 - 00:35:12:03
if you have people, you know, on
consent and, and all that good stuff,
00:35:12:17 - 00:35:15:19
the visiting hours, you know,
don't know what the regulations are.
00:35:17:00 - 00:35:20:00
I know a lot of the locked
facilities have visiting hours
00:35:20:00 - 00:35:23:22
every day, at least for like two hours
in the nighttime for us.
00:35:23:22 - 00:35:27:10
We do visiting on Saturdays
and Sundays from 1 to 3.
00:35:27:10 - 00:35:30:02
So there is family control?
Yes there is. Engage. Absolutely.
00:35:30:02 - 00:35:30:17
Yeah.
00:35:30:17 - 00:35:33:15
I will also want to touch on
when you when you talk about
00:35:33:15 - 00:35:36:15
like accessibility to patients or staff.
00:35:37:12 - 00:35:40:21
I, I just heard this again this
morning from a family that
00:35:42:00 - 00:35:43:05
it was really hard to get
00:35:43:05 - 00:35:46:15
Ahold of the doctor
while my loved one was there.
00:35:47:11 - 00:35:50:11
And yes,
00:35:51:07 - 00:35:52:09
it's true.
00:35:52:09 - 00:35:55:12
And and I'm going to say that
that's the case pretty much
00:35:55:12 - 00:35:58:23
in any hospital and,
and really like, almost on any unit.
00:36:00:14 - 00:36:03:20
And it's
because the doctors are not our employees,
00:36:04:04 - 00:36:07:04
so they come on their own schedule.
00:36:07:07 - 00:36:12:02
Many of them are, are,
are privileged at a number of hospitals.
00:36:12:02 - 00:36:16:03
And so they're making rounds
at a couple of different places a day,
00:36:16:09 - 00:36:17:23
and then depending on
how long it takes them.
00:36:17:23 - 00:36:19:18
So but they're social workers in.
00:36:19:18 - 00:36:22:19
Case there are workers, there's case
managers.
00:36:22:19 - 00:36:24:05
There's the nursing department.
00:36:24:05 - 00:36:25:21
So there's always someone to talk to.
00:36:25:21 - 00:36:29:12
Yes. If you if you call the nursing unit
wherever your loved one
00:36:29:12 - 00:36:32:23
is and just say, you know,
can you check if I'm on consent?
00:36:33:09 - 00:36:36:03
And if you are ask, you know what, what?
00:36:36:03 - 00:36:36:11
Have there been
00:36:36:11 - 00:36:39:13
any medication changes like what are the
what are the notes saying?
00:36:39:13 - 00:36:41:19
What you know, how are they?
Are they attending groups?
00:36:41:19 - 00:36:42:13
Are they eating?
00:36:42:13 - 00:36:44:10
Are they you know,
you can ask all those questions.
00:36:44:10 - 00:36:45:18
It's all in the system.
00:36:45:18 - 00:36:51:02
And, and and if if it's not then there's
staff there who know your loved one.
00:36:51:14 - 00:36:54:14
You know, like we spend a lot of time
00:36:54:14 - 00:36:57:19
I mean, the nurses and all the staff at
the hospital are working 12 hour shifts.
00:36:57:19 - 00:36:58:06
Yeah.
00:36:58:06 - 00:37:02:22
So that's a long time with people
and they get to know them pretty well.
00:37:03:06 - 00:37:07:21
So, I know when I go to visit patients,
I, I try to like
00:37:08:09 - 00:37:10:00
I might, with their permission,
00:37:10:00 - 00:37:13:11
like, take a picture of us together
and send it to the family.
00:37:13:22 - 00:37:16:01
So they're like, you know, okay,
this is what he looks like.
00:37:16:01 - 00:37:17:07
He's here. He's okay.
00:37:17:07 - 00:37:19:06
Like, you know, but,
00:37:19:06 - 00:37:21:22
And you personally have a relationship
with patients and families.
00:37:21:22 - 00:37:23:08
I them I know. Yeah.
00:37:23:08 - 00:37:26:20
Yeah, I tend to it just because I for me,
00:37:27:19 - 00:37:30:06
I, I try to be who I would have needed.
00:37:30:06 - 00:37:30:17
Yeah.
00:37:30:17 - 00:37:34:09
You know
and and I recognize that they're sending
00:37:34:20 - 00:37:38:01
their child their wife, their mom,
00:37:39:02 - 00:37:39:21
their brother.
00:37:39:21 - 00:37:42:20
Like they're sending this person to what
00:37:42:23 - 00:37:46:01
you've identified
clearly as a very scary situation.
00:37:46:01 - 00:37:46:17
Yeah.
00:37:46:17 - 00:37:52:04
And, and nothing pleases me more
than hearing, like, for example, a mom
00:37:52:04 - 00:37:57:10
that I spoke to this morning, she told me,
you know, I'm so glad that we went
00:37:57:23 - 00:38:00:14
because she felt safe.
00:38:00:14 - 00:38:02:00
It did her so well.
00:38:02:00 - 00:38:04:14
The doctor, the medication like
00:38:04:14 - 00:38:06:11
to know that we can be that.
00:38:06:11 - 00:38:10:08
Please for someone at literally
00:38:10:08 - 00:38:14:14
one of the most vulnerable points
of their entire lives.
00:38:16:01 - 00:38:20:04
There's nothing,
I think, more sacred than that, you know?
00:38:20:04 - 00:38:23:04
So. So, yes,
I tried to be involved when I can.
00:38:23:18 - 00:38:27:17
So what would be your one piece of advice
for the listener out there,
00:38:27:17 - 00:38:31:01
the viewer out there that is concerned
about their mental health,
00:38:32:01 - 00:38:34:04
but they're so afraid of the stigma
00:38:34:04 - 00:38:37:04
because we, we,
we stigmatize what we fear and don't know
00:38:38:00 - 00:38:41:02
and have been recommended
to seek treatment
00:38:41:02 - 00:38:44:09
or seek care at a facility of any kind.
00:38:44:09 - 00:38:46:21
And just the idea of the facility,
a hospital.
00:38:46:21 - 00:38:48:16
And I mean,
00:38:48:16 - 00:38:50:14
what would be your piece of advice
to someone out there
00:38:50:14 - 00:38:54:17
listening that that is aware
that something is going on and,
00:38:54:21 - 00:38:57:21
and they might benefit
from accessing care?
00:38:58:14 - 00:39:01:00
I think
00:39:01:00 - 00:39:03:23
I would say
00:39:03:23 - 00:39:06:08
if you don't do anything,
00:39:06:08 - 00:39:09:07
it's not going to get better.
00:39:09:07 - 00:39:12:07
And with mental health
00:39:12:08 - 00:39:14:14
it tends to get worse.
00:39:14:14 - 00:39:17:14
So try it.
00:39:18:23 - 00:39:21:06
You can always leave,
00:39:21:06 - 00:39:24:22
but try it and I,
I feel the same way about medication.
00:39:24:22 - 00:39:26:21
You know, a lot of people are hesitant
about medication.
00:39:26:21 - 00:39:28:10
I don't want to be on medication.
00:39:28:10 - 00:39:30:16
Okay. Doesn't
mean you can be on it forever.
00:39:30:16 - 00:39:33:16
Maybe you just need to get through
this period of time, like this
00:39:33:19 - 00:39:37:08
difficult period at work,
or this difficult time of loss
00:39:37:08 - 00:39:42:07
or some something situational
and you just need help to get through it.
00:39:43:23 - 00:39:45:15
For now.
00:39:45:15 - 00:39:48:12
It's not it doesn't have to be forever,
right?
00:39:48:12 - 00:39:50:15
That that those would be my two things.
00:39:50:15 - 00:39:53:01
Just try it
because it's going to get worse
00:39:53:01 - 00:39:56:01
and it doesn't have to be forever.
00:39:58:05 - 00:40:00:05
That's it.
00:40:00:05 - 00:40:01:12
So what haven't we covered?
00:40:01:12 - 00:40:04:12
And as far as any stereotypes or
00:40:05:22 - 00:40:08:11
myths that need to be debunked.
00:40:08:11 - 00:40:10:07
We talked about medication.
00:40:10:07 - 00:40:12:15
We talked about.
00:40:12:15 - 00:40:14:03
Locations, halls.
00:40:14:03 - 00:40:17:14
Yeah. Scary dark screaming places.
00:40:17:15 - 00:40:21:17
I think the other thing people are afraid
of is use of force.
00:40:21:22 - 00:40:24:22
Yeah. Right. So,
00:40:25:06 - 00:40:28:05
it's kind of like any other situation
where
00:40:29:05 - 00:40:34:03
if you don't need to be restrained,
you won't be.
00:40:34:15 - 00:40:39:03
And there are always interventions first,
00:40:39:19 - 00:40:43:13
you know, if you, let's say,
are starting to ramp up,
00:40:44:15 - 00:40:48:08
you know, we have a whole protocol,
at the hospital in terms of,
00:40:49:12 - 00:40:50:04
observing
00:40:50:04 - 00:40:53:05
patients on the unit
when nothing is happening.
00:40:54:08 - 00:40:57:07
And then that way we can see,
oh, you know,
00:40:57:07 - 00:41:00:06
Sharon has started pacing.
00:41:00:06 - 00:41:00:14
Okay.
00:41:00:14 - 00:41:02:04
So that's a sign that's an alert for us.
00:41:02:04 - 00:41:04:04
Like Sharon is experiencing something.
00:41:04:04 - 00:41:04:10
Yeah.
00:41:04:10 - 00:41:07:15
So a social worker might go out
and be like hey Sharon.
00:41:07:16 - 00:41:10:16
You know, let came out to see
we want to chat,
00:41:11:21 - 00:41:13:04
check in with you.
00:41:13:04 - 00:41:16:04
You're like I'm fine, I'm fine. Okay.
00:41:16:15 - 00:41:19:14
And then you keep pacing
and now you're pacing faster.
00:41:19:14 - 00:41:22:14
And now your facial
00:41:23:08 - 00:41:24:21
expressions have changed.
00:41:24:21 - 00:41:27:17
So now we're more concerned
and somebody is going to come out,
00:41:27:17 - 00:41:31:21
probably the nurse and the social worker
and say, hey, Sharon, great about you.
00:41:31:23 - 00:41:33:20
You know,
00:41:33:20 - 00:41:37:17
can we give you something to help you
relax or feel better?
00:41:38:14 - 00:41:41:04
Do you want, you know,
you put on your form when you admitted
00:41:41:04 - 00:41:42:16
that music helps you to calm down.
00:41:42:16 - 00:41:45:01
Would you like a headset? Well.
00:41:45:01 - 00:41:49:09
You know, we offer these interventions
as Sharon has the right to say. No.
00:41:50:15 - 00:41:53:00
Okay, so now Sharon is pacing.
00:41:53:00 - 00:41:56:02
She's got the face,
and now she's starting to, like,
00:41:56:13 - 00:41:59:09
ramp up verbally.
00:41:59:09 - 00:42:01:07
Okay, then we're going to go.
00:42:01:07 - 00:42:04:07
Maybe we send the doctor if he's there.
00:42:04:08 - 00:42:05:04
What's that?
00:42:05:04 - 00:42:08:05
Someone's going to come to you
and be like, Sharon, we're very worried.
00:42:10:15 - 00:42:11:09
We've offered you
00:42:11:09 - 00:42:14:08
this, this and this,
and you've not wanted it.
00:42:14:20 - 00:42:17:08
And I'm just going to really strongly
00:42:17:08 - 00:42:20:08
encourage you to help us help you.
00:42:20:18 - 00:42:25:08
Because if this keeps going,
then we're going to have to call
00:42:25:08 - 00:42:28:11
for a third party evaluation,
which is a pet team.
00:42:28:11 - 00:42:29:20
It's a county.
00:42:29:20 - 00:42:32:09
Second unit evaluation team. Yes.
00:42:32:09 - 00:42:37:12
And if they come and they decide
that you're a danger to yourself
00:42:37:12 - 00:42:40:15
or to other people here,
they're going to take you on hold.
00:42:41:04 - 00:42:44:19
And when that happens,
I can't get you out.
00:42:45:02 - 00:42:47:14
I can't get you back. I mean, it's like
00:42:48:17 - 00:42:50:08
you're going to another hospital at that.
00:42:50:08 - 00:42:52:23
So we're going from the least intrusive
to the most intrusive.
00:42:52:23 - 00:42:54:07
But there's so many interventions.
00:42:54:07 - 00:42:57:18
You talk about music and social workers
and nurses and coping
00:42:57:18 - 00:43:00:21
skills and groups and just.
00:43:01:09 - 00:43:02:20
We try everything.
00:43:02:20 - 00:43:05:15
So much that is not common knowledge.
00:43:05:15 - 00:43:07:01
Yes, yes.
00:43:07:01 - 00:43:11:06
And then on the rare occasion
that Sharon's like,
00:43:11:06 - 00:43:14:08
you know what, if you have all of you,
I don't want any of that.
00:43:15:12 - 00:43:20:05
And and now like,
Sharon's like throwing chairs.
00:43:20:05 - 00:43:23:05
Okay.
That is like 100% unacceptable, right.
00:43:23:08 - 00:43:26:08
So let's say you
00:43:27:06 - 00:43:29:17
make some kind of gesture,
00:43:29:17 - 00:43:34:23
you do something that shows us
that you're trying to hurt yourself.
00:43:34:23 - 00:43:36:17
Someone else. Right?
00:43:36:17 - 00:43:40:02
That's when we have to
00:43:41:09 - 00:43:42:15
to intervene physically.
00:43:42:15 - 00:43:43:20
Right.
00:43:43:20 - 00:43:47:14
Again, we have a very strict protocol
because we are hands off.
00:43:47:14 - 00:43:51:15
So if and this and, you know, in
other facilities too, if we put hands on
00:43:51:15 - 00:43:55:11
somebody, it that is going to require
a whole bunch of paperwork,
00:43:55:11 - 00:43:59:10
a whole bunch of justification,
of why, right, why
00:44:00:09 - 00:44:01:12
we don't want to do that.
00:44:01:12 - 00:44:02:20
Because patients have rights.
00:44:02:20 - 00:44:05:18
We've gone from the least intrusive,
the most intrusive,
00:44:05:18 - 00:44:08:19
and really the most important is safety
and care. Yes.
00:44:08:19 - 00:44:10:23
And if we have to protect you
from yourself, we will.
00:44:10:23 - 00:44:11:20
Yeah.
00:44:11:20 - 00:44:12:15
You know. Yeah.
00:44:12:15 - 00:44:16:09
But there's always going to be
a whole bunch of stuff leading up to that.
00:44:16:12 - 00:44:17:02
Yeah.
00:44:17:02 - 00:44:21:00
Again, I've only worked at Oceanview,
so I'm speaking from my own perspective.
00:44:21:12 - 00:44:23:05
There might be people out there
who are like, that's not true,
00:44:23:05 - 00:44:23:15
that's not true.
00:44:23:15 - 00:44:26:06
And maybe, maybe in some sense it's. True
for all other hospitals.
00:44:26:06 - 00:44:29:12
And what I love about Oceanview
is that it's a private hospital.
00:44:29:20 - 00:44:31:12
It is voluntary.
00:44:31:12 - 00:44:34:13
There are many other hospitals
that we have worked with
00:44:34:13 - 00:44:38:04
and have wonderful relationships
with that have locked and voluntary,
00:44:38:04 - 00:44:41:22
and a lot of the
themes are very similar across the board.
00:44:41:22 - 00:44:42:04
Yeah.
00:44:43:12 - 00:44:45:06
Oh, everyone has a bad story.
00:44:45:06 - 00:44:47:03
Yeah. About a place.
00:44:47:03 - 00:44:50:05
Much like if we go to a coffeehouse and
someone didn't make our drink correctly,
00:44:50:10 - 00:44:52:06
that happens everywhere.
00:44:52:06 - 00:44:56:10
But it's not as common
as media sensationalize it.
00:44:57:08 - 00:45:00:11
It makes for great TV drama,
but it's not in real life.
00:45:00:13 - 00:45:00:21
Yeah.
00:45:00:21 - 00:45:03:22
And it's really wonderful
and a privilege to have this conversation
00:45:03:22 - 00:45:06:22
because so many people don't know
what to expect.
00:45:06:22 - 00:45:08:08
And the idea is so scary.
00:45:08:08 - 00:45:11:13
And for any of our viewers and listeners,
and I'm sure some of our clients
00:45:11:17 - 00:45:14:07
are going to be listening and saying,
I can attest to that.
00:45:14:07 - 00:45:17:07
And and I wish I knew,
00:45:17:13 - 00:45:23:01
and it's just so nice to have these taboo
conversations that no one talks about
00:45:23:01 - 00:45:26:02
in the world about,
you know, let's talk about suicidality.
00:45:26:06 - 00:45:28:23
Let's talk about mental
health. Let's talk about symptoms.
00:45:28:23 - 00:45:32:16
Let's talk about the impairment that does
take place that people don't talk about.
00:45:32:16 - 00:45:35:14
I know until it's too late,
and it's so secretive
00:45:35:14 - 00:45:38:14
and isolated and stigmatized,
and we don't need to do that.
00:45:38:14 - 00:45:41:16
We can access good health care,
00:45:42:02 - 00:45:45:02
good medical care without the stigma.
00:45:45:05 - 00:45:47:00
Yeah. And, you know, to,
00:45:48:07 - 00:45:49:03
kind of
00:45:49:03 - 00:45:53:09
I just had this afterthought
about when you asked, about privacy and,
00:45:53:09 - 00:45:57:21
well, people know another question
that comes up a lot is, what?
00:45:57:21 - 00:45:59:15
I can't miss work.
00:45:59:15 - 00:46:02:19
You know, I need the money
with all of us, right? So,
00:46:03:20 - 00:46:06:23
in those situations,
we can write a letter,
00:46:07:04 - 00:46:10:22
the doctor can write a letter,
you know, for your medical absence.
00:46:11:04 - 00:46:14:07
And it's not going to say from Oceanview.
00:46:14:11 - 00:46:17:05
It's not going to say I'm a psychiatrist.
00:46:17:05 - 00:46:20:08
It's going to say Sharon is under my care.
00:46:21:02 - 00:46:24:12
And it, you know, and he'll put in there
why you can't return.
00:46:24:21 - 00:46:28:23
Well, not why like in detail, but that
you cannot return to work based on his,
00:46:30:11 - 00:46:31:05
his treatment plan.
00:46:31:05 - 00:46:33:18
A very discreet letter,
unable to work at this time.
00:46:33:18 - 00:46:38:00
And it's an excused absence
from work, and it is 100%
00:46:39:03 - 00:46:39:19
real valid.
00:46:39:19 - 00:46:41:09
Yeah. Yeah, exactly.
00:46:41:09 - 00:46:44:07
So I just I know people are like, well,
I don't want my work to know.
00:46:44:07 - 00:46:45:19
And it's like, no, they won't know.
00:46:45:19 - 00:46:48:04
Yeah. Nobody has to know. Yeah.
00:46:48:04 - 00:46:48:11
Yeah.
00:46:48:11 - 00:46:51:17
We tried to try to remove
all the barriers.
00:46:51:17 - 00:46:54:15
Yeah. So final thoughts.
00:46:54:15 - 00:46:56:07
Thank you.
00:46:56:07 - 00:46:59:03
Thank you for thinking of this
00:46:59:03 - 00:47:02:20
topic and bringing light to it.
00:47:03:12 - 00:47:05:04
I'm sure people have other questions.
00:47:05:04 - 00:47:09:10
If you ever get any other questions
and you want to talk about them,
00:47:10:07 - 00:47:11:04
let me know.
00:47:11:04 - 00:47:15:12
Because the more yeah,
the more people know,
00:47:15:23 - 00:47:18:22
you know, the better off
we'll all be. Yeah.
00:47:19:03 - 00:47:20:12
Thank you so much for coming.
00:47:20:12 - 00:47:21:13
Thank you.
00:47:21:13 - 00:47:24:00
Thanks for joining us
for this important conversation.
00:47:24:00 - 00:47:24:22
If you want to learn more
00:47:24:22 - 00:47:28:10
about Oceanview Psychiatric Facility
or connect with Carla DiCandia visit
00:47:28:10 - 00:47:31:13
www.ovphf.com
00:47:31:13 - 00:47:34:07
And if this episode changed
how you think about mental health care
00:47:34:07 - 00:47:35:22
share it with
someone who needs to hear it.
00:47:35:22 - 00:47:38:22
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00:47:38:23 - 00:47:41:19
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