Search terms answered #3: “how to interact with psych inpatients”

Today someone searched “how to interact with psych inpatients” and ended up here.

Here are my thoughts of what you should do.

-Treat them like humans.
-Recognize that mental illness does not necessarily equal cognitive impairment. So many people talk to adult psych inpatients like they’re children.
-Don’t push your own agenda on them. Listen to them, instead. Part of this means keeping boundaries. Don’t talk about that relative/friend who overcame their depression. Your inspiring story probably will just sound preachy.
-Often there can be a lot of miscommunication in hospitals. Don’t assume the patient is wrong, just because the chart or staff may say otherwise. All of my psych hospital records are filled with errors that impacted my care, but I never knew about because I didn’t know there was any misunderstanding until I read the records.
-When upset sometimes people need space and sometimes they need support. Ask them which they prefer in that moment, rather than assuming one or the other. There have been times where problems of mine have escalated because a mental health worker kept trying to talk about something while I needed space. One of the best examples of how to do this well was in a hospital where I filled out forms the first day about many types of situations and how I preferred people to respond to me in those situations.
-Remember that saying someone does a behavior “for attention” is never a full explanation of what is going on and is never an excuse to forget that they are probably suffering.
-Don’t forget that the quiet well behaved person can be struggling just as much as the more obvious acting out person.
-Try to understand motivations of problematic behavior.
-Don’t sit behind a closed door waiting for people to come to you. At the hospitals where staff stayed in the nurses station unless they had a specific task to do they were very inaccessible. In another hospital there was a desk more out in the open. So they could still get work done, but there was no wall separating them. They were approachable. You obviously can’t change how your work environment is set up, but you can try to minimize time spend behind the window. People who need you may not feel comfortable knocking on the door. When people only leave the room for a specific task then everyone is always too busy to help.
-Keep all information about events you’ve witnessed with the patient private from visitors unless you have explicit permission to share them. It can be easy to casually let things slip that seem benign, especially if the visitors are chatty, but you don’t know what everyone’s situation is and their relationship with that particular visitor. This might seem obvious, but in all my hospitalizations information has been shared with my family that should not have even though the only information I specially authorized to share was about coordination of care after the hospitalization and billing. This makes having visitors very anxiety provoking at a time when I obviously don’t need more anxiety.

There are a lot of don’ts up there. But I guess among all this it’s important to remember that these people are just people. There are certain professional roles you need to follow, but a lot of your interactions should just pull from your general interpersonal skills.

I’m sure people who read this blog have their own thoughts. Feel free to add some.

5 thoughts on “Search terms answered #3: “how to interact with psych inpatients”

  1. This is a great response.
    I’m going to carry this over to my blog.

    One comment on this one: Don’t push your own agenda on them. Listen to them, instead. Part of this means keeping boundaries. Don’t talk about that relative/friend who overcame their depression. Your inspiring story probably will just sound preachy.
    I had a nurse confess to me that she was suffering in a way that was similar to me (this was at the end of my third admission to the same ward in 8 months), and I was impressed that she shared the information. She then came back to apologise (profusely) for sharing her own life. Everyone has their own comfort level – patients and care providers both. In this case, I think the nurse felt comfortable enough to share with me so that I could see how the grass could become greener. She is a great human being.

  2. The most irritating aspect of my last hospitalization was that some of the nurses and social workers projected this attitude that ending up in the hospital was a failure. This self-blame was something i was struggling with at the time, and it was really not helpful, at least at first, to have it reinforced by the health care providers. It is hard for me to ask for help, and i am glad i did so before i got too deep into the spiral!

    I should say, i do agree that ending up in the hospital is really not desirable (certainly not enjoyable!), and i understand working to prevent relapse, but i really disliked the attitude with which the issue was approached.

    I want to comment further on some of your suggestions but end up writing pages so will just say that your list is great, really useful, if folks can take it to heart.


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