What Is Psychiatry?

Psychiatry is a sub-specialty of medicine that is devoted to both the study and treatment of mental illnesses.

Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Mental illnesses are serious medical illnesses. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence.

Read more about mental illnesses.

Psychiatric Assessment for a person with a mental illness may be performed by a psychologist or psychiatrist. This assessment usually begins with a check of current mental status and collection of a complete case history about the mental illness and other stressors in the personal life. This information is used to diagnose mental illnesses.

Mental illnesses are diagnosed using the criteria in such diagnostic manuals as The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), put out by the American Psychiatric Association as well as the International Classification of Diseases (ICD) put out by the World Health Organization (WHO).

How Are Mental Illnesses Treated?

Treatment for psychiatric disorders uses a variety of methods including, psychotherapy, medications, psychoactive meditation, as well as other techniques.

Treatment for mental illnesses may be given on an inpatient or outpatient basis, depending upon the severity of symptoms, aspects of the mental illnesses, and other factors.

What Is Inpatient Psychiatric Treatment?

Treatment for mental illnesses have changed dramatically over the past few decades. While in the past, those with mental illnesses were confined to a psychiatric hospital for periods greater than six months (sometimes for several years), most people today are treated for their mental illnesses on an outpatient basis.

Once in the care of a hospital psychiatric unit, people with mental illnesses are continually assessed by a group of doctors and nurses who specialize in the treatment of mental illnesses.

Medication and treatment plans are developed with a team of doctors, psychologists, psychiatric social workers, therapists, occupational therapists, psychiatric nurses, and pharmacists.

Those who are admitted to an inpatient psychiatric hospital may be admitted voluntarily or involuntarily.

What Is Involuntary Admission To A Psychiatric Unit?

Involuntary Commitment (or Civil Commitment) is a legal process in which a person who has severe mental illness is ordered by the court into treatment at an inpatient psychiatric hospital.

The criteria for an involuntary psychiatric commitment are established by law and vary tremendously from nation to nation and (in the US) state-to-state.

Commitment proceedings usually follow a period of emergency psychiatric hospitalization during which the mentally ill individual with acute psychiatric conditions is held for 72 hours (also known as the 72-hour hold). During those 72 hours, an individual is:

  • Evaluated by a team of mental health professionals
  • Stabilized

At the civil commitment hearing, it's determined whether or not the person should continue to be involuntarily held for further treatment.

Why Are People Involuntarily Committed To Psychiatric Hospitals?

Most areas of the world confine those who are mentally ill to such an extent that it impairs abilities to reason, or "found incompetent."

It is important to note that involuntary commitment to a psychiatric hospital for a personality disorder, social deviance, or substance abuse is not allowed.

The most common reason for involuntary commitment to a psychiatric hospital is because the person is considered to have a mental illness, severe dementia or other intellectual disability that means the person is a:

  1. A danger to him or herself - such as in the case of people who have attempted suicide or confessed to plans of a suicide.
  2. A danger to others - such as people who are in psychosis, driven by delusions or hallucinations to harm themselves or other people.

What Is Voluntary Commitment to Inpatient Psychiatric Care?

The large majority of people (approximately 88%) who receive inpatient psychiatric care do so voluntarily - or, who decide freely to enter the inpatient psychiatric hospital for treatment. It's important to note that voluntary psychiatric patients aren't entirely free to leave the unit without the permission of the staff.

Should a person who has been voluntarily committed prove to be a danger to him or herself or others, he or she may be detained via involuntary commitment for up to 24 hours.

Voluntary admission to a psychiatric facility happens very similarly to the way that one is admitted to a hospital. Your GP or psychiatrist may write you a referral and you may check-in for treatment at an agreed-upon time.

What Are The Goals of Inpatient Psychiatric Care?

While the first goal of inpatient psychiatric care is to stabilize the person so that he or she is no longer a danger to his or herself or others, there are a number of other goals that can be met through inpatient psychiatric care.

  • Titration and experimentation with medications to treat the mental illness.
  • Group therapy to connect with other people experiencing similar mental illnesses.
  • Supportive structure aimed at establishing normal, stabilizing routines for the day and night.
  • Individualized goals for each person.
  • Development of proper self-care habits - from resting to hygiene, to medication compliance.
  • Learning to take responsibility for one's actions.
  • Boosts self-esteem by being part of a community.
  • Forming relationships and supporting people going through the same things.
  • One-on-one therapy to work through problems, past and present.
  • Additional types of therapies, like occupational, art, animal, and music therapy. 

What Sorts Of Freedom Are Available At Inpatient Psychiatric Hospitals?

One of the major benefits to staying as an inpatient at a psychiatric hospital is the reduction of every day stresses. This comes at a cost of personal freedom.

Most inpatient facilities limit the amounts and types of belongings brought inside. Activities are scheduled. Usage of television and internet may only occur at certain times of the day. Most facilities have a strict bedtime as well.

What Happens After Checking Into The Psychiatric Hospital?

Generally speaking, after arriving at the psychiatric hospital, a nurse will meet with you to discuss your mental illness and problems. You will be searched to make sure that you're not carrying anything dangerous on you and your belongings will also be inspected. Anything considered contraband (something as innocuous as mouthwash may not be allowed) will be removed and given back to you when you leave.

Your first hours will likely be spent settling into the hospital as your treatment team learns more about you so a treatment plan can be developed.

Within 24 hours of admittance, you will speak to a doctor for a complete psychiatric evaluation.

Goals for treatment at a psychiatric hospital center around discharge planning, developing healthy coping mechanisms, working through mental illnesses, obtaining proper medications, as well as learning basic self-care.

How Long Will I Stay At An Inpatient Psychiatric Hospital?

The average length of stay for an adult in a psychiatric facility is 12 days. Discharge planning is begun on the first day of admission to the unit.

Medical research and new, highly effective treatments mean that those who suffer from mental illness can recover more quickly than people have in the past.

Children In Inpatient Psychiatric Facilities:

Both teens and children can suffer from mental illness. Certain mental illnesses often emerge during the early years. When a child's mental illness symptoms become very severe, it may be suggested to hospitalize the child. The following things will be taken into consideration:

  • Is the child an actual danger to him or herself or others?
  • Is the child's behavior bizarre and destructive?
  • Does the child need medication that must be carefully monitored?
  • Does the child need 24 hour care to stabilize?
  • Has the child failed to improve in less restrictive environment?

While a child is hospitalized in a psychiatric facility, a treatment plan - including goals for discharge - will be created. The child may have group therapy, individual therapy, family therapy, and occupational therapy. Treatment will also focus upon academics. To increase social skills, children are often involved in activity therapy.

The family of the child is a major part of recovery from childhood mental illness, so the child's treatment team works closely with parents and siblings to ensure proper communication, teach the family about the mental illness, recovery prognosis and treatment options.

Families will learn how to work with their mentally ill family member and cope with the stresses that accompany those mental illnesses.

Related Resource Pages on Band Back Together:

Mental Illness

Suicide

Pediatric Mental Illness

Therapy

Additional Resources for Inpatient Psychiatric Care:

Depression and Bipolar Support Alliance: information, stories, patient's rights, treatment facilities, and other information for those who are going for an inpatient psychiatric hospitalization.

Mental Health America: Information and resources to locate a hospital or treatment center for treatment of mental illnesses.

List of Psychiatric Hospitals: state-by-state list of psychiatric hospitals and treatment centers for mental illnesses.