What to Expect from a Long-term Psychiatric Hospitalization

Friday, April 18, 2014
You made the call. You scheduled the stay. Now you’re waving goodbye as your loved one begins treatment at a long-term psychiatric facility. What’s next?
Not knowing what happens during treatment can heighten anxiety for family members. While each psychiatric facility is different, here’s a general idea of what to expect:

A grand tour before the goodbye

Many long-term psychiatric facilities encourage family members to stay with their loved ones throughout the admissions process. Family members may visit the facility’s common areas and the unit where the patient will stay during treatment, and meet members of the treatment team.
Parents of children in The Menninger Clinic’s Adolescent Treatment Program typically stay a few days to help ease the transition.
"Sometimes the separation is very difficult for both the patient and the family,” says psychiatrist James Flack, MD, associate medical director for Menninger and medical director for Menninger’s Division of Adult Services. “Seeing the environment firsthand and meeting the treatment staff is reassuring.”
A detailed diagnosis
By the time they make it to a long-term psychiatric facility, many patients have received numerous psychiatric diagnoses, and many of them don’t seem like the right fit.
“Because patients stay here 24/7, it is easier to come to a definitive diagnosis,” says Dr. Flack. “At Menninger, we take data from 24/7 observation, clinicians and testing for an accurate picture of what’s happening.”
The process can take between three and four weeks on a patient unit, or about a week on a specialized assessment unit, like Menninger’s Comprehensive Psychiatric Assessment Service. The treatment team meets with the family to discuss the diagnosis, which will form the basis of the patient’s wellness plan.

Continual communication and education

During a psychiatric stay, family members are encouraged to participate in family meetings, support groups and educational sessions that provide more information about the patient’s psychiatric illness or addiction. 
Treatment professionals also work to communicate realistic expectations for the treatment process. “Sometimes people expect their family member is going to be cured,” says psychologist Michael Groat, PhD, MS, director of Menninger’s adult division. “But the main task of a long-term care psychiatric facility is to further healing or the process of healing.”

A detailed wellness plan at discharge

“Every patient should leave with a detailed wellness plan that will act as their guide to navigating life after treatment, and ideally family members should have input into it,” Dr. Groat says.
For the short-term, the wellness plan may include a list of follow-up appointments to outpatient mental health providers and summary of the patient’s medications. For the long term, the plan may cover steps to rejoin the workforce, reestablish family relationships and friendships and strategies for staying well. “It helps families keep their loved ones on track, and recognize warning signs, such as not getting enough sleep or exercise to regulate their moods,” he explains.