How do psychiatric clinics work? Is it possible to receive psychological treatment in a hospital?
As a result of the pandemic, lockdown and social isolation, there has been an increase in psychiatric illnesses both in our country and in the world. Existing psychiatric illnesses have intensified and non-existent illnesses have emerged. In this process, although the number of people receiving psychiatric support has increased, the number of people refusing treatment has also increased. Some psychiatric illnesses require inpatient treatment. However, prejudices about psychiatric clinics lead to refusal of treatment. Some depression patients also need inpatient treatment depending on the severity of the illness. In this article, we plan to break your prejudices about psychiatric clinics and inpatient psychiatric treatment. Remember, postponing the problem will only make it worse.
After the corona virus entered our lives, psychological problems have also increased. Research shows that psychological problems such as anxiety, depression and panic attacks are the most common. However, most people refuse treatment for these psychological problems. Each refused treatment causes the disease to progress further. Moreover, some patients need to be hospitalized. For many people, receiving psychiatric treatment in a hospital can seem like a terrible situation.
Psychiatry Specialist Assist. Assoc. Prof. Dr. Semra Baripoğlu from Üsküdar University NPISTANBUL Hospital told Posta Newspaper about psychiatric clinics and inpatient treatment...
There are various social and individual factors underlying people's reluctance to be hospitalized in psychiatric clinics. In some cases, the patient and/or his/her family experience the anxiety of being ostracized from the society they live in very intensely and refuse inpatient treatment even though it is absolutely necessary. Behind this preference is the fear of being labeled as a "psychiatric patient". In some cases, individual factors, such as personality traits or lack of judgment due to the illness, prevent the patient and/or family from recognizing the seriousness of the illness and refuse inpatient treatment.
Nowadays, the physical conditions of psychiatric clinics have been improved with an emphasis on patient safety, so they are not places to be feared.
"Psychiatric clinics are not as scary as people think."
Which patients can/should be admitted to a psychiatric clinic?
Patients of all age groups can be admitted to a psychiatric clinic. Pediatric and adolescent patients are hospitalized and treated in specially designed wards.
The hospitalization decision is made according to the severity of the illness. To give a few examples, inpatient treatment in the hospital is the first choice in clinical pictures such as severe depression that causes the person to stop eating and drinking and leads to suicide attempts, manic attacks that lead to self-destructive behavior, schizophrenia attacks, eating disorders with severe weight loss that pose a risk of death in adolescents, etc.
Can the patient be hospitalized voluntarily, or are there certain conditions?
Inpatient treatment is decided by the doctor depending on the patient's condition. If hospitalization is necessary, he/she informs the patient and his/her family of this recommendation. Patients who are aware of their illness and desire treatment accept inpatient treatment voluntarily with the doctor's recommendation.
But can a patient be admitted to a psychiatric clinic against his/her will? Under what circumstances can this happen?
In cases of severe illness, there is a risk that the patient may inadvertently (without deliberately planning it in advance) harm himself/herself or others around him/her. He/she may have paranoia, which is very frightening for him/her, and under the influence of these paranoia, he/she may attempt suicide in a moment of anger, or injure/kill someone else with a firearm/sharp weapon. Or he/she may run away from home, reappear days later in another city and may be abused. In some cases, the patient does not sleep for days, talks constantly, does not eat, and loses weight.
A patient in this situation is not aware of his/her condition and never accepts that he/she is ill. Therefore, the responsibility lies with the family and the medical treatment team. Hospitalization and treatment is planned without waiting for the patient's consent.
What kind of treatment is given to patients in psychiatric clinics, how does it differ from normal treatment?
In psychiatric clinics, medication, psychotherapy, Magnetic Stimulation Therapy, which are also applied in outpatient treatment, are basically applied. However, since inpatients are at the most severe stage of the disease process, powerful treatment options, such as electroconvulsive therapy, are also used, with a much faster response rate.
Another advantage of inpatient treatment is that the patient is under 24-hour supervision. This provides the treatment team with other data about the patient and family that cannot be seen in outpatient treatment, and sheds light on family relationships.
The patient's getting away from his/her own environment, being alone with himself/herself, sharing the same environment with other patients with similar problems in the clinic, participating in group therapies, increases his/her self-awareness, helps him/her accept the situation and gain the strength to fight the disease.
"Group therapy provides the strength to fight the disease"
Is clinic treatment or home treatment more effective?
Inpatient illnesses can of course be treated more successfully in a clinic. At home, there will be no close observation and follow-up as in the hospital, and no opportunity to apply strong treatments.
"The patient should be convinced by talking first"
How to convince a patient to be admitted to the clinic?
A patient who needs to be admitted, regardless of his/her presentation, should first be talked to and convinced. The doctor will inform the patient about the disease and biological evidence (test results) can be shared. The patient can be reminded of past episodes of the disease, if any, and how he/she recovered and was able to return to a normal life. The family can also express to the patient that they are with him/her, that they will support him/her and that they will fight the disease together. If the patient is convinced, hospitalization will be easily realized. However, in the very severe cases mentioned above, our expectations should be close to zero. It is important to keep in mind that the patient is not capable of making decisions. Persistence may lead to increased anger, aggressive behavior, or running away from home. The responsibility lies with the family and the treatment team. The best way is to take a decision and implement it quickly.
"The only option for patients with suicide attempts"
Should patients with depression be treated in a clinic?
Whether outpatient or inpatient follow-up of patients with depression depends on the severity of the depression. If there are symptoms such as severe depression, which is also called major depression, severe depression, a state of complete abandonment of life, loss of interest and desire, constant desire to lie down and sleep, loss of appetite, significant weight loss, sleep disturbance, thoughts of death, and if the patient has not benefited from previous treatments, inpatient treatment is on the agenda. Patients who have attempted suicide in the recent past have a high risk of attempting again and inpatient treatment is the first and only option.
