Psychiatric hospitals

Going to hospital for psychiatric treatment

Most people living with mental illness will never need to go to hospital for treatment. But if you do have to go, hospital can be the best place for you to rest, feel safe and receive the help you need.

Staff at the hospital are trained to help you get through what can be a stressful time for you and your family.

Why go to hospital?

You may need to stay in hospital when you can't cope with your mental illness symptoms at home and need more intensive help.

That might be because you are:

• feeling really sad, really frightened, or if you are feeling out of control
• injured or have physical symptoms from self-harm, alcohol or drug use, or eating disorders
• experiencing hallucinations (seeing or hearing things that are not there)
• having thoughts of hurting yourself or others.

In hospital, you can feel safe, be in close contact with doctors and nurses, get medications right (if you need medication) and have some treatments you can’t get at home.

Types of hospitals

In Australia there are psychiatric units in major public hospitals, as well as specialist psychiatric hospitals that can be public or private.

In New Zealand, all psychiatric hospitals except for the Ashburn Clinic in Dunedin are part of the public system.

Public hospitals are free for citizens and some overseas visitors.

Private hospitals charge fees for their services.

More about private health insurance and hospitals (Australia)

What do I need to know before going to hospital?

Admission

Admission to a public psychiatric unit is usually through the emergency department, or the hospital’s community mental health team.                                                                                                                                 

For a private hospital you need your GP (family doctor) or a psychiatrist to arrange admission for you.

If you need an interpreter, the hospital can organise this for you.

Intake and assessment

When you come into hospital, you will be shown around and given information about what will happen during your stay.

You will meet with a psychiatrist or a registrar (a doctor training to be a psychiatrist), who will talk to you about your concerns.

This could include:

• talking to you about your thoughts, feelings and symptoms
• asking about how you're currently coping
• asking you about things you're good at, what has worked in the past and possible supports available to you
• asking about your medical history
• asking you some questions to test your attention and concentration.

The doctor may also want to talk to your family, partner or friends. They will ask your permission first.

They may do some blood tests, brain scans or other tests.

In New Zealand, Māori patients under Māori mental health may be met by a kaumātua or kuia and welcomed into the hospital.

What happens day-to-day?

How long will I be in hospital?

The length of time you’ll be in hospital really depends on why you’re there, the treatments you need and how you’re responding.

Some people only stay a day or two. Others may stay for 2–3 weeks or longer.

People who haven’t been in a psychiatric ward before sometimes worry they may never be able to leave. That never happens these days.

What happens after I leave hospital?

Being in hospital is just one part of your recovery.

Before and after you’re in hospital you might have home visits, telephone or internet case-management and appointments for psychological and medical treatment.

A social worker can help if you're worried about accommodation after you leave hospital.

Can I be treated without my consent?

Sometimes a mental illness can become so severe that the person with the illness may not even realise they are unwell.

If someone is so sick they don’t understand they need treatment, and if not having the treatment would put them (or others) in danger, the law allows that person to be treated involuntarily.

This means they can be kept in hospital (if necessary) and treated, even though they say they don’t agree to it.

To make sure this only happens when it’s absolutely necessary, the law requires that doctors present a case for this in front of a tribunal (or, in New Zealand, a judge).

The law also protects your rights. You have the right to legal representation and in some cases this is provided for free. (In New Zealand all cases under mental health compulsory treatment orders receive free legal representation.)

You have the right to be seen regularly by your psychiatrist and to have contact with family/whānau.

Each Australian state and territory and New Zealand have their own mental health acts, which set out these rights and the other rules that doctors must obey.

Seclusion and restraint

Seclusion or restraint may be used when a person is acting violently and the person, other patients or staff members are at risk.

Seclusion is where a person is kept alone in a room or area where they are unable to leave.

Restraint is where a person is physically restricted from moving around, for example by someone holding them, through medication, or by being strapped down.

Seclusion and restraint are a last resort where all other options to keep people safe have been tried or considered. Both should be very rare.

The RANZCP’s position is that the use of seclusion and restraint should be reduced and where possible removed entirely.

RANZCP Position statement on minimising use of seclusion and restraint 

Your rights in hospital

Tell hospital staff if you are uncomfortable with any part of your treatment or are unsure of anything.

While in hospital, you have the right to:

• privacy
• safety
• respect for your cultural identity
• ask questions about your treatments and medications and their side effects
• know your diagnosis, and disagree with it
• get a second opinion (this could be at your own cost)
• refuse treatment (though if you are under an involuntary order your doctors may end up insisting on some medications)
• make a complaint
• have a family/whānau member, friend, family consultant or anyone you choose to help you ask questions.

Help for families/whānau

If you have a family member or friend who is in hospital, you can be involved in the person’s treatment, with their permission.

Most hospitals will have workers whose main job is to help families learn about the person’s illness, find community supports and work out how to best use the health-care system.