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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.

Private psychiatric hospitals admit a really broad range of people.

They range from adolescents, through to adults through to elderly people, with a whole range of mental health problems.

Common problems like depression and anxiety, drug and alcohol problems.

Even less common things like schizophrenia.

One of the reasons people come into hospital is things like suicidal ideas where there's a real risk and danger. 

And clearly in hospital we can observe people and support them during those difficult times.

The treatment of a person is tailored to what they need and will usually involve a close discussion between them and their psychiatrist. 

Almost all patients will be involved in therapy, both group and individual. 

There'll be other group activities involving things like art therapy, yoga or exercise - all of which we know can be beneficial to the treatment of mental health problems.

There's also some treatments like ECT that we utilise for some of the most serious conditions. They also have lots of opportunities to have one-on-one discussions with their nurse. 

In hospital you will be greeted at a reception desk.

They'll help you get to the ward and find your way around.

Usually a nurse will greet you, take some admission details and show you around the place - so you know where to go for various things.

Your psychiatrist is responsible for leading your care. That means your psychiatrist will meet with you most days, review how things are going and what you need to work on next. 

Your psychiatrist will also meet regularly with the rest of the team. That means nurses, psychologists, occupational therapists or whoever else in hospital is there to help you.

The average length of stay in a psychiatric hospital now, is about two to three weeks. Many people worry about - what's it going to be like with the other people in hospital.

For many people, having a mental health problem can be quite isolating. Remember that these people are more likely to understand what it's like than most people you meet every day.

People get better in hospital.

They usually need ongoing support afterwards, and your psychiatrist is likely to continue to be part of that care team.

Why do people go to hospital?

People go to hospital when they can’t cope with their mental illness symptoms at home and need more intensive help.

That might be because they are:

  • 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 themselves or others
  • feeling really sad, really frightened, or out of control.

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?

What to bring
Visitors
What to tell work

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 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?

Activities and treatments
Surroundings
Staff members
In a sense, [going into hospital] is a relief. You can’t stress about work, or running here or there. Your job while you’re there is to reclaim your life, to learn skills to better handle the things that might have brought you there in the first place.

Abby Heugel

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 seclusion and restraint [PDF; 305 KB]

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.

Remember

  • Your care and treatment in hospital will be matched to your needs.
  • You will be involved in putting together a treatment plan, even if you are being treated involuntarily.
  • The main aim of everyone you meet in hospital will be to help you and your family as much as possible.
Page last reviewed March 2017 | C1026V1

This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.