Understanding When to Admit a Schizophrenic Patient to the Hospital

In the realm of mental health, the decision to admit a patient, particularly one diagnosed with schizophrenia, can be complex and often fraught with challenges. As a chaplain in a hospital setting, my duties extend to both self-admitted and involuntarily admitted patients, and the latter can present some of the most challenging situations. This article aims to explore the criteria and considerations for admitting a patient to the hospital when they are actively refusing treatment, and the progression of their condition indicates a need for intervention.

The Role of the Chaplain

My role as a chaplain is multifaceted. On one hand, I work in the Adult Mental Health ward, where patients are typically self-admitted and participate in intense therapy and medication management sessions before discharge. Even those diagnosed with schizophrenia may arrive voluntarily, often unaware that their symptoms were the result of non-compliance with treatment. I have encountered cases where patients initially did not realize the impact of their condition.

On the other hand, I deal with the acute mental health ward, where patients are brought in by family members, EMS, or law enforcement. These patients are often in a state of psychosis, non-compliant, and difficult to manage. Convincing someone to enter the hospital voluntarily can be more challenging than keeping them there once admitted. It's crucial to remember that the hospital visit should be viewed as an act of love and support, aimed at alleviating suffering, fear, and confusion. Some of the ER doctors I work with may not be adept in handling mental health cases, preferring to pass patients off to mental health services as quickly as possible.

Approaching the Patient with Schizophrenia

A case that stands out is a patient with schizophrenia who recognizes that her experiences are not ordinary. She has even sought professional help by requesting to be taken to the hospital. However, this case is not without its complexities. Patients like this one still face challenges in being admitted, as they may not be a danger to themselves initially, leaving them less likely to be hospitalized.

Given the patient's current condition, one of the most effective ways to facilitate her admission may be to engage in discussions about treatment, using reality checks to help her understand her delusions. Support forums and peer networks can be particularly helpful in such cases. These forums are not places for rainbow and hugs, but for tough, reality-based conversations.

The Role of Support Forums

I am part of a support forum for the mentally ill, where reality checks and peer support are paramount. Members here are self-selected and often engage in discussions to help others recognize their symptoms and improve their treatment compliance. While we are pro-treatment, recognizing that sometimes quitting medications can be a symptom of the illness, we work to help patients with schizophrenia become compliant.

The site, CrazyBoards, is a community-driven platform where members share their experiences and provide support. It's a challenging environment, but one that can be immensely beneficial for those struggling with schizophrenia. However, the site is 1st person and requires users to be actively mentally ill. If your sister is interested, she would need to use a pseudonym that is not a recognizable celebrity to participate.

Conclusion

Deciding to hospitalize a schizophrenic patient can be a daunting decision, especially when the patient is resistant to treatment. However, seeking support from chaplains, ER doctors, and mental health networks can provide crucial assistance. Engaging the patient in conversations about treatment and reality checks, and utilizing support forums like CrazyBoards can be powerful tools in helping them recognize their symptoms and agree to treatment.

As a mental health professional, it's important to remember that the patient's journey is complex and multifaceted. While the decision to hospitalize can be difficult, the goal is to provide the best possible care and support for the individual.