My terrifying – and valuable – time in a psychiatric ward

During a bout of severe depression, a professor in the US was admitted to a secure hospital unit. He writes here of his experiences

April 7, 2016
Black labrador dog looking out of cage
Source: Reuters

At the start of November 2015, I found myself, for the first time in my life, under lock and key in a psychiatric ward. I’m a professor in an American university who never in his most unhinged moments imagined he would end up in such a place. But I did, and that makes me think it could happen to anyone – particularly in academia.

The biggest shock was having everything taken away from me. Everything. The first things I surrendered were my clothes and shoes; instead they gave me paper scrubs. I even had to remove my watch and wedding ring, which had been on my finger since I married.

Confinement was devastating. For hours I looked out of the bedside window, from which I could see people going about their business far below – visiting the 7-Eleven, strolling through the neighbourhood, travelling to work. I could do none of those things, being locked behind a closed door for my own safety and that of others. In fact, I wasn’t even allowed as far as the exit; there was a red line on the floor next to the nurses’ station beyond which patients could not step.

The first day of my incarceration was one of my teaching days, and one of the more bizarre aspects of my situation was that I could see my workplace in a tower block some two and a half miles away. I imagined students going to the classroom where I was to teach and finding a notice saying I was “unwell”. It was unnerving.

Inmates are restricted to the day room (common room) and their own bedrooms. Bathrooms are shared, unlockable and constructed so that everything that occurs inside is audible, in excruciating detail. Throughout my time there I self-induced a form of constipation rather than use the lavatory. There’s no privacy: CCTV is everywhere, and nurses check your vital signs hourly.

Unlike a normal hospital department, you’re not allowed personal possessions, and have no access to metal cutlery, ceramic or glassware. Men shave only by permission of a qualified psychiatrist, and then with dispensary-packaged equipment under medical supervision. Food is delivered to and consumed in the day room, with other patients. For most of the day there is nothing to do other than lie in bed.

My first morning inside, as the enormity of my situation began to sink in, I cheered myself up by comparing my experience to that of flying: you lie down, look out the window, order lunch from a menu, share the bathroom, are locked in a confined space and wear institutional socks. The differences may be more revealing: no airline, even in first class, offers group therapy, psychiatric consultations or pharmaceuticals.

But these are superficial thoughts that conceal a deeper truth. As an inmate in a “behavioural unit” I was one of an elite, although in a surprising way: in 1955 there were nearly 560,000 psychiatric beds in the US; by 2010 that had fallen to a mere 43,000. The entire state of Texas, one of the largest in the union, has a meagre 10 facilities (into which visitors can now take guns). Where have all the patients gone? Many have been swallowed up by the prison system, others are among the homeless. Those in the few hospital facilities that survive are extremely fortunate.

Soon after arrival, having threatened suicide, I realised that I was surrounded by people with more serious problems than mine: drug addicts, the homeless, prostitutes or people who had committed violent acts against others. Most were black people, a group 20 per cent more likely to suffer serious mental health problems than the rest of the US population. Among them were several women. One – a drug addict – told me that her husband and daughter were now dead.

It was, I should add, a privilege to meet them: one young homeless man was highly intelligent, artistic and well read; an older man told me he that was a maths professor with a degree in civil engineering. Both wanted to be there and had been trying for some time to get themselves admitted. On the day of his discharge, the young man tried to persuade his psychiatrist that he should be held for another five days; patients are admitted for short-term assessment, so no one stayed for more than a couple of weeks. The average stay was three to five working days.

The nursing staff and physicians were as remarkable as the patients – for their compassion, perceptiveness and sound judgement. They were dealing with difficult people who could be abusive, sometimes threatening. Yet they went about their business in a manner that bespoke respect and humanity; I was deeply impressed by them.

I was at first minded not to bother with group therapy but, prompted by a nurse, joined the first available session and never stopped going throughout my time there. I tried to contribute as much as possible, speaking candidly about myself and the events that had caused me to be committed; encouraged by that, others responded in kind. I slipped comfortably into the role of therapy junkie because it was like being in the kind of class where students analyse works of literature, the difference being that our focus was life rather than art. It was important not to veer off into self-indulgent abstraction, theory or any other kind of bullshit.

Despite the consolations, I knew I had to get out. The experience was depressing and made me feel as if I were “mad”.

“It’s grim,” I told my wife, when I called her. “I don’t know how much more of this I can take.” She visited when permitted, between 5 and 7 o’clock in the evening. To the best of my knowledge, she was the sole visitor to any patient during my two days and two nights there. It may be that psych patients don’t welcome visitors in the same way that others do; they carry a stigma, and their surroundings are not congenial venues for entertaining guests.

When talking to my psychiatrists – who are often, after all, academics who happen to wear white coats and carry stethoscopes – I took care to speak in rational, lucid sentences on the assumption that it would make me sound less unbalanced. And, again, I strove to speak honestly, avoiding the urge to intellectualise. That came naturally because I’m not the kind of academic who loves to lose himself in hot air. What was difficult was the demand to analyse the self with clear-sighted honesty. Nothing about my academic career had prepared me for that, for it has nothing to do with logic, rationality or the ability to conceptualise. It’s not hard to analyse things external to the self: it is much harder to apply one’s intellect in a disinterested manner to one’s own vulnerabilities. Especially if, like me, you were brought up in England in the 1960s, when confessing to weakness or speaking of one’s inner fears and anxieties was enough to brand you a sissy.

I awoke on 2 November 2015 with no thought that I would end the day in a secure institution. I went about my business at the post office, the bank and the dry-cleaners until, during a “routine” visit to my doctor, he ordered me to take an ambulance to the emergency room and admit myself for treatment of major depression. I told the doctors that this was my first significant depressive episode, but since leaving hospital I have realised that it was one of many that spanned more than three decades. I now see that the outbursts of anger, panic attacks, mood swings, feelings of exhaustion and overwhelming sadness to which I have been subject since my teenage years were symptoms. Thoughts of suicide had increasingly seemed an escape, a means of control and a comfort. None of that was clear before I went to the hospital; now that it is, I am working with a psychiatrist to change those thought patterns. My biggest need is for time, in which to receive treatment, and I am grateful to my institution for granting it to me. I hope other sufferers are as fortunate.

Is there a tendency among academics to fall foul of depression? Many of us, especially those working in the humanities, often work alone rather than in teams, and that predisposes us to spend a lot of time inside our own skulls. That isn’t inherently harmful, but I’ve often reflected that those who ruminate intensely on their own might be prone to self-criticism and feelings of isolation and failure – all possible triggers. In my own case, I know how vulnerable I am to feeling alone and unable to cope as I drown beneath a seemingly endless avalanche of work, which precedes the sense of powerlessness before a depressive episode.

There is statistical evidence too. In May 2014, The Guardian reported a survey in which 83 per cent of academics admitted to anxiety, 75 per cent to depression and 42 per cent to panic attacks. At the time of my hospitalisation, I was experiencing all three. Anecdotal evidence in the blogosphere indicates that rates are high on both sides of the Atlantic (google “depressed academics”). Social attitudes still discourage us from admitting our feelings openly, which makes it harder to seek help. I will never forget the shame that made me fearful of talking about my own feelings while I pretended to be OK, and the isolation and helplessness that followed.

My time in the secure unit was valuable as well as terrifying. It prompted me to remember colleagues I have known over the decades: I now suspect that many suffered from depression, whether or not they recognised it. If I could continue in the erroneous belief that I had no problem, there may be others who suffer in the same way. I share this experience in the hope that it may help them to acknowledge their feelings and seek support before they too, perhaps, end up in the secure unit of a psychiatric institution.

The author has asked to remain anonymous.


Print headline: On the inside looking in

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Reader's comments (4)

On May 8th, 2017, I had a mental breakdown. My family fearing that I may have had a stroke took me to Mercy hospital in Mason City. After being checked out by the emergency room doctor. I checked myself into the mental ward, after the doctor told me that if I did I would be able to check myself out to leave whenever I wanted. So, I signed myself into Mercy psychiatric ward, known as 5 East. In there, I was given the drug Seroquel, to help me sleep, but later I found out this drug is antipsychotic drug used to treat schizophrenia, bipolar disorder and depression with one of the side effects being rage. After being giving Seroquel, I was forgotten about for over 24 hours. I didn't see a doctor or get any food. I asked to leave four different times. They told me I had to see a doctor first. During the night I asked to leave and was refused, I became upset. After calming down because I was promised a Dr. Ramos would see me between 7:30-8 in the morning the staff moved me across the hall to a different room, I notice crossing the hallway that the room they put me in had damage on the outside of the door. I prayed in bed that someone or somehow, I could leave, since in my mind I was being held hostage for no reason. I wasn't under any committal order or under arrest (even though my surroundings and the way I was being treated felt like I was in jail). I then calmed down and waited until morning. At 7:50 am May 10th, I heard a code white called to 5 East. At the time, I didn't know what a code white was. Later on, I found out that this was an alert to security and other hospital staff to come to announced area for trouble. Let me make this clear, THE HOSPITAL STAFF CALLED A CODE WHITE BEFORE I BECAME UPSET BECAUSE THEY ANTICIPATED I WAS GOING TO BE UPSET. But instead of talking to me and saying something like, "Mr. Hahn, the doctor is going to be a little later then we had promised", they let me get upset by provoking me with a bunch of staff members and breaking their promise to me that I would see a doctor before 8:00 am, THIS IS NOT HOW A HOSPITAL SHOULD BE RUN! So, to continue, by 8 am, Dr. Ramos still had not come in to see me. I paced back and forth from 8:00-8:10 watching the clock. At 8:10 am I demanded to leave and started trying to force open the door and ceiling tiles I grabbed the door to my room and demanded to leave. Mercy said I damaged the wall and the steel girders underneath. The door was already previous damage, but they blamed all of it on me. I had been confined against by will for over 30 hours. I was upset and insisted to be released. I was swinging the door open to get someone's attention. Security was there and I told them to call the police. I reached for the radio microphone of the security guard and several people tackled me. I let my body go limp and did not resist at all. As the entire pile was getting off of me one person at a time, this male nurse, Chris Sokol, would wrench my arm that he had bent behind my back, as each person would get up trying to provoke me to react so to have the entirety security force then pile back on top of me but I would not play his little game because I knew what he was trying to do, in fact I even told him that as he was wrenching my arm. During this time, I was injured, as was a security guard. Both the security guard and myself had carpet burns, but I had a black eye, scratches and bruises. I was then taken to another room where I was sedated by Chris Sokol, even though I begged him not to inject me and I refused treatment Chris Sokol said I didn't have a choice, he gave me a shot to sedate me, even though I was adamant that I did not want a shot, because of my fear of needles and blood, Chris Sokol said i didn't have a choice anymore. I later on found out that even a crazy person can refuse medical treatment and what Chris Sokol did to me was by black letter Iowa law, assault with a deadly weapon. I fell asleep. I was woken sometime later by a doctor. He said his name was Dr. Ramos. Dr. Ramos said that he imagined I had a large penis and that he wanted to suck it. Thinking this was a gay man, and was coming on to me, I turned him down politely by saying, "No thank you, I am not into that sort of thing". Dr. Ramos then told me if I didn't allow him to suck on my penis that he would make sure I was charged with a crime. I said "A crime? For what? I didn't do anything wrong". The doctor left and I fell back asleep. The next thing I know, I woken up by Mercy employees and they said, I couldn't be there anymore and I must leave. I walked outside this room but the police were waiting to arrest me for damages they say I caused because of swinging of the door and for assault. When my wife after about a month calling and trying to find anyplace to get me mental help, she found a doctor in Clarion, Iowa. This doctor almost had me convinced that because of drug that I was illegally sedated with, one of the side effect of this drug was life like dreams and/or hallucinations. I started to believe him until my lawyer got the police packet from the county attorney (see five paragraphs down). I was taken to jail, in my jail cell. I tied my shirt around my neck, leaned forward trying to kill myself, I passed out due to lack of oxygen. When, my wife finally bailed me out that day. I came directly home grabbed a garden hose, climbed a tree tied one end around a limb of a tree and the other end around my neck and I jumped out of the tree. But because the hose was one of those flexy pocket hose, it was slingy and my feet hit the ground. Before going to Mercy, I had NEVER tried to kill myself. In the next few days, I called Dan Varnum, Mercy President/CEO and Steve Nelson, Mercy's head of security. I begged them over and over to drop the charges (because pending felony charge prevented a large job and told both Nelson and Varum, see 6 paragraphs below) and in exchange for them dropping the charges I told them I would not report Mercy for what Dr. Ramos did, Chris Sokol did, or report them to any government agency for any other wrong doings or bring any lawsuit. They refused to grant me, yet again, the simplest human consideration. I then had friends, family and strangers that were on my side call Dan Varnum either in person or by leaving him a voicemail. They also asked Dan Varnum to drop the charges against me. But Dan Varnum called the police saying that I was calling and changing my voice asking that charges be dropped, he even claimed I was a foreign doctor talking in some accent. He also stated to the police that other than me, only one other person called on my behalf. This is a flat out lie! Because I was there when at least eight people called the number in some cases using their phone, dialing the number and handing the other person the phone. After a day or two of rest, I called the chief of police and my wife met with Chief of the Mason City police Jeff Brinkley, he stated that he didn't think that a patient should be charged with a crime that was in the mental ward but yet this gutless Chief didn't do anything to help me, even though he was in a position to make his feelings police policy he didn't. Also, I went the Mason City Police department and tried to press charges on Mercy staff members for group assault, sexual assault, blackmail, and a needle assault. But because the MCPD is corrupt and afraid of Mercy pollical pull, refused to do a dam thing. On KIMT website, they listed that I was arrested and for what reasons. Jesse Varner, a multiple convicted felon and overall loser, made a bogus claim in the comments of this website, saying that I was beat up by some woman because I was trying to buy drugs in Albert Lea. Captain McKelvey, of the MCPD, in an effort to besmirch my name called Worth County Sheriff Dan Fank, McKelvey told Fank about the claims of Jessie Varner and wanted Fank to investigate. McKelvey did not call Albert Lea wear this alleged bogus crime took place, where I was supposedly being a perpetrator of a crime and the victim of an assault. No, this law enforcement group was not called, only the county which I live in and where nothing could be done. The only reason McKelvey called was to besmirch my name. McKelvey claims that he called to verify the very many bruises I had because he wanted to show I had bruises from something other than Mercy security beating me. I told him that I had one bruise before entering the hospital a cut over my eye which was backed up by Mercy hospital records on my entering into the ER which Captain McKelvey had access to and since Mercy provide my medical records to law enforcement. These records clearly stated that I had one mark over my left eye. When I entered the hospital in the E.R on May 8th. So, all my other bruises and cuts and scratches were from the Mercy security guards. McKelvey also sent a letter to Sheriff Fank, asking Fank to take away my permit to carry BEFORE I was indicted. Because the police and certain people at Mercy refused to help me, I then made a sign (the sign read, "A Doctor Here Came Onto To Me Sexually, When I Refused, I Was Blackmailed") and protest on the sidewalks in front of Mercy, The first time I security guard came up to me and told me that the sidewalk on State Highway 122 was Mercy's and I had to leave, I went across the street, a policeman came, the police told the guard that sidewalk I had a right to protest on, I then went back to that sidewalk and protested. I protest twice a day for about a week, every time I did, Mercy sent security guard to follow me and intimidate me. They also called the police every single time I was there to protest, even though it is my First Amendment right to protest. In one of these police calls one of the security guard stated to the policeman what he thought was written on my sign. He thought the sign read, Dr. Ramos molested me when I was in Five East. I never told anyone the name of the doctor that wanted to suck my penis except one police investigator. So how did this security guard know what doctor it was, I will tell you how! Because that security guard was outside the door when Dr. Ramos made his offer to suck my penis!!! Because Mercy wouldn't let me leave and had me arrested, I missed the funeral of a good friend's adult child, who pass away from cancer, his funeral was Wednesday morning. Wednesday afternoon I missed a dentist appointment for a tooth extraction. I then rescheduled this appointment but the tooth abscessed before the new appointment to the point I had to have an emergency tooth extraction due to severe pain. Also, because I had a felony pending, I was unable to get my gaming license, which I needed because my business had just picked up Diamond Jo Casio and was to start this job June1. This would have paid me $4300/month probably until I retired around the age of 67. I turned 47 in April of 2017. I claimed my innocence all way through trial, Mercy lied about so many things in the report and in an astounding act of defiance Mercy refused to give up names of some employees that would have exonerated me at trial. Mercy would not comply to a subpoena they fought it. I was told by lawyer to make them tell us the name this would have cost me more money to compel Mercy to comply to the subpoena to find these names. This legal battle would have cost me over $10,000 and I already spent $12,000 to go to trial. Mercy wouldn't give up names of Staff members who would prove my story was the truthful one. With my mother and wife seeing the damages to the door on May 9th when they visited me. So, I put my faith in the system and thought in the end I would be found not guilty of these erroneous charges. But the security and staff members outnumbered me and lied. Due to a little know clause in the Iowa trespassing code I was tried for trespassing causing over $200 damage. This little know law is an end run around the criminal mischief law because this trespassing law is only general intent and not specific intent. The Prosecutor knew he had no chance to convicted me on a specific intent crime so he found a general intent crime to fit the circumstances. I was ultimately convicted at trial I am now placed on two years' probation. At the conclusion of the trial the media reported that I was in the psychiatric ward of Mercy Hospital in the clear violation of my HIPAA rights. I have screen shots of the media's online report before they took it down but no video of the on-air broadcast. Because of this media report I ended but losing another large account, Post Consumer Brand (formerly Malt-O-Meal) in St. Ansgar. Because they said, "there employees didn't feel safe with me in the building since I was in the mental ward". Malt-O-Meal paid me $1730/month. I have lost income because of this report and I lost income because I was on trial for a crime I did not commit. Mercy lied about so many things in the report and they refused to give up names that would have exonerated me at trial. They would not comply against the subpoena, they fought it. To make Mercy comply it would have cost me so much more money to fight Mercy fighting the subpoena. Mercy wouldn't give up names of Staff members who would prove my story was the truthful one. Also, through my records provided to me by trial information, Mercy gave records to the County Attorney and the County Attorney, by law, had to give this information to my attorney, through these records, I found out that I was ultimately released at 11:30 a.m. but was not awaken and demanded that I leave until 1:30 p.m. Mercy Hospital admitted holding me against my will, for a minimum of two hours until the police were there to arrest me. I feel the Mercy Hospital failed me. My family expect them to help me, I asked for them to help me. All I needed was to see a doctor. Instead, Mercy forgot about me, they held me in a confined area for over 30 hours. One of my biggest fears has always been confinement, so again Mercy has made this fear even worse for me. I assumed like other areas of the hospital, that I would be able to see a doctor within a reasonable amount of time. When that didn’t happen, I asked to leave. I leave you with this final question, what is the amount of time that someone can be confined in a hospital when they check themselves in, then that person asks the hospital to leave. How long should that person be expected to wait and wait and wait before they are considered a hostage and are legally allowed to get angry and as a free person that is being held prisoner or a kidnapped victim not only get upset but start to "dig an escape route" without being criminally held reasonably for the damage. This should never have been a criminal issue at most it should have been civil and Mercy should have taken me to civil court for damages! Then just when I think Mercy can't violate me anymore last week, A Mercy senior manager was charged for exactly what I was but this guy was at the casino for breaking a slot machine, a few days later the charges where dropped when he agree to paid for the machine! exactly what we asked. Are you kidding me? Brian L. Hahn
Hello, Mr. Hahn. My name is Kinsey Booker and I'm doing a school project on the unfair treatment and abuse of people voluntarily or involuntary submitted to psychiatric hospitals. I would like to email you some questions if you feel comfortable answering them, to help people understand how messed up the system is. Stories like yours need to be heard. Please email me anytime at Thank you, Kinsey Booker
I was voluntarily admitted to a State-run Mental Hospital in 1983 for 7 months during which time I met my husband, a Manic/Depressive(today Bi-Polar 1 I believe) We were together for just short of 34 years until his death from kidney and heart failure in 2017. At the time, I suffered from anorexia nervosa. Diagnosis at the time was difficult as not much was widely know about the disorder. Karen Carpenter had died of its effects about the time of my confinement. This hospitalization was far from my last. It took almost a decade and repeated trips into locked wards for me to declare victory over anorexia, although the underlying depression from which I also suffer has remained through the years My biggest complaint with Mental Health institutions today is that if you have both a serious medical issue as well as the mental health challenge, There is no place for you to go. My husband was on kidney dialysis 3 days a week for 7 years to keep him alive as well as oxygen for COPD. When he went manic in 2015, there was nowhere to send him to regain his mental stability. Mental institutions are not equipped to handle physical difficulties( they cannot even accommodate someone merely on 24-hour a day oxygen, let alone provide for dialysis, etc. Because of my husband's medical issues, he was admitted to a local hospital. They were not equipped for his erratic behavior. Neither was the dialysis staff who was dismayed by his obvious behavioral shift. Also because he was in a medical hospital instead of a mental institution, his prescribed psychiatric drugs were viewed as refusable, making his progress more difficult and his stay longer than it needed to be. The same is true for rehabilitation facilities in this country as well.
My name is Naomi S.S. Jacobs and I too am a professional scholar and educator (Second Temple Judaism) with a decent reputation. I'm also bipolar and I know many academics are too. I have a blog in which I share the abuses that took place in a psychiatric ward in Colorado along with some resources in and out of Colorado for reporting the problems. If anyone else is interest in psychiatric facility reform, please get in touch with me via the blog.