Hospital-based treatment for depression

Getting a bed in an NHS psychiatric hospital usually happens when someone is considered very ill, for example if they may be a a danger to themselves or others. It can be voluntary or through being ‘sectioned’. Sometimes it can be difficult to get an NHS bed, and one woman once felt she had to act-up a little to get one. If someone has private health insurance, they may be able to go to a private psychiatric hospital.

Hospitals also have A&E (Accident and Emergency) as well as Outpatient departments which people use when they do not need to be admitted to a psychiatric hospital.

Felt she had to present ‘dramatically’ in order to get into hospital.

Age at interview 58

Gender Female

Age at diagnosis 20

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He felt he got better care at a London-based outpatients clinic compared with local services.

Age at interview 35

Gender Male

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Experiences of NHS psychiatric hospitals were mixed for the people we interviewed. In most peoples’ experience, psychiatric hospitals did not usually live up to the highly negative stereotypes in the community, (e.g., that they are ‘lunatic asylums’, a place for ‘nutters’). But people as well as families who had negative and stigmatised impressions of psychiatric hospitals could feel ashamed and fearful about being hospitalised.

Especially in past times, there were aspects of NHS hospitals that were very poor. One woman described a 1970s experience of a psychiatric hospital ‘like something out of Dickens’.

Describes her mother’s shame about her hospitalisation. (Played by an actor)

Age at interview 33

Gender Female

Age at diagnosis 24

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Describes an experience of sexual misconduct by a member of staff at a hospital over 20 years ago.

Age at interview 58

Gender Female

Age at diagnosis 20

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Describes a negative and frightening experience of an NHS hospital in the 1970s.

Age at interview 60

Gender Female

Age at diagnosis 27

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More recent experiences of hospitals included positive experiences. For instance, people reported getting better medication in hospitals, as well as consultations with health professionals (e.g., psychiatrists, nurses, occupational therapists), much needed rest, physical and creative activities, emotional support, ‘relief about being in the same boat’ as others, and counselling/therapy. All such experiences could be helpful.

Describes the comfort felt when she realised in hospital that others felt similar to her.

Age at interview 60

Gender Female

Age at diagnosis 27

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Describes getting excellent care at an NHS hospital outpatient clinic.

Age at interview 73

Gender Male

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Describes getting helpful treatment and partaking in beneficial activities in an NHS hospital.

Age at interview 69

Gender Male

Age at diagnosis 39

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Not all the problems in NHS hospitals have been fixed though. Certainly, there were mixed feelings about the care now available in the NHS. There was a sense that some staff do care, and the experience could be empowering, but also ideas that NHS hospitals are geared more to ‘containing’ patients, rather than really demonstrating care. There were numerous accounts of an over-emphasis on medication, or staff who made little attempt to engage with patients who were depressed and in need of encouragement.

Several people also described how they had become ‘institutionalised’ in short time periods and so needed to learn how to live in the real world again. Those who had been on mixed wards found the practice of mixing depressed patients with other non-depressed (yet seriously ill) patients disturbing.

Explains that while some staff do care and you can feel safe in NHS hospitals, staff can appear…

Age at interview 33

Gender Female

Age at diagnosis 24

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Believes there is an over emphasis on medication for sedation in the NHS hospital she went to.

Age at interview 43

Gender Female

Age at diagnosis 40

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He feels that hospital staff need to be more engaging and nurturing of depressed patients who…

Age at interview 69

Gender Male

Age at diagnosis 39

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Did not like the NHS hospital she went into when she could not get into a private hospital.

Age at interview 39

Gender Female

Age at diagnosis 33

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Describes how she became institutionalised in an NHS hospital by the routines and safety, making…

Age at interview 33

Gender Female

Age at diagnosis 24

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Some people had private health insurance that allowed them to get a bed in a private hospital. Private hospitals were described as akin to a nice ‘hotel’, generally with staff who appeared engaged and ‘caring’. There was a wider range of treatments that were more readily available than in the NHS, including complementary therapies like group therapy, massage, yoga, and meditation. However, private hospitals were not always highly rated. For instance, one woman escaped from a private hospital while suicidal and thought that the staff there were mostly agency staff.

Was pleasantly surprised by her welcome at a private psychiatric hospital.

Age at interview 24

Gender Female

Age at diagnosis 14

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Says that while some nurses did care in her NHS hospital, there was more care that felt genuine…

Age at interview 43

Gender Female

Age at diagnosis 40

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Experiences of A&E departments in hospitals were mixed. After making attempts to die by suicide, it is possible for people be met by a lack of empathy, or even hostility, from staff who may not comprehend their mental despair. Nevertheless, some non-mental health professionals can be supportive.

Describes a suicide attempt where he was not met by empathy by hospital staff.

Age at interview 75

Gender Male

Age at diagnosis 35

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Describes a suicide attempt where the surgeon was keen for her to tell at least one parent about…

Age at interview 20

Gender Female

Age at diagnosis 19

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