Six Psych Wards, One Woman
Where to go—and where not to go—should you have a psychotic episode in or around New York City.
I have been hospitalized a total of twelve times in psych wards since the onset of bipolar disorder in my late teens. Some have been helpful, some were abysmal. Gratefully, I've been properly medicated for the past eight years, without the need for hospitalization. Looking back on my experiences in hospitals, I decided to review these wards and illustrate which were helpful, and which weren't. What follows is a Zagat's-style guide to the psych wards in the NYC area I have been a patient in.
Food, décor, and service are rated on a 30-point scale.
26-30: extraordinary to perfection
21-25: very good to excellent
16-20: good to very good
11-15: fair to good
0-10: poor to fair
New York Hospital/Cornell Medical Center
White Plains, NY
Patients are miraculously cured and released when their insurance runs out at 30 days.
I found myself in my first psych ward at NY Hospital (now New York-Presbyterian) in 1992 after a manic psychotic break landed me in the Dallas Airport, hanging out for days in the airport bar and then sleeping on the benches in the waiting area when the bar was closed. After getting in touch with an old friend in the area when airport security threatened to kick me out, I was put on a plane back to NY and quickly escorted by my mother and sister to the White Plains facility.
This hospital is located on the grounds of the old Bloomingdale Estate and looks quite lovely on the outside. The landscaping is beautiful. People dropping off their loved ones at the hospital probably think it's going to be a country club for the patients. Unfortunately, patients on the psych ward are rarely allowed to go out and explore the grounds. The psych ward is typical, with grey nondescript carpet that people shuffle back and forth over in their slippers, and cheesy Impressionist prints on the wall meant to calm the patients.
First of all, the doctor I was assigned to misdiagnosed me, and I was on all the wrong medication. Due to this I suffered a psychotic break in the hospital and was too frightened to leave my bathroom. Instead of comforting me or helping me overcome my anxiety, the psych aide goon assigned to check on me decided to slam me up against the wall when I refused to get out of the shower stall. Powerless against his assault, I did the only thing I could do to protest: I spat at him. This led to me being pinned down on the ground under this huge guy, and then put in restraints on a gurney and wheeled into the “Quiet Room.” I was left there for about 5 hours. I peed on myself because the staff wouldn't let me out to use the bathroom. I remember lying there in restraints, looking up at the barred window at the sky beyond and wondering how my life had led to this point.
When I got out of the “Quiet Room,” I called the toll-free number to the Psychiatric Patient's Legal Services from the ward pay-phone and filed a complaint against the goon who had mismanaged my care. What followed was a half-hearted investigation, during which time the psych aide in question was transferred to another ward. His co-workers on my ward now hated me because I was causing trouble for their friend. In the end the investigation found in favor of the psych aide. After all, who were the investigators going to believe: a respected mental health professional, or a crazy psych patient?
I remember sitting later in the TV room with my fellow inmates, all of us in paper slippers, drooling from our medication, watching the winter Olympics. After an interview on TV with ice skater Kristi Yamaguchi, one of the patients said, “She seems so well-adjusted and grounded.” A beat later, several us blurted out, in unison, “I hate her!” I also remember, a few days later, jumping up and down on the couches laughing hysterically with Henry, a schizophrenic who always wore a blue bathrobe and thought the Chinese Mafia were after him. This moment of exuberance earned me another trip to the Quiet Room, this time with no shoes, sitting on the matted floor.
I give the hospital a few points for service despite this miserable experience because there was one nice nurse who took pity on me and took me out for secret extra smoke breaks.
New York Hospital
I received a $1200 bill for the 24 hours I spent in the ER psych holding cell.
I landed in the Manhattan branch of New York Hospital after a psychotic break led me to cut myself and burn some of my roommate's posters in a fire in the kitchen sink. My terrified roommate called 911 and police escorted me to this hospital.
I spent 24 hours in the dismal little psych holding cell in the ER. A guard outside the cell monitored my every move. Every now and then an over-worked and under-experienced psych intern would come and ask me a few questions.
I give this hospital a better rating for service because I do think the doctors meant well and were on the right track in their analysis of my psychosis. Also, the guard had a heart of gold and after watching me pace back and forth for hours, he took me outside for a cigarette break.
However, after all the time I spent in their ER, staff decided to transfer me to—you guessed it—the White Plains branch of NY Hospital. After an ambulance ride to Westchester I found myself once again listening to the sound of a door closing and locking behind me, trapping me back on the ward I had survived a year earlier.
At least the White Plains hospital had better food.
I was hospitalized again at the White Plains facility a year later after swallowing a bottle of Klonopin in a suicide attempt. Fortunately my last admission to New York Hospital was less traumatic than the first, mostly because I had learned how to keep my head down and fly under the radar of staff to avoid another abusive incident. This survival skill became useful in all my later hospitalizations.
Free for a good reason.
I was experiencing profound psychotic depression and started experimenting with self-harm as a way of easing my emotional pain. Sometimes when I cut myself with a razor blade, the minimal pain I felt gave me momentary relief from my depression. But my friends became alarmed at this new behavior and insisted that I go to the hospital. I had no insurance at the time, so we went to Bellevue.
Once I showed the admissions nurse the cuts on my arms, she immediately led me to the psych waiting room where about twenty other people were milling about awaiting admission to the hospital. I sat down on a cold cement bench in this drab grey room and took stock of my fellow inmates. Next to me on a gurney was a man handcuffed to the railing who periodically shook his chains and screamed incoherently. Then there was the guy pacing back and forth who kept repeating “Kill Whitey! Kill Whitey!” It was all the people one changes subway cars to avoid, now locked in a room together.
I became very scared of the prospect of being admitted and going upstairs to be locked in with these people for weeks. I started telling the staff that I had made a mistake by coming in, trying to convince them that I would be okay and that they should let me go.
I give Bellevue a low rating for service because the staff seemed bored and did very little to control the behavior of the more aggressive patients, not bothering at all to protect me and others who were clearly traumatized.
I give Bellevue a “0” for food simply because in the ten hours I was held there, I was not offered any food or water.
After being interviewed by three separate doctors, begging to be released, Bellevue let me go. I don't know if it was because I was such a good actress, or perhaps they thought they would save the taxpayers money by not admitting me, despite my self-harm, because I wasn't as bad off as some of the other patients.
I was thrilled to get out of there, but the decision not to admit me was a mistake on the doctors' part. A week later I cut myself so severely I had to get stitches.
Gracie Square Hospital—Asian Ward
I was billed the same as all the other patients, despite the fact that I couldn't participate in any of the activities or groups
After several suicide attempts over the years, my family and friends had grown more and more desperate to get me help when I cycled into depression. Whenever I started to isolate, failed to maintain basic self care, exhibited crying jags or became semi-catatonic, my loved ones encouraged me to go to the hospital to avoid another suicide attempt, since over the years, each attempt had become more and more serious and frightening.
And so my husband brought me to Gracie Square Hospital one night, worried about my inability to even hold a conversation, my thinking was so slowed and I was so introverted, I barely recognized what was going on around me.
We had heard good things about Gracie Square from a friend who had been in their dual-diagnosis unit. But when we arrived and were interviewed by the Indian doctor who barely spoke English, we learned that the dual-diagnosis unit was full. In fact, all the wards were full except the Asian Ward. I am not Asian, but that's where Gracie Square staff decided to place me.
I was the only non-Chinese person on the ward. The groups were in Chinese, the activities were in Chinese, the doctors spoke better Chinese than English; even the TV in the day room was tuned to the Chinese channel. I spent two weeks there bored out of my mind, basically pacing back and forth in the grungy grey hallway or sitting in my sad little room staring out the window at people living their lives in the city below.
I also spent days working alone on a huge jigsaw puzzle depicting rows and rows of Oreo cookies. I finally almost finished it, only to discover it was missing a piece. I remember I burst into tears over this disappointment.
Staff did little to relieve my boredom, reach out to me and talk to me about how I was feeling, or find ways to fill my time. However, the doctors did manage to get me stabilized on meds and I left the ward better off emotionally than I had entered it. Plus I was just so grateful to be released so that I could have a conversation with an English-speaking person.
Lennox Hill Hospital
Takes most insurance.
I was admitted to Lennox Hill in the midst of a manic episode brought about by an attempt to get off Zyprexa, an antipsychotic drug that had been helpful to me but had caused severe weight gain. Under doctor's supervision I tried to wean off this drug, but quickly spiraled into manic psychosis. At first, like most manic episodes, it was fun. I was witty and quick and full of energy. I went to the gym at 2 am and exercised furiously on the elliptical machine, singing loudly along to the music on my Walkman, to the annoyance of fellow gym members.
But this hypo-manic state soon cycled into full-blown mania, causing me to be paranoid that tenants in my building were spying on me, that my phone was tapped, and that I was under surveillance by police. Recognizing that I was spinning out of control, my husband took me to Lennox Hill on the advice of my doctor, who must have realized that weaning me off Zyprexa was a huge mistake.
Lennox Hill was less depressing than other hospitals I had been in. By this time I had perfected the art of flying under the radar on the ward, which protected me both from aggressive inmates and staff with a tendency to be abusive.
Lennox Hill had a really great activities staff, who did a lot to stimulate the patients mentally and physically. We had seated aerobics—seated because a lot of us were dizzy from antipsychotic meds and jumping around might be dangerous. In one of the activities counselors showed us slides of artwork from around the world and we talked about how we felt looking at the paintings. Another great activity was the aromatherapy, where we were given our choice of essential oils and plain white lotion to mix, creating our own perfumed cream. But the best activity was the therapy dog. This beautiful Old English Sheepdog came every couple of days to hang out with us in the lounge, and it was so calming to pet her and play with her. This therapy dog also made me miss my own dog and led me to do whatever I could to get better so that I might go home to see her.
Well worth the cost to insurance.
After the disastrous attempt to get off Zyprexa, I switched doctors and began working with a pharmacologist who specialized in mood disorders. Since no antipsychotic drug I had ever been on had ever completely kept me symptom-free, he decided to try me on Clozaril. This is a drug of last resort to many doctors because there is a small chance of a fatal blood disorder associated with it, and patients need frequent blood tests lifelong to make sure the drug doesn't trigger the disorder. In fact, pharmacists can't even dispense the drug unless the doctor has reported a negative blood test.
Since most psych patients don't have it together enough to have weekly blood tests, many doctors don't want to put their patients on Clozaril. But the flip side of this drug is that it is probably the most effective and successful treatment for bipolar psychosis, period.
Dr. Bienenfeld (who has actually been published on The Fix) was associated with Mountainside Hospital in New Jersey, so that's where I went to do a medication trial on Clozaril. It's important to be hospitalized for the first month on Clozaril to make sure the blood disorder doesn't occur.
Not only was Mountainside more cheerful than many of the psych wards I had been on previously, the staff was also quite supportive and the groups and activities were interesting. But best of all, Clozaril worked. I hadn't felt so stable in years. In fact, I am still stable on Clozaril. Mountainside Hospital was my last hospitalization, and that was eight years ago. I get my blood tests done religiously and take my meds every day. I have a life now, after years of living marginally with varying degrees of depression, mania, and psychosis.
I think about looking through the Quiet Room window in White Plains and out the window of my room in Gracie Square, watching the world go on without me while I was locked up. Now I am part of that world, with friends and work and activities that make me happy. It's been a long journey, but the destination was well worth the trip.
Sadie Long is a regular contributor to The Fix. She last wrote about a newcomer's best friend.