Depression and low mood (young people)
Treatment in hospital for depression
Sometimes people with depression require hospital care. This may be because their depression is severe or because of suicidal thoughts or suicide attempts. We spoke to a few young people who had been admitted to hospital for treatment for their depression, either for a few days or, occasionally, for extended periods of a couple of months up to a year. Some people had stayed on a psychiatric ward of a general hospital but most had been to a specialist psychiatric hospital. This won’t be specified in the text as young people didn’t always identify which kind of hospital they stayed in.
Staying on the psychiatric ward
Some of the people had stayed on children’s wards but most had been on adult wards, often as the only under 18-year-olds there. A few had stayed on a specific adolescent unit where other patients were the same age. A few people had been “in and out” of different hospitals and units over a longer period of time. Many said they’d felt “anxious” or “scared” to go in and one woman said she’d been afraid beforehand of being hurt by others on the ward. The majority of people had been willing to go into hospital although we spoke to two young women who had been sectioned (i.e. taken to hospital against their will).
When getting treatment for his spinal injury, Loz stayed on a children's ward (not psychiatric) where the bed was too short for him.
When getting treatment for his spinal injury, Loz stayed on a children's ward (not psychiatric) where the bed was too short for him.
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I mean back to the [hospital name] sort of thing, I mean that was, that was a good time and there was a couple of times that I was sort of put on my own in a sort of separate ward because I was getting older and there was more young people getting in, and I think I was about sort of 15, 16 at the time and I was put in to this sort of very sort of cold silent sort of ward weren’t I? Yeah, and the room just went … just short bed, I didn’t fit on the bed at all, I mean by this time I think I was about 6’ and my, and my feet just went ding, so “Oh God, nurse. Bigger bed I think,” [laughs]. And that, they had, they had something where they could stretch it and so I, I could fit in it better. That was quite funny. I mean I’ve had, I’ve had sort of like bad times and very, very good times.
Most of the people had stayed on the ward with family or friends visiting them and one man only stayed in during the week and spent weekends at home.
The life on the psychiatric ward, described by young people, consisted of different types of therapies including one-to-one counselling, group therapy and art therapy, spending time and socialising with the others on the ward, playing pool or other games, schooling and “being bored”. One woman said that without the other young people on the ward “we would have died of boredom”.
The hospital school ran on a 3-month-cycle and after the 4th round, Joanna 'knew all the answers'. She also found the trips on a minibus 'stigmatizing'. (Read by an actor).
The hospital school ran on a 3-month-cycle and after the 4th round, Joanna 'knew all the answers'. She also found the trips on a minibus 'stigmatizing'. (Read by an actor).
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They had this school upstairs and they my original school were meant to send me work, but they never did. and so I was quite keen to, well I don’t know if I was quite keen actually, I can’t really remember but some of the other patients were doing stuff for their GCSE’s, and that, but I never did. And I’m not quite sure why that was, but I used to just like, some of it was just like pottery and stuff, or just give us a bit of clay and we’d make ashtrays or and then they’d have like art stuff, and all that sort of stuff and it wasn’t really like a school and they only had a 3-month-cycle of all the school stuff that they did, so I did everything 4 times. So by the end I knew all the answers. but yeah we didn’t really do any proper school work, I didn’t. I just did so I soon thought that was a bit pointless.
And they used to take us on trips in this minibus which was quite stigmatising being in a big minibus, and people used to point at us and laugh and stuff from the local school, and we’d go swimming but they wouldn’t let us show our scars so we used to have to go swimming in trousers and long tops. Which was a bit, again, a bit stigmatising, sort of thought well if I can’t show my scars here, in these people, with these people here you know with other people with similar problems and staff that are meant to understand this, then when, when am I ever gonna feel comfortable with the fact that I have scars.
Experiences of hospital care
Most people had mixed experiences of staying on the ward and those who had stayed in different hospitals described big differences between them. One of the main benefits people felt they had gained from the ward stay, was being among other people who’d experienced similar things and making friendships which could last a long time following discharge. One woman said that without the friends she made on the ward, the stay would’ve been “hell” and simply “unbearable”. One woman said of the friends she made on the ward' “we all kept each other sane in the most insane way”.
A few people said that they had learnt to know each other better than the staff did and always looked out for each other. In some areas, people felt better able to rely on their peers, rather than the staff on the ward.
Sian, Frankie and Mandy met on a psychiatric unit and have been friends ever since.
Sian, Frankie and Mandy met on a psychiatric unit and have been friends ever since.
Sex: Female
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How do you know each other?
Frankie' Psychiatric unit, we all went to the same one.
Sian' We did.
Mandy' That’s the short answer.
What happened, when?
Frankie' I went into the unit about what five months before Mandy came in, and then I was in there for two months while Mandy was there. I left and then Sian came in not long after.
Sian' I was in my room having a pretty hard time and Mandy just knocked on the door.
Mandy' Cheryl Crow blasting out on her radio. You could have shoved the music really.
Sian' And she sat down with me and she just, we had a good chat didn’t we.
Frankie' When Mandy came into the unit, like she said, you know she was totally doped up on meds, to the point where her reactions were like really, really slow, and I was sort of the only person to kind of like actually have the patience to talk to her. And I was like her mentor for the week, like showing her around and like making sure she was okay and stuff, and then we just became really good friends from that. Like we were inseparable.
Mandy' You were the only one I so I came in to like visit for…
Frankie' Yeah, and I was the only one who said, “Hi.”
Mandy' Yeah, you were the only one that said, “Hi.” And I mean like I remember that.
Frankie' The karaoke Frankie!
Mandy' Not that you’re easy to forget, but yeah.
Sian' And then we met, we met afterwards, after we’d all come out and like we, we were all meeting up.
Mandy' Yeah because we have like a group meet up sometimes.
Sian' Yeah we have group meet up.
Mandy' Yeah, meet ups, we’ve stayed friends.
Frankie' Yeah. That’s, we’ve been friends for three and a half years now haven’t we?
Sian, Frankie and Mandy say that the staff on the ward were 'crap' but they had each other and knew they were 'not alone'.
Sian, Frankie and Mandy say that the staff on the ward were 'crap' but they had each other and knew they were 'not alone'.
Sex: Female
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Mandy' It was quite good though; it was quite a good experience wasn’t it? It was nice to know you weren’t alone. Don’t you think?
Frankie' Yeah. The staff were crap though.
Sian' The staff were crap.
Frankie' The staff were crap. It got to the point where basically like the really close, close friends you made in there you’d have to call on them, like, your staff nurse. She was staff nurse, Mandy for me, and another girl.
Mandy' I did everything but not have keys.
Frankie' Yeah. Pretty much. I was Staff Nurse Frankie.
Mandy' It got to the point where the staff asked us if the person was okay and where they were. we were supposed to do obs every fifteen minutes, it got to about 6, 5, 6 o’clock, and we were going, “Where were you at 10 o’clock this morning?”
Frankie' Yeah. They were supposed, they were supposed to come in your room every half an hour for general obs, and you know we used to be awakened most of the night, and they’d come in,
Mandy' Asleep, asleep. Yeah, “you slept the whole night through”. No I didn’t, I was awake till 4am.
Frankie' Yeah. You could have been doing anything in your room at night, and they came in twice a night, if that, to check on you.
Holly says people have negative stereotypes of people staying on a mental health ward but she met 'the best people I've met' on the ward.
Holly says people have negative stereotypes of people staying on a mental health ward but she met 'the best people I've met' on the ward.
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I think a lot of people have a common stereotype about mental health wards and think you know that there’s people quite unwell, and the people I met there were some of the best people that I’ve met, I can honestly say that, and there were one or two characters that were, weren’t, well really quite unwell, and they didn’t stay there for very long. Most of the people that I’ve met there were sort of, became, and the best people that I have met, and I’ve made some very good friends there.
And whereas they had their own problems as well there were people there who were sort of in rehab for drug abuse, or alcohol, and there were people there for depression, there was a lady there ‘cos she was quite old and obviously the senile thing was kicking in. But they were lovely people and yeah we have a sort of a good friendship, we have sort of go and order takeaways and things and sit and watch movies and, it was, yeah it was, it was good. , and whenever I hear people say you know, “Where were you for that time?” And if I said, “Well I was on a mental health ward.” They always think, you know, she’s a really quite strange and quite unwell, but it wasn’t, it was just a space where I could take myself away from everyday life and have that, just to somewhere completely different. I didn’t have to worry about the schoolwork, I didn’t have to worry about home, I didn’t have to worry about sort of paying my bills, none of that. I could just spend some time thinking about my own life and how I got to the state where I’d have to be in that ward in the first place.
Spending time on the ward with other people could also be fun and especially those who had stayed for a few months or longer said they had done a lot of fun things together and had their own inside jokes. Being with other teenagers could also make life feel more “normal”'
“We used to speak about just general stuff, what’s it like to be a teenager and you know what music do you like, and you know those sort of things, which kind of made it a bit more normal in way.”
A hospital stay could also give people a much needed break from the pressures and difficulties of home life or school and the time and space to think things through without any external influences. A couple of people also said that staying in hospital had helped them build up their confidence and that they came out feeling stronger. They said that having immediate access to help and someone to talk to them was great and something they hadn’t experienced before. They also praised the individual staff members on the ward with whom they’d developed bonds.
One woman said she had been “petrified” about going into a private hospital because of common misconceptions. It turned out to be “nothing like expected”, “magnificent” in “lovely grounds” and with “no security, no high fences”. And one of the most helpful things she had done.
People also recounted unpleasant aspects to their hospital stays. A lot of these experiences were to do with their relationship with the staff, often with individual staff members. Some said they had found staff unhelpful and in some cases “insensitive”. One woman had a particularly bad experience with a staff nurse who she described as “malicious” towards young patients. The woman had launched an official complaint against this member of staff.
Erika-Maye describes difficult experiences with a particular nurse on the ward who 'made anorexics finish their food and told depressives to laugh'.
Erika-Maye describes difficult experiences with a particular nurse on the ward who 'made anorexics finish their food and told depressives to laugh'.
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There was a nurse at the psychiatric unit and I, they were supposed to be going out on a walk and we’d gone out on one the week before, and they’d told me there wasn’t much walking, but I was actually stuck in bed for the next three days. So obviously when they said we’re going on another walk, I refused to go, which I thought was actually perfectly logical because I didn’t particularly want to be stuck in bed for the next few days. They tried to persuade me to go, and watch other people walking around. I was like, “Yes, because I love watching other people doing what I can’t do.” I got quite upset, understandably I think. I ended up staying. They sent me to sit in the lounge. I was crying by this point, and the nurse they sent in to see me was, is, rather cruel anyway.
No-one liked her. And it wasn’t just because she’d make the anorexics finish their food, or she told the depressives they had to laugh sometimes, it was because she was genuinely nasty. She told someone with an eating disorder they should just roll into the lounge. And she sat down opposite me flicking through paper work and said to me, “So what is actually physically wrong with you Erika?” I went, “Well they think it’s Chronic Fatigue.” She was like, “Well is it in tune with your mood?” She was like flicking through a magazine at this point while she was asking me these really personal questions. And I said, “No it’s not psychosomatic, if that’s what you mean?” She said “Did those words leave my mouth?” “Okay then.” When I’m in a mood where I feel quite low, but not completely down, I can usually cheer myself up, but I’d prefer to be left alone because then I can just think quietly and think about the stupid little things, and make myself feel okay. But she said to me, “You know if you don’t talk to me you’re not gonna get better.” “And not being funny but when I’m in this kind of mood I’d rather just be left along please.” She got up and slammed this magazine back down on the table, and said, “Well when you feel like actually doing something about your health, you can walk and come and find me can’t you?” just to give an example, and that’s not right. I don’t think that’s fair that someone who is being, ‘cos that’s just malicious, that someone who’s gonna react like that should actually be allowed to interact with teenagers who have got serious problems. Because we’re, we’re at a tier 4 status, so we’re like supposed to be the most crazy of the crazy lot. And yet she’s allowed to, I don’t think that’s right. She’s actually left now. We’ve put in a couple of official complaints.
Some people also felt that the hospital building and environment themselves did not help them feel safe or comfortable and described them as “clinical” or “run down” with nothing for young people to do.
Darren describes his room and the daily routine on the ward.
Darren describes his room and the daily routine on the ward.
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Well, I mean, they looked after me well, and they had some good psychiatrists there and, the rooms were good as well. Nice and clean and it was a good place. The food was nice, yeah.
What were the rooms like? Do you remember at all?
Well you each had your own room and TV, comfy bed. Wardrobe, desk, your own toilet you know? It was nice.
And what was the, sort of the routine like there?
I think you were up at 8, breakfast, then, then you were doing, well you each had, you had a different timetable each day. Like, it’s like school and like you’re meant to do something educational in a class, but all I done was sit and draw. And they accepted it, you know, I’d do a drawing and they said, yeah that’s good art, so you know, so that was fine with me.
Some people described feeling “patronised” or “controlled” on the ward when they felt they weren’t being treated with respect or they were made to take part in activities they didn’t want to. One woman felt that she was being controlled rather than helped on the ward and described a sense of “loss of control”. Another woman, who was sectioned, recounted how hard it was to feel like she had to do what the staff told her.
B describes being sectioned as a "horrible" experience. (Read by an actor).
B describes being sectioned as a "horrible" experience. (Read by an actor).
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Yeah. what about being in hospital then? What was it like being sectioned?
It was horrible, it was really, really horrible, I hated it. I’ve never actually, I’ve never been a person to like hospitals anyway, and just being closed up and because it was a secure unit so you had to go through pins and checks and stuff because obviously people would run away and stuff and so...
It was I remember, I can vaguely remember my first day, I remember from the police station in [town name] actually, they sedated me I think, ‘cos I remember them putting me into the ambulance, like the police and the nurses and them putting me into the ambulance, and then I don’t remember anything, like I just blacked out sort of so I assume they did sedate me, or I’ve fallen asleep or something. And I remember waking up and like I was in the ambulance, and I had a bit of a fit and I was just like ergh, and the nurse, the nurse I was with, the nurse who was escorting me, she was really nice and she was like, “Well do you want to hold my hand?” and stuff, and I was just ranting and raving and swearing at them, and I was just like, “Leave me alone.”
And we got to the hospital, and I remember going through all these doors, there must’ve been at least six doors we must have gone through. We went through reception and then we went through other doors and when we got to this to the ward bit it was like a massive like dining area sort of, and there was little doors like into offices and rooms and stuff, and there was a nurse was meant to be my key worker and she was she was really lovely, but then even though I didn’t like the nurse who was escorting me, I was like, “No I want to stand with her, I don’t want to, I don’t want you ‘cos I don’t know you, at least I’ve been with her for a couple of hours, so I don’t know you”.
And because obviously she had to go and I had to stay there, but ‘cos I didn’t know I had to stay there, I thought, for some reason I just thought I was there and they were gonna take me back or something, I don’t know. But then, and then when she had to go, they put me in a room, it was a very nice place, it was, actually it was new at that time, there was only like three or four patients there, and ‘cos we got there about 10 at night, so everybody had, were in their rooms or they were watching telly or something, and I didn’t get to meet anyone that night apart from my nurse and I was given like medication to help me sleep.
Several people had been admitted to hospital following a suicide attempt. Some had stayed in a general hospital and others in a psychiatric unit. For a couple of them, it had been their first contact with mental health professionals. People also described self-harming whilst on the ward and a couple had attempted suicide during their hospital stay. Some people had been under ‘observation’ during their hospital stay because of concerns about their safety. Being followed and watched either continually or at short intervals, day and night, was frustrating and awkward for people.
Sian, Frankie and Mandy describe what it was like to be "under observation" on the ward.
Sian, Frankie and Mandy describe what it was like to be "under observation" on the ward.
Sex: Female
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Sian' I had to have door open and someone sat there, like two people sat there weren’t they? Go to toilet, someone follows you.
Mandy' Never had that pressure.
Sian' It was horrible.
Frankie' Were you not on visual obs?
Mandy' 1 in 5.
Sian' Oh you lucky cow.
Mandy' In the shower, I got to have a 15 minute shower before they knocked on the door.
Sian' Now?
Mandy' They were convinced I answered, I didn’t.
Frankie' When I got a shower, they tried to get into one of the, one of the HDA’s called [nurse name], a dude, they were like, “Ah [nurse name] gonna be in your obs.” I was like “No, I’m having a shower.”
Mandy' They can’t have that.
Frankie' I know.
Sian' It’s not allowed.
Mandy' To the point of, if you’re on visual obs you would literally get watched in the shower.
Frankie' And on the toilet.
Sian' It’s horrible.
What’s “obs”?
All' Observations.
Mandy' Visual obs was someone who was within arms reach of you. At all times.
Sian' Yeah, so they could basically just grab you.
Mandy' They would sit by your bed while you slept.
Frankie' Yeah, or just outside the room if you’re lucky.
Sian' It was just as scary.
Mandy' One in five was had to be in the same room with you, one in fifteen was actually pretty much being in the next room, if they had to be elsewhere they had to be in the next room. And then it was, it was one in…
Frankie' Half hour, which was general observation.
Mandy' But you get to walk around and do what you want most of the time.
Sian' I never got that chance [laughs].
Mandy' lucky!
One man said that the adult psychiatric ward he had stayed on had been a horrible experience for him as he’d seen a lot of “nasty” things going on there and had been shouted at by some of the other patients. One woman had also stayed on a few mixed-sex adult wards which she had found “scary” and lacking in privacy. She had found her stays at private clinics more useful than the NHS hospitals'
“I found private health care, the people in private health care more helpful in their professional capacity than the NHS ones. Probably ‘cos they’re all overworked or whatever… I’m sure that they don’t mean to do that, but it’s just a completely different set up. [Private hospital] was a very non-threatening environment and you respect the staff really.”
Some people said they were able to see the positives of staying in hospital, when looking back on those experiences. One woman who had been going through very difficult time and stayed in different hospitals, said that “staying in hospital saved my life”.
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Last reviewed June 2017.
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