OP-EDS

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November 9, 2021

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12:54 p.m.

At the Forefront of Medicine: My Summer Involuntary Hospitalization

A neuroscience student reflects on the psychiatric system’s failure to care for its patients.


Stella Bevacqua / The Chicago Maroon

Content warning: The following article contains a personal narrative of involuntary hospitalization in a UChicago psychiatric facility, including detainment by campus police, detailed descriptions of medical procedures, and brief mention of previous sexual assault.

Editor’s Note: This piece is a personal account of the author’s experience with UChicago Medicine. Maroon editors have verified key details of the account, including the University of Chicago Police Department (UCPD)’s intervention at the author’s address, the author’s stays in various psychiatric facilities, and that the author communicated with friends and family while hospitalized about their experience and with the University following their hospitalization.

Our culture conditions us to keep quiet about mental health interventions and the trauma that can co-occur with those experiences. Due to both the stigma about people who receive mental health interventions and misconceptions about us, there is very little conversation around how the mental healthcare system itself can be traumatizing even as it claims to be a system of care. When survivors do speak up, we take a risk. There seems to be a drastic mismatch between the narrative that people have about what psychiatric interventions are like and the reality. There is very little visibility for psychiatric survivors, and as such, people have a narrow conception of who we are. This allows a narrative of medical benevolence to be upheld because people who have survived traumatic psychiatric intervention are dismissed by virtue of the stigma around their experience.

In June 2021, I was committed to UChicago Medicine’s psychiatric ward against my will. As I discussed this experience with others—including those who work in the mental health field—I was often met with surprise. My experiences did not fit with their expectations because they assumed that psychiatric facilities help patients rather than hurt them. From the moment the UCPD came to my door, I knew that what followed would not be care. I study neuroscience and human rights in the College, with a particular focus on psychiatric ethics and pedagogies of pathologization. I have read extensively on these topics, so I know that the psychiatric system too often harms the patients it purports to help. Even knowing the lengths to which these institutions go to protect themselves at a cost to patients, I still felt dehumanized by what occurred, and I left in a worse mental state than I arrived.

Nothing that happened was illegal or against institutional rules. Even when everyone does their jobs in a psychiatric setting, these systems of so-called “care” are not designed to administer life-bettering interventions for patients because the need to protect practitioners and institutions from liability gets in the way.

Here is my story.

One Friday this past summer, an experience in a UChicago neuroscience lab where I was working prompted a flashback to some previous trauma from the psychiatric system. On Saturday morning, I was still feeling distressed, so I did as many people—including mental health professionals—had told me to do: I reached out for help because I felt I was in crisis. From bed in my off-campus apartment, I called the student counseling service and asked to speak to the counselor on call because of how I was feeling. Throughout the call, I emphasized that a previous traumatic experience with a psychiatric ward had triggered my crisis and prompted me to reach out. I felt that we were making some progress when I heard an intense banging on my door. It sounded like they would break down the door, so I ran and opened it. Four male UCPD officers entered my apartment. I was not dressed. The only thing I was wearing was a shirt that I like to sleep in.

I had been crying throughout the call and still was when the police came in. I expressed that I was upset but not in imminent danger. One officer told me to sit down in a folding chair that was in my bedroom. There was a pair of pajama pants on the floor, which I put on as I was uncomfortable being so exposed in just a shirt. Another officer took my phone, with the counselor on the other end, and walked away with it, eventually ending the call with the counselor.

I thought that they had observed enough to see that intervention was not needed, and I thought that they would leave, but another officer who had been walking around my apartment came up and told me to stand up and turn around. When I complied, they handcuffed me even though I had not been resisting and they had made no request for me to come with them. They guided me toward my door. I asked if I could get my keys and moved toward them, but they held me back while an officer took them. They took me downstairs. As they were putting me into the back of one of the four squad cars outside of my building, they suggested that I might be more comfortable riding with the female officer who had been down at the street while they were in my apartment. (This concern for my gender had been absent moments before, when men had entered my apartment, searched the premises, and handled my body.)

During the car ride, no one would really answer my questions about what was happening. The handcuffs were too tight, and I was losing feelings in my fingers. I told them this, but I don’t know if anyone heard.

In the emergency room (ER), I was uncuffed and left in a room on a gurney. They took away my clothing and gave me a hospital gown. I asked for water and information at any opportunity I could, but I was given neither. It was my worst nightmare: After reaching out for help because of a re-traumatization, I was now on track to end up in the exact environment—a psychiatric ward—that I had cited as traumatic.

After several hours, some medical students came in to talk to me. I explained that I have a long mental health history, that I am aware of my conditions, and that I work with counselors and psychiatrists. I told them that I am a psychiatric survivor, that I am a sexual assault survivor, and that I was in no active danger. While my distressed state was initially because I had a flashback, my distress now stemmed from the repeated disrespect of my bodily autonomy throughout the day and from living out my worst nightmare.

Even at this point, I believed that I would be released. By showing that I was doing fine, saying the right things, and showing that I have a safety plan and extensive experience working on my mental health through therapy and psychiatry, I thought I would be guaranteed a safe discharge.

None of that made a difference.

One of the medical students finally brought me a small cup of water. After what I think was a few more hours, they came back with a psychiatrist who told me that they were going to hospitalize me. I cried, telling them that this was the worst possible thing they could do for my well-being. I explained again that the hospital was a traumatizing environment and that the intrusions on my bodily autonomy that came with hospitalization were harmful to my mental health. That did not change anything. The psychiatrist left. What I said seemed less important than their interpretation of the notes in my medical chart.

I lay down on the floor, finding comfort on the cold tile. Someone walked by and said, “You can’t be doing that. If you continue to act this way, we are going to sedate you.” I got up. I went to try to talk to someone who was at a desk area across from the rooms. I feel better when I know what is going on—getting information is something that I have been encouraged to do to help with anxiety—so I asked and tried to talk to him and asked for water again. I was told that I was “monopolizing the staff’s time.” I was then asked if I would take sedatives orally or if they would have to inject me. I said I would take them orally, and only then did they give me water.

When the sedatives started to wear off, I would intermittently wake and ask to use the phone to connect with my support network. Sometimes, the staff would let me; sometimes, they wouldn’t. When they would allow it, I was able to reach friends or my mother to explain where I was and what was happening, but opportunities to contact the outside world were limited. On Sunday, the psychiatrist came in again and told me they were holding me for a bed to open up in a psychiatric ward. I tried to sleep as much as I could throughout the day because there was nothing to do and being awake in that environment was unpleasant. They talked about moving me upstairs to make room in the ER. In anticipation of doing so, they put an intravenous needle into my arm but never connected anything to it. There was a bathroom in the ER, but it did not have toilet paper. I was also not allowed to close the door if I used it.

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Sofia Capua Montoto / The Chicago Maroon

At around 1 a.m. on Monday—after about 37 hours of being held in the ER room—I was transferred to a different room within the hospital. I now had a window, and there was a nurse's assistant present as I had to be monitored all day. The nurse’s assistant changed shifts around 7 a.m. I was told I could brush my teeth and was given a brush to use while monitored, which they had not let me do in the ER. They let me shower, but it was required that the nurse’s assistant watch me the entire time, and I was not allowed to hold the soap myself. I asked what they thought I would do if I was allowed to hold my own soap while I showered. She answered that I could eat the pump and that when someone’s “in for what [I’m] in for, they have to take precautions.” I asked what I was in for. She said she didn’t know.

At 5 p.m. on Monday, I was told that a bed had opened at a psychiatric unit and that I would be transferred in an ambulance. My concerns about the cost of an ambulance went unaddressed. I later received a bill for the ambulance that came to $792 out of pocket after insurance. It was about a 30-minute drive to UChicago Medicine Ingalls Memorial Hospital in Harvey, IL. Mealtime had passed, so I wouldn’t be able to eat until morning. They told me that I couldn’t shower or wash my hands because the water was out that day. I eventually tried to sleep, without much success. The bed and blanket were uncomfortable, I did not have access to needed sleep medication, and people would come into the room every 15 minutes or so, sometimes turning on the lights when they entered.

I woke up early on Tuesday morning and asked the behavioral health technician if the water was back on. He did not know. I wandered around until someone came up and talked to me about signing into the ward. I was confused at the implication that I wasn’t signed into the ward. She said I was “under certain petition.” I asked if this meant I could leave. She said I had to sign in. I asked if any of the prior three days counted for anything, and she said no. I asked if I had rights. She said yes and gave me a piece of paper. The first line said that when a patient signed in, they could request for discharge. I pointed this out, and she took the paper away, saying it was misleading. I could only request for discharge and sign myself out after five business days; weekends didn’t count. I asked again what the point of signing in was since I had to be there anyway. She replied that it would reflect well on me to do it. After five business days, I could sign myself out. She encouraged me to sign, saying that it would show that I was willing to work with them and that I would be able to get out faster. She told me it would benefit me to sign in, so I signed it, but it didn’t feel like I actually had a choice: I didn’t really understand what doing so meant or to what I was “consenting” in the process.

Now that I was officially signed into the psychiatric facility, this is where I would, in theory, get the treatment that would help me feel better. Nothing that followed made me feel better, and if anything, it made things worse. There was almost nothing to do on the ward. There were two 30-minute “therapy” groups a day, but sometimes they didn’t happen. The groups included one on healthy eating, where they described how some food—including what they were feeding us on the ward—was terrible for your physical and mental health, and one where they told us about neurotransmitters in a way that was not scientifically accurate. At one group, we all read through a printout of a WebMD article on nervous breakdowns. At another group time, we went out to a courtyard as we were otherwise not allowed to go outside.

If you were lucky, you would meet with a psychiatrist or a social worker. I met with a psychiatrist on Tuesday. The reason they had given for why it had taken so long to transfer me to the ward was that they wanted me to be at a hospital with the same medical team that had worked with me in the ER. But so far, I hadn’t interacted with anyone from the ER, and my new practitioners didn’t seem to be in communication with the prior ones because I found myself explaining my circumstances anew in each conversation. When I met with the new psychiatrist, it seemed I was back to square one. They only asked me about the call to the counselor on Saturday and didn’t seem to account for anything that had happened since then or what I had said to the other doctor.

Whenever I had the chance to talk to anyone, I expressed that the worst thing for me is when I am alone with my thoughts and taken away from the things that give my life meaning. I talked to a social worker, and I told her that this was my tailor-made hell because I have sensory issues; because I was unable to have my own underwear for many days; because I had been taken away from everything that gives me any joy or comfort in life; and because I was being subjected to infinite small indignities, dehumanization, pathologization, and infantilization—the exact environment that I explained was traumatic in my initial call for help to UChicago’s student mental health services. The time in the hospital was not helping me, and I hoped to get discharged soon. On Wednesday, I saw the social worker and asked if we could talk about discharge. She said no, saying that she had talked to me yesterday and had other people to see today.

Those few days were miserable. I was extremely bored, I was sleep-deprived, and I didn’t have any of my own clothes or underwear. Whenever I mentioned any of these factors, they were dismissed as a “comfort issue.” I had limited contact with the outside world. There were designated times for phone use, but the schedule was not always followed. When I saw that the phones were available, I would try to call my mom, but because the phone number was out of state, someone in the nurses’ station had to dial and transfer it, and they weren’t always willing to do so even during phone time. If someone called for me outside of phone time, I wouldn’t necessarily be told about it.

Later in the day on Wednesday, I talked to yet another psychiatrist—the third different one during my stay—who did not seem to know anything I had told the previous one. She asked me again about the call on Saturday and treated me as though it had just occurred. I did my best to summarize what I had previously said and to describe my time there thus far. I wanted to get out. I brought that up again, and they said they needed to “gather collateral” in order to discharge me. I asked what that meant, and they didn’t answer me. Only after discharge and looking into this further did I understand that “collateral” was information about me and my conditions that the institution was collecting to inform my treatment and release plan. They asked me to sign a release of information so that they could talk to the Dean of the College. When I asked what would happen if I didn’t sign it, they said it didn’t matter because the College already knew I was in the ward because I had come via Student Counseling’s report.

Over the course of four days, I had talked to many people, but I felt that no one had a sense of me as a person and that there was a lot of inconsistency between what different people told me. At one point, a nurse came up to me and injected me with a shot without obtaining my approval after I was told in the ER that they would not give me medication without my explicit consent. It was only vitamin B, but it showed that the previous promise that I wouldn’t be given any medications without my full consent and understanding was hollow: I had just been injected with something without being told what it was. Even with each person individually following policies and procedures, how they acted really had nothing to do with who I was as a patient or what would help me. It was about following procedure, even at the expense of care. People did the exact things others said they wouldn’t do. I was subjected to the exact things that were the worst for my mental health. Everyone on the ward went to the same therapy groups and resided in the same space regardless of how they got there. I spoke with patients who were awaiting trial for domestic battery, people in recovery for addiction, and one person who said he genuinely did not know why he had been placed there. Each of us was treated as an identical input in a bureaucracy that had little concern for our circumstances, our individuality—or even our humanity.

On Thursday, I was optimistic that they would discharge me. It became increasingly clear that it wasn’t serving me to be there: I made repeated pleas about how this was the worst thing for me, how this wasn’t care work, how it made no sense and was actively damaging to keep me there, and how I was perfectly safe to be released. In their gathering of collateral, my mother recognized the impact of the situation on me and expressed similar sentiments. Additionally, I had now been held for more than 72 hours, a standard time for an emergency hold. When I saw the social worker, I asked if I was getting discharged, and she said I would be the following day. I was disappointed.

The psychiatrist and medical students took me aside during group therapy that day to tell me they were going to discharge me later on. They called an Uber to arrive about four hours after they met with me. I was told to strip my linens. Then I gathered my few possessions, consisting of a bottle of baby shampoo, a roll of toilet paper, and various papers I had accumulated over my time. I had asked for my shoes and other belongings that they were holding, but they did not give them to me until the Uber arrived.

From Saturday morning to Thursday night while I was held, I did not speak to a therapist or counselor, or at least not anyone I could identify as either, outside of the initial call that was the cause of my hospitalization. From the time I was admitted to the time I was discharged, nothing about my treatment plan changed. All that had happened was the passage of time and the enforcement of their holding procedures. There was functionally nothing different about me or my circumstances that would have made me any “safer” than I was on Saturday. If anything, my mental health was much worse. I don’t know if they finally believed that I was not a danger to myself or if I just passed an arbitrary amount of time in the institution determined sufficient for release. Although I was relieved to be discharged, I did not feel “better,” and I also had to deal with the aftershocks of the experience. I felt that who I was and how the experience affected me was lost among the policies, procedures, and algorithms of the system.

To my understanding, nothing that happened to me was illegal, and no individual outrageously failed to perform their assigned role in the psychiatric system. I don’t think what happened to me was unusual in UChicago’s psychiatric institutions, and such failures are replicated across our country. Because of my prior personal experience with the psychiatric system, my interest in how it functions, and my perspective as a neuroscience student and researcher, I was somewhat able to brace myself for the trauma of being held against my will, but I know that to many people, my story will come as a surprise. My hope is that this account raises serious questions in our community about how we talk about and treat survivors of psychiatric trauma—because nobody should be dehumanized in the very place they seek care, and no one should be dismissed because their experience does not match the public narrative.

Editor’s Note: The Maroon plans to report further on this matter. If you have experienced involuntary hospitalization on campus or work within UChicago’s psychiatric system and would like to share your story, please email us at editor@chicagomaroon.com or submit an anonymous tip to https://forms.gle/LBWUrbFeqUC3daZ97.