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Old 09-11-2019, 07:06 PM   #1
Kaybarr
 
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Graphic - When to go to hospital?

Labelled it just in case. I know you guys can't give medical advice that's not what I'm asking for. I just need help to figure it out. I'm pretty brain-foggy atm so this probably won't be too organised, sorry.

Two weeks ago, we upped my antidepressant to the max dose, and it's been affecting me in weird ways. Other meds gave me bad side effects or just didn't work, so this isn't a first-line medication. I've been on it for a while, at least a few years, and it helps. I know it helps because I tried to go off it once and that went badly. Anyway, I think the dosage change was the right choice, because I'm hoping this weirdness is going to even out at some point, but it's hard to wait it out. I've never really had a med affect me like this before.

I've had an unusual number of suicidal crises the past few months, and I got pretty concerned when I noticed new risky behaviours popping up. But it's been much more ups-and-downs than I'm used to, especially since the dosage change. I've had a couple consecutive days of high physical energy, which is weird because I've chronic fatigue, though my brain was still foggy as ever. I've had several times that my mood plummeted unexpectedly, which again is weird because I don't get mood swings.

There was one time recently that I definitely should have checked into the psych unit, but I didn't because I'm still on my parents' insurance and they'd see it. I was really drunk that time, which obviously didn't help, but I think the only reason I survived is because I somehow redirected my impulsivity (that I only really get during crises) to call my best friend on Skype, even though it was like 4am where he lives. And yes, it's dumb that I can't go because of the insurance.

Particularly in the last week or so, I've been cutting a lot more frequently, though not really any more severe than usual. I've been in this kind of mindset before, where I go about perfectly fine, go home and cut, rinse and repeat. But not so much since I've been on this med. SH and suicide are on my mind most of the time recently. I'm still way better than I used to be, though, so it's like this weird "I'm worse but not really" sort of feeling. I've been more self-destructive than usual in other ways, too.

I've been wondering and thinking really hard about whether I should go to the hospital for the psych unit. I have an advance directive just in case, I can be hospital-ready at a moment's notice, and I'm well familiar with the process here. I'd have to go to the local ER and, assuming they admit me, I'd have to be transferred to another hospital that's kinda nearby. But:

I'm already critically struggling in classes this semester, and I can't afford to screw up my academics any further. I also can't tell or let the hospital figure out my insurance, so I have no idea how that would work since I simply don't have money. And most importantly in my mind, do I really need inpatient? I know there's a shortage of beds here, and a surplus of people more in need of them than I. I'm only actively suicidal for like half a day at a time, but if I'm admitted the minimum required hold is 72 hours.

If I hold out until winter break, I might be able to figure something out then, so as to not miss classes. But if I can wait that long, do I really need it? How do you know when you should go to hospital?

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Old 09-11-2019, 07:44 PM   #2
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I don't have time to respond properly right now, but if you are an adult, your parents cannot see admission or medical records without your consent, and generally even insurance eobs go to your name and not theirs. The only thing that goes to their name is the bill for the premium. I imagine you could phone your insurance company to clarify this if you needed or had concerns, but that's always been my experience. Any bills for copays or deductibles get sent to you directly as well.



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Old 09-11-2019, 07:47 PM   #3
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Can you speak to the people involved in your treatment about what might be the best option? It can be hard to make a decision alone and it's hard for us to advise since we don't know your background etc. Are there options for more support as an outpatient if you think that might help?





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Old 09-11-2019, 08:02 PM   #4
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Quote:
Originally Posted by Auror. View Post
if you are an adult, your parents cannot see admission or medical records without your consent, and generally even insurance eobs go to your name and not theirs. The only thing that goes to their name is the bill for the premium.
Thanks for taking the time to help me out. Unfortunately, while I know that is legally the case and morally it should be the case, in practice it has frequently not been the case in my experience. Professionals, especially medical professionals, have straight-up blatantly ignored HIPAA and other applicable laws, many times. And I don't know how, because I've never dealt with my own insurance yet, but there is something my parents can see on the insurance that tells them I was in the hospital. So far, they haven't found out the reasons for admission through the insurance, but with them, admission is bad enough on its own.

Quote:
Originally Posted by one_step_closer View Post
Are there options for more support as an outpatient if you think that might help?
Thanks for the reply, and yeah I totally understand that you guys technically can't really do much, but I never get to hear other peoples' thoughts on it irl, so it's just me going in circles. But to answer your question, unfortunately, no. I've exhausted all my resources, literally triple-checked that I didn't overlook something, and the very little outpatient treatment I'm getting is very useless. Essentially, I'm alone.

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Old 09-11-2019, 08:04 PM   #5
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What do you think hospital might be able to do for you? Or, what do you want any kind of treatment/option to do for you?





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Old 09-11-2019, 08:13 PM   #6
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I mean, in the past it's been therapy that's kept me arguably functional: an hour every week for like six years. But when I started college, I lost that (I'm rather far from where I lived before college). After a lot of fighting with the school, the best I've gotten from them is an hour every three-ish weeks with a guy who's nice but focuses on all the wrong things; but that's a great improvement from their 'solutions' before, like half an hour every four weeks or less, or Peer Counselling. It's a fairly rural area and I don't have much transportation, but even ignoring whether I could physically get myself there (I've checked out programs meant specifically for that sort of thing) nothing worked out.

The hospital can keep me safe for a few days at least, and even if that's all it does that would still be a big improvement from my current circumstance. But it's also a chance to get reevaluated, have my meds monitored, stuff like that, and maybe it'll even help me feel a little better. Nothing else has, so idk.

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Old 10-11-2019, 02:45 PM   #7
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It does sound like you need some respite from everything that's going on for you. I'm not sure about how healthcare works in your area so I don't know about your insurance etc, I hope someone else who does know can reply. Would a few days in hospital badly affect your college work? How long is it until your winter break? I understand how hard it must be to make this decision since you've said if you can wait until your break then how do you know if you need to be in hospital. I'm also not sure about the criteria for admission in your area and what they would do for you in hospital. I sometimes have planned admissions, is that something you could discuss if you think you can be relatively safe until it's a more suitable time for you to go into hospital? If you are in serious danger of course you shouldn't wait and should get some advice from a professional asap.





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Old 10-11-2019, 07:01 PM   #8
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Quote:
Would a few days in hospital badly affect your college work? How long is it until your winter break? I understand how hard it must be to make this decision since you've said if you can wait until your break then how do you know if you need to be in hospital. I'm also not sure about the criteria for admission in your area and what they would do for you in hospital.
I'm not sure exactly how much my schoolwork would be affected, but during the semester it's more than would be ideal. If I assume it's just the 72 hours, I could only miss one class and my workstudy (college funded busy-work) if I went on a Friday, or anywhere between 4 and 8 classes on other days of the week. I've a couple big projects coming up soon that I'm probably going to do poorly on anyway, but most of my professors are pretty understanding about stuff like this. (Actually, it just occurred to me that if the hospital lets me have anything to write with, which I think they will, I could still make progress on one of my final projects during free time)
It's a little over a month til winter break, but there's another problem with that: I have an unavoidable pick-up date at the start of break that'd take me 600 miles away from here, and I trust the hospital there a lot less than the one here. The best idea I've come up with to manage that issue is, I might be able to come back to school a couple weeks early before the start of the next semester. But that would be closer to two or two-and-a-half months from now.

Voluntary inpatient here is mostly based on 'danger to self or others,' and unless they're completely out of beds they're unlikely to turn me away. Basically the process goes like this: I go to the ER, tell them what I'm here for and why, they'll do a medical check followed by a psych eval, and if it's determined that I'm a 'danger to self or others,' they'll confiscate my stuff and get me a room to wait in until they're able to transfer me to the other hospital. Depending on their opinion of me, they might have someone 1-1 obs while I wait.
Then at the other hospital I'd most likely go straight to psych, talk to the psychiatrist guy, and if he confirms what the first guy thought, I'll get the approved bits of my stuff back and be admitted. The psych unit here is big on group activities, which I hate, but they're technically voluntary (but lack of participation will be noted and could affect my stay). Other than that, there's a lot of talking, like group therapy (which I also hate) and 1-1's (which can be helpful). There's supervised excursions, outside if the weather's good and if I'm not deemed an elopement risk. But the most helpful part imo is just the lack of opportunity/means to hurt myself, the highly structured schedule and constant availability of support.

I think my main worry at this time really is, if I can wait that long do I really need it?

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Old 10-11-2019, 07:05 PM   #9
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If you can wait that long then maybe you could re-evaluate things at a later point and see where you're at then.





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Old 10-11-2019, 09:09 PM   #10
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As you sound like you're aware, a 72 hour hold only works/applies if you're admitted involuntarily and for the record, non business days like weekends and holidays are not part of the 72 hours. It's 72 hours of business days.

If you show up to an ER voluntarily like you said, there's also the possibility they would just talk to you and give you some outpatient appointments or suggestions without being actually admitted. And if you are voluntarily admitted, you can stay less than 72 hours.

I know sometimes folks have also had planned admissions if they work with their outpatient providers, so if you have any outpatient support maybe you could work with them for a planned weekend admission or something of the sort.

As far as school, since you said your professors are understanding, if you have documentation for the absence which you would, most professors should count being in hospital as an excused absence and would let you make work up.



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Old 10-11-2019, 09:23 PM   #11
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@Auror, thanks for the info/advice, I'll look into that

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