inpatient treatment options? long term or short term?

[babii.blu.eyes.]

firstly i'd like to say i don't really know if this is the right place for this question but i didn't know where else it would fit. it is about what treatment is seen as more effective or not.

i live in australia and have private health insurance which allows me very good treatment in private psychiatric facilities. over the past few years (since 2006) i have spent a lot of time in hospital causing me to have to start and stop any work or study i attempted. in the end i was too depressed to work or study and i was bouncing in and out of hospital so much i couldn't have stuck to anything anyway.
in australia in the private system it is only short term. sometimes people may spend a few months in hospital (as i have) but normally people don't spend as long in hospital as in other countries. the aim being to treat people in a way that they can maintain a job or study while also receiving psychiatric care. this has not worked for me. although i only spend a few weeks, sometimes a few months, in hospital at a time i never leave well enough to work or study because my treatment is ultimately long term however i am seen to have a recoverable illness (severe complex PTSD).
i heard that in england when people are admitted through public or private hospitals they have long term stays instead of short term and only leave when they are seen as able to reintegrate into work or study. is this true? and if so is it more beneficial then the short term work done here?
wouldn't it be better to just stay in hospital for as long as it takes and then leave ready to live your life or bounce in and out of short term stays unable to do work or study because you are in hospital too much but seemingly doing nothing with your life because you aren't constantly in hospital..

opinions people?? please comment. i really would like to know what is seen as a better treatment option.

[Cacoethes]

There's no simple answer to this question really.
It very much depends on the person and what they suffer from.

I spent years at a time in hospital and I don't really think that it helped that much, all it did was make me instituationalised and struggle to function in 'real life' because I was so accustomed to hospital. This also means I missed out on nearly all my education, I took no exams and have never had a paid job.

In my opinion, lots of work outside of hospital, therapy etc. along with short hospital stays if needed, would have been more helpful than just years in hospital, when I know the therapy I did could have been done in the community.

It's not as simple as staying in hospital until you're ready to reintegrate back into work or study, because if you've been in hospital for a year or so, going back home takes a lot of adjustment in itself, it's not an easy thing to do.

In England, I believe short term stays are more common, maybe a few weeks or months. There are specialist units and secure units which are more long stay, I knew some ladies in the medium secure that had been in there for 10+ years and didn't actually want to leave because they were so insitutionalised.

There are pros and cons to long term stays and as I said before, it very much depends on the person and what kind of things they are suffering from.

Have you been offered/looked into any therapy or anything you can do outside of hospital?

[babii.blu.eyes.]

i'm currently doing different types of therapy 4 days a week plus regular inpatient therapy. i do something called schema therapy in a group on monday, art therapy on tuesday, individual psychologist on thursday and individual schema therapy with a psychologist on friday, wednesday, saturday and sunday i do nothing because i cant hold down a job. i spend 4 weeks out of hospital doing this every week then i spend 1 sometimes 2 weeks in hospital doing the groups they offer to inpatients as well as having nursing staff and my psychiatrist see me. sometimes i dont last the full 4 weeks out and end up in sooner then planned and sometimes i stay a lot longer then 2 weeks like after an overdose or self harm or suicide attempt.
i have severe complex PTSD and borderline personality disorder and major depression. everyone tells me i need to do long term intensive therapy with constant support but they dont offer that as an inpatient and i cant do it as an outpatient because im considered at too high a risk of hurting myself during the hardest parts which are inevitable. they are basically saying they cant help me here so i feel lost and like people are just giving up on me because our healthcare system doesnt offer the treatment i need.
it makes me feel lost and i dont know who i can reach out to or where i can get treatment that will actually make me get to a point where i feel like my life is worth living.

[Cacoethes]

Do they have any specialist units where you are?
I know here, they have specialist personality disorder units.

Have you talked to any of the people involved with your care about this?
It might be that you work towards becoming stable enough to do the more intense therapy with less risk involved.

[Snow White.]

That sounds really difficult hun :(

It is hard if all your admissions to date haven't got you to a point where you feel life is worth living. I know your team say you're too high risk for all the outpatient stuff but what else do they say about this admission thing? You're right that no places here seem to keep people for more than a few months. How long do you think you would need though? I'm wondering if you've tried speaking to your professionals about this. Maybe a longer one can be arranged if you outline your rationale.

I guess the concern worth long admissions is institutionalization, as beckie touched on above. Maybe after solong in there the focus will sshift from preparing you for the world to just coping in there. Would it be hard to maintain motivation of getting back to life if you know you're in there so long? I don't know I'm tired but I guess this is something you can decide based on how you've felt after admissions for several months.

Hmmm not sure I've been helpful but please keep talking and sharing your thoughts :)
Ps I will get back to your pm I just haven't been on my laptop and it's hard from my phone xxx

[babii.blu.eyes.]

there are so many positives and negatives to long term and short term and i just dont know how to decide which one is best. i dont know what would be a better option..but i know i need something to change..i cant keep going like this because i feel like life isnt worth living if this is all there is.

[Snow White.]

Is a long term stay possible though?

I guess only you know how you feel both in and out of hospital so you have the best insight into the pros and cons, as difficult as it is. If it helps you can share your own thoughts about the treatment a bit more, sometimes writing pros and cons out can make it a bit clearer.

What does your treatment team think?

[babii.blu.eyes.]

my treatment team all think that my treatment needs to be intensive and long term but because of how the system here works it will have to be done mostly on an outpatient basis. the thing is is for with my 'issues' i have to rip down to the core of everything. right down to being raw and exposed and a lot of pain and build my life back up from there. i dont feel i can do that on an outpatient basis because to rip down to such a raw and exposed state i need the intensive care of a hospital environment and seeing as no one can say how long it will take to build myself back up i need somewhere i can do it without a time limit being set but the way the vic system works that isnt an option. plus my current psychiatrist doesnt agree with long admissions even though she admits i may need them she doesnt agree with them.
ive been looking online to see if long term treatment is available in australia anywhere and i found a place in qld that say it has a long term inpatient ward but i dont know much about it. i have emailed them and i hope they email me back.
i think i would prefer long term treatment. to just go in and take as long as i need to get better without the pressure of having to keep myself alive and strong outside of hospital. im not addicted to hospital and i dont want to spend the rest of my life in hospital. im talking about spending an extended period of time in hospital so that i can prevent a life like i have now just bouncing in and out..
if any of that makes sense.

[Snow White.]

Yeah that does make sense. I hope you hear back from them. I wonder if your regular hospital would work with you to do a long term admission even if they don't usually do that here? It's good to hear you're not addicted and want to work towards bouncing in and out of hospital. At least you've got a clear idea of what you want x

[Revival]

Thinking of you sweetheart, I hope it goes well calling them on Monday. You're not untreatable, you can get through this xxx

[Steel Maiden]

Long stays in hospital are toxic to my brain. All that art therapy crap and group work. I've had over 14 admissions but never longer than a couple of months at a time (except for one occasion of 4 months when I was homeless and waiting for housing). I generally have to be sectioned to force me into hospital, even then it's on my notes to only ever put me on a section 2 as long hospital stays make me more ill.

But if long term works for you then try. But it might make things worse.

[sherlock holmes]

To be honest I think long term inpatient stays do more harm than good, especially with people who have personality disorders.

If you have a personality disorder it does no good to remove you from your life and place you in a bubble (hospital) that's for the most part safe. Any therapy you do will not be very effective as hospital is an artificial environment.

You need therapy in your home environment with all its stresses and ups and downs so you learn how to cope with them at the time.

I was in hospital nearly 2 years and all it did was give me agoraphobia and a yearning to go back to the safety of hospital life. It didn't help me cope at all with real life which was what I really needed.

I think short hospital stays are fine for if you're at risk and acutely well, but other than that you're better off at home getting outpatient treatment.

[babii.blu.eyes.]

i certainly see where youre coming from. i think its a hard thing to decide because of how desperate i feel. i dont know how much longer i can keep going the way things are now which scares me.