Your family member is in the hospital

What a hospital stay is for

A psychiatric hospital stay is short-term, intensive care in a safe place. This kind of care is called inpatient care, which means the person stays in the hospital day and night. NAMI describes a few main jobs for a stay:

• Keep the person safe while a crisis passes.
• Watch symptoms closely and clarify the diagnosis.
• Start treatment, or adjust medicines that are not working. The psychiatrist makes those choices with the person.
• Help the person become stable enough to continue care at home or in a day program. In a day program, treatment happens by day and the person sleeps at home.
• Sometimes, help fix a living situation that was making things worse.¹

A stay is not a punishment. Mental illness is a medical condition, and NAMI is direct that no one is to blame, not the person and not the family.⁴ A stay is also not a cure. Recovery is an ongoing process that continues after discharge, with treatment and support.³ The hospital is one step on that road, not the finish line.

How people are admitted

There are two general paths into the hospital.

Voluntary admission means the person agrees to be admitted. The person and a doctor decide together that inpatient care is the right step. NAMI notes that this path is usually preferable, because the person can take part in decisions about their own care.¹

Involuntary admission means the person is admitted without their agreement. It is sometimes called commitment. It is used when someone is very ill, refuses care, and is judged to be at risk of harming themselves or others. In some states, being unable to meet basic needs like food or shelter also counts. Many stays begin with an emergency hold, which is a short period when a doctor can keep a person in a secure setting. Holds often last about 72 hours, while next steps are decided. Keeping someone longer requires a legal process with a judge and a hearing.³

Time limits, who can start a hold, and what counts as risk all differ by state.³ Ask the unit’s social worker to explain how it works in your state, and what happens next for your family member.

An involuntary admission is hard on everyone, and family members often feel guilty. NAMI describes it as a last resort, used when every other option has failed.¹

What the unit is like

A psychiatric unit can be noisy and busy. People and staff move around common areas, and some may be loud or upset. Doors are locked. There are rules about clothing, gifts, and what can be brought in. Phones are usually in shared areas, and phone use may be limited. There are limits on where people can go.³ These rules exist to keep everyone safe, not to punish anyone.

If your family member arrived by ambulance or with police, they probably came with nothing. NAMI suggests planning a visit soon to bring clothing, toiletries, and a book.³ Ask the unit first what is allowed. Anything you bring may be inspected, and you may be asked to lock up your bag and coat.

Days on the unit have a structure built around group therapy and treatment schedules. Visiting hours are often limited so they do not conflict with those groups. Stays are often short, sometimes only a few days.³

Who is on the team

Inpatient care is delivered by a group of people called the treatment team, meaning everyone involved in the person’s care. Roles vary by hospital, but these are the people families usually meet:

• Psychiatrist. A medical doctor who specializes in mental health. The psychiatrist usually leads the care plan and decides on medicines with the person.
• Nurses. They check on progress, give medicines, watch physical health, and offer support.
• Mental health workers or aides. They help with daily needs and keep the unit safe.
• Social worker or case manager. This is the person to ask about discharge, housing, insurance, follow-up care, and state laws. A case manager is someone who connects services, providers, and community resources.
• Therapists. Counselors, clinical social workers, and psychologists run groups and one-on-one sessions.
• Peer support specialists. A peer specialist is a trained person who has lived with a mental health condition and now works alongside the team. Not every unit has one.
• Patient advocate. Someone who helps resolve concerns about care.³

The team holds regular treatment team meetings, which are scheduled reviews of progress and next steps. With the person’s permission, families can ask to attend. Families who have a concern about care can raise it with staff first, then the nurse manager, then the patient advocate.³

Visiting, calling, and privacy

Rules for visits and calls are different at every hospital, so ask the unit directly. Common patterns include set visiting hours, limits on visitors, and age limits for young children. Many hospitals also require the person to sign a privacy form before staff will confirm they are there.³ If the main operator cannot confirm anything, you can ask to be connected to the unit and leave a message.

HIPAA is the federal law that protects health information. For adults, the team generally cannot share details about care unless the person agrees.⁶ The person can sign a release of information, which is a form naming who staff may talk to. If your family member says no at first, they can change their mind later in the stay. Parents of children under 18 usually have access to records and a say in treatment, though this can vary.⁶ HHS also explains that staff may share with family involved in care if the person does not object. If the person cannot decide, staff may share what is in their best interest.⁷

You can always give information to the team. No privacy law stops you from telling them what you have seen at home, what has helped before, medical conditions, and allergies.⁷ If privacy rules come up, you can explain calmly that you are not asking for information. You are offering it. You can hand over a written history or ask for the unit’s fax number. If you are worried about your relationship with your family member, you can ask the team to keep your name confidential.

Planning for discharge

A discharge plan is the written plan for care after the person leaves. The treatment team makes it with the person, and ideally with the family.³ It is finished before discharge, but it is fine to ask about it from the first day. Ask the social worker early what the plan will look like and how you can help.

NAMI lists what a good discharge plan includes.² Families can ask for each piece:

• The reason for admission and the diagnosis, in plain words.
• The follow-up appointment, usually within about seven days. Ask for the date, time, place, and who it is with. Confirm it before the person leaves.
• Medicines the person will take at home, what each is for, how to take it, possible side effects, and where to get refills.
• A safety plan, which is a set of steps the person and the team agree on for when warning signs return. It names who to call, including 988 and 911, and what to do after hours. Families can ask to be part of it and to have a copy, with the person’s consent.
• Warning signs to watch for, and which symptoms to report to the team.
• Referrals to outpatient care, meaning treatment while living at home, plus support groups or community services.
• Where the person will live. If living with you is not an option, it is okay to say so.

You can also ask what happens if the person leaves against medical advice, which means leaving before the team recommends it. Our page Coming home after discharge covers the first weeks at home.

Looking after yourself

A family member’s hospital stay is a crisis for the whole family. NAMI describes the normal reactions: confusion, fear, anger, guilt, exhaustion, and worry about being judged.⁴ Feeling relieved that the person is safe, and also resentful of the strain, can happen at the same time. Both are allowed.

Constant worry, unusual sadness, short temper, poor sleep, and frequent health problems are signs that stress is wearing you down.⁴ Families often find these things help:

• Keep simple routines. Sleep, eat, drink water, and move.
• Let people help with meals, rides, and childcare.
• Find others who understand. NAMI Family Support Groups are free, and NAMI Family-to-Family is a free class for relatives.⁴
• Keep other children in the loop. Siblings can feel pushed aside. Tell them what is happening in words that fit their age, and spend time with each of them.⁵
• Lean on your faith community or cultural traditions if they are a source of strength.
• Tell your own doctor you are a caregiver. Consider a therapist for yourself.

SAMHSA notes that caregivers who look after their own health are better able to support recovery.⁹ This is not selfish. It is part of the plan.