Semi-Surreal self portrait in Lavender

When it is Time to go to the Hospital: 11 Steps to Take Before and After Admission

I don’t do well in mental health settings.

I don’t look sick.

I don’t act like a ‘mental patient’.

Not all people with mental illness end up homeless and hallucinating
on the street.

I also have expectations.

I expect my treatment providers to be as passionate an advocate as I was
when I was a treatment provider.

If you have Dissociative Identity Disorder and you are you are about to enter treatment at a Behavioral Health facility it’s a good idea to prepare.


Don’t assume that behavioral health professionals are trained psychotherapists. Psychotherapy treats the mind. Behavioral Health treats behaviors.


If your primary treatment provider is an outside therapist, ask him or
her to communicate your treatment status and history to the facility.
All decisions regarding your stay should be made by your therapist.


Confirm that intake physician at the treatment facility has spoken to
your outside therapist after you arrive .


Ask if the staff knows how to treat dissociative symptoms.


If you have concerns about the quality of your treatment, speak to the
attending psychiatrist.


Do treat the staff with respect and consideration. Most people want
to do a good job.


Do tell the staff about suicidal thoughts or self-destructive alternates.


Discuss your physical health and if one is needed, ask for a physical.


If you are diabetic or have high blood pressure, ask the staff to check your blood pressure and sugar levels. Diabetes and high blood pressure affect mood.


Ask for a medication assessment.  Mention all unusual side effects or problems.


Don’t enter a hospital or day clinic alone. Ask your partner and friends to call and ask about your progress.  Make sure that you sign the releases the clinic needs to discuss your case with friends and family.

(c) Rob Goldstein 2017-2018

This post is specific to people with Dissociative and other Trauma
related disorders.

Some of this information may not apply to you.

More reading:

Advocacy for mental health: roles for consumer and family organizations and governments

The Importance of Self-Advocacy in Mental Health Recovery

The Self Advocacy Toolkit

stand up against stigma, no health without mental health


29 thoughts on “When it is Time to go to the Hospital: 11 Steps to Take Before and After Admission

  1. So right to get this out in the open, I do admire you for that. There is still such a stigma in so many folks feelings about mental problems…yet here in the UK , I read 1 in 4 has trouble of this nature some time in their life. Well done.

    Liked by 1 person

  2. Wow… This is a really important post, Rob. It just makes me feel very uneasy that so much proactive effort is necessary from the patient. Sadly that seems to apply to every kind of health care.
    I’m happy to read that you are “finding your way.” I can certainly relate to feeling so many different ways all at once. Be good to you, my friend. Hugs.

    Liked by 1 person

    1. Thanks Teagan. Some of these rules apply to getting treatment in general. Never go alone, bring a list of questions, don’t assume the doctor knows everything, prepare for the an event in which you can’t advocate for yourself and study your diagnosis as if you were going to treat it. I wouldn’t have a psychotherapist if one of my alternates had not learned how to write a Statement of Medical Necessity. DID is an interesting ‘illness’ in that a patent’s alternates can often rational and highly accomplished.

      Liked by 1 person

  3. It shows that I already “liked” this but I have not even been awake until just now and it looks like you only posted it a few hours ago. How bizarre is wordpress!
    Anyway!! I completely agree with you!
    I learned after my seizures started that my husband would go into every appointment and every hospital or ER with me and not leave my side. We need an advocate. Especially when we are unstable due to physical or psychological crisis, we need someone to do what we would want if we weren’t in PTSD or dissociative state. Great article

    Liked by 1 person

    1. I reblog posts about mental health to the Survivor’s Network which uses up the one time I can reblog a post. One way around this is to take the post offline and schedule it as a new post which I do if I make significant revisions. So you may have seen the post in an earlier incarnation. I’m glad you saw it again and found it relevant.

      Liked by 1 person

      1. I see so much needless suffering. I can’t end all of it but helping people gives my pain meaning. I don’t think we’re meant to live pain free lives. I think we’re supposed to learn from our pain and transform it into positive action. Thank you for being such a consistent support these past few years, Erika.

        Liked by 1 person

      2. I think the same we need the pain in order to learn. As long as all is well we won’t start to take action or move and the lesson we learn from the pain is so much more insightful!
        I simply admire the person you are and how far you have come, Robert! And I thank you for sharing your experience, dear friend!!

        Liked by 1 person

    1. Yes, it is. I’m in intensive out patient treatment which is a step down from being ‘in’ the hospital.

      I go to a Kaiser Clinic three days a week and see my therapist on the off days.

      I feel like I’m finding my way through this–it takes time.

      I feel a dozen different ways all at once so it’s a bit overwhelming.


  4. This is a VERY important reminder and tool for anyone who has or will experience this or the loved one of someone who does. I related to this especially, the idea that we should not assume a mental health professional is always as proficient as we may wish for, I have heard too many times of bad calls especially in the ER where people have been put on really dangerous medications and misdiagnosed. Being as ‘together’ when we are not together, may seem impossible but it’s also something we often do – the other thing is the idea of ‘not looking sick’ that’s very true. I find I’m often told ‘oh you don’t look like anything is wrong’ I want to say something clever like oh what is a sick person supposed to look like? but I usually just clam up. Thanks a lot for posting this my friend

    Liked by 1 person

    1. Thanks for your comment.

      The stigma against people with chronic mental health conditions is thickest in the behavioral health system which is as much an economic model as it is a set of treatment approaches.

      Behavioral Health Systems prefer relatively healthy people with easy to solve problems related to temporary life adversity.

      One can think one’s way out of believing that one are a loser because one was ‘downsized’ out of a job.

      It’s much harder to cope with getting fired because you have a chronic form of Schizophrenia and stopped taking your meds because you lost insight.

      Liked by 1 person

      1. Exactly. My second cousin has Schizophrenia I totally agree w/u. Stigma kills more than mental disease ever could. And having worked in that setting I saw so many UNcaring people in it I could not believe what I was seeing. You are so right. They definitely believe mental illness is somehow a choice. It drives me crazy. I am thinking of you today, your sister is somewhere above us, glad for your love of her, and she hears all your heart says to her, I really believe this.

        Liked by 1 person

      2. Definitely. Like with feminism. It couldn’t stand for equality. The black women got mad with the white, the transgender with the non transgender, the upper class with the lower class, the mothers from the non mothers, the gays from the straights. Good grief. If we KNEW the power of standing together we actually could do more or less ANYTHING and completely change the world but we’re so indoctrinated to compete and compare.

        Liked by 2 people

      3. Totally true. And legal concepts are foul because they are ‘controlled’ so basically our ‘truth’ is open to the interpretation and control of those who are chosen to make the decisions for us all. NOT representing our interests 😦


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