Loony Bin Score Card: Facilities, Patients, Programs, Doctors & My Subjective (But Primary Source) Opinions

McLean Hospital, Belmont, Massachusetts

Patient in: Proctor House II (acute inpatient ward; Dissociative Disorders and Trauma Program) and at the Hill Center for Women: 
DBT Solutions for Borderline Personality, Trauma, and Related Disorders (partial hospitalization program)

I attended the Women’s Treatment Program at the Hill Center, which is a Partial Hospitalization program focused on Dialectical Behavioral Therapy (DBT), a therapeutic model designed to treat Borderline Personality Disorder, but also proven effective for Major Depressive Disorder, Bi-Polar, and various Anxiety disorders (or those lucky folks with more than one diagnosis [read: everyone]). As far as the clinical staff goes, the nurses and postdoctoral fellows running the group therapy are largely brilliant with a few real duds. (If you’re unlucky, you get one of those duds as your case manager, but most are quite talented and authentically caring.) This was my first time working with DBT–and it is ridiculously difficult, especially for someone with my characteristics (e.g., you’re supposed to be “mindful” and “get out of your head.” Yikes.). The more intuitive doctors totally catch you not pulling your weight in the various classes and will definitely call you out–not in an embarrassing way, but in order to help you. And to make you laugh. There needs to be some of that.

According to McLean Hospital, "The Women's Treatment Program at Hill Center offers residential and partial hospital services for women with mood and anxiety disorders or those recovering from trauma."

Unfortunately, the program is far too short. I understand they designed it as a “crash course in DBT that is meant to be continued on the outpatient level, but the average is two weeks–which, honestly, is about two weeks too short. And it’s not just me who thinks so. That was the overwhelming consensus of my fellow nuts…who were some of the most awesome people I have ever met in my entire life, and a few who have become intensely close friends. The patients were in the best part of the WTP. It attracts folks whom I felt lucky to have met and learn from and be humbled by and laugh with. I definitely recommend it, though, as with anything, there are several imperfections.

I decided that, yes, this happened, and the information is too valuable to be vainly secretive about. I did a stint in Proctor House II, a locked acute inpatient unit (with 45 minutes of super precious outdoor time). It is actually a very okay place. The facilities are extremely spacious and as comfortable as possible, given the situation. I had a truly badass nurse and the BEST counselor in the world. (I even wrote him a thank you letter after I was released, which may be unorthodox, but hey, consider the circumstances.) They do care, very much, if you are afraid or angry or anything else, and they are patient and truly supportive. I would give a few shout outs right here if that wouldn’t be beyond weird and maybe way inappropriate re: privacy. Don’t be afraid. It is not a holding pen, and you can get a lot out of the experience if you really, really try, as there is group therapy available. It is probably one of the best places you could wind up if you need to be in this sort of place. Honestly. 

The administration and red tape is indeed a NIGHTMARE. This is long enough, and thus I will not get into it, but it’s bad enough for me to downgrade McLean in my feeling of it. Additionally, there are some egos that border on megalomania. Collectively, they are exhausting to deal with–both during and after your stay. Sometimes it was difficult to tell why they weren’t my roommates…

But still: if you’re gonna go crazy, this is the place to do it.

SCORE: A—

Gracie Square Hospital, New York, New York

Patient in: Acute Inpatient Ward

This prison—I mean psychiatric hospital—is absolutely horrific. There are absolutely no redeeming qualities. From the unbelievably sub-par care to the actual facility, this should be your last stop if you can’t get a bed at more reputable hospitals, like Payne Whitney at New York Presbyterian/Weill Cornell, Lenox Hill, or Columbia. The hospital staff provided NO THERAPY. Yes: 0%.

An absolutely repressive mental institution that provides the patients with NO therapy, and becomes angry when there are medication requests, particularly those to treat insomnia. Also, the vegan/MAOI diet would seriously give one major nutritional issues; one evening's dinner literally consisted of grapes.  JUST GRAPES. Seriously.

Patients sat around all day, talking or reading in their rooms or literally just starting at the walls. Some of the patients were indeed quiet ill, and it was surprising everyone was on the same floor. At McLean, for instance, there are separate buildings for diseases like Depression, OCD, and Schizophrenia, and Psychosis, so people can get apt treatment, and therapy all day long. I was in total shock at what a bomb Gracie Square was: so clearly useless, and even made some people feel worse, which they had no problem voicing. It is more like a holding pen so people don’t off themselves (though, um, I don’t know how sitting around for a week or two in a disgusting environment would eradicate behavioral health illnesses). Also, the nurses should have been patients! Seriously: they were whack. They would actually scream at the patients if the patient could not sleep (and pretty much in every interaction) rather than try to provide aid and comfort. My arm was broken when I arrived at Gracie Square, courtesy of Brooklyn Hospital (who shattered and broke several parts of my arm), and they failed to set it for over ONE WEEK despite my actual begging. The pain was blinding. A doctor examined it by hand and deemed it “swollen,” and then sent me for the x-ray I’d asked for every 15 minutes. Too bad it was of my CHEST. I mean, really? Really? I went to Lenox Hill after getting out of that dump and boom: x-ray done, risk broken in five places along the ulna with the carpal completely shattered. I made it through my time at Gracie by ripping a hospital gown and making a sling. I shit you not. Additionally, I scarcely got to eat while I was here. They didn’t know what an MAOI diet was (that’s pretty scary, considering it is a psychiatric hospital) and I had to give them a list of “unsafe” foods. They would literally serve me just fruit for dinner. No protein at all. I lost weight even in the relatively short time (one week) I was there. If I’d been there as long as I was at McLean, I truly think I would have developed some serious vitamin deficiencies. No joke. Also, this place is mad dirty! There were roaches in my bedroom. Roaches. What? I get that it’s a large building in Manhattan, but that is quite unacceptable and rare for a “hospital.” Get an exterminator. Man. Additionally, the blinds faced down so you couldn’t even look out the windows and down at the street, and they were covered in dust. It was just revolting. When my folks came to visit me, they couldn’t believe what a shithole I was in, and tried to have me transferred, but no dice. At least I got to polish off a 500-page novel. From going crazy so often recently, I admit I did get kind of addicted to those little juices.

THERE IS NOTHING GOOD ABOUT THIS PLACE. IT IS HORRIBLE. PLEASE MAKE SURE YOU AND YOUR LOVED ONES STAY AWAY. HONESTLY. IT’S THAT BAD.

SCORE: F

Weill Cornell Psychiatry, ­Payne Whitney, New York, New York

Patient: Partial Hospitalization Program (PHP) & Intensive Outpatient Program (IOP)

I was wildly disappointed with the psychiatric care at Payne Whitney, as it is such a heralded facility (consistently doing battle with McLean for “US World & News Report’s” best hospital). I was not on the inpatient ward here (the Greenberg Pavilion), which I heard from fellow patients was intense by exceedingly helpful at regulating adverse psychiatric conditions, getting people on the correct medication, and engaged, constantly, in therapy of variouos sorts.

New York Presbyterian-Weill Cornell's Payne Whitney is home to an acute inpatient psychiatric ward (the Greenberg Pavilion), as well as Partial Hospitalization (PHP) & Intensive Outpatient Programs for behavioral health stabilization.

They seem particularly fond of ECT; ~10% of inpatients get it. (I should mention there is no outdoor time at all, unlike Payne Whitney Westchester, where you can ultimately earned such a “privilege”; and this is something I think [and many behavioral health professionals agree] is gravely unhealthy [never seeing the light of day] when trying to recover from a depressive episode or what have you; though, to be fair, this seems to be the unfortunate standard in NYC hospitals for insurance company reasons (big shocker!), which is why I would elect, if ever essential, to go back to McLean or to Four Winds [the latter has hours of outdoor time, but I cannot speak to the care on a personal level, though I have heard excellent things].)

I was enrolled in what I thought/what was supposedly, a Cognitive Behavioral Therapy Partial Hospitalization Program, and ultimately an Intensive Outpatient Program. And I gotta be straight: it was really kind of worthless, and even a waste of time (many other people in the program fiercely agreed). The best part was meeting, yes, some more fabulous folks with whom I am now deep friends. My case worker seemed grossly inexperienced; raised her voice without realizing it; had an exceedingly convoluted analysis of my conditions and was unable to be of any assistance whatsoever in sorting it out with me, and was even rather antagonistic and defensive. I literally thought she was an intern after our first meeting. I left Payne Whitney feeling worse nearly every day. My parents came to the family meeting, and agreed with my assessment completely, as does my actually brilliant and enormously kind psychiatrist.

The program was just not challenging; it was frustrating and sometimes even ridiculous (i.e., dance therapy made me feel even more crazy). 

To be fair, there is a Social Worker there named Caris who is unbelievably talented. I wish she ran the entire program. I simply cannot resist shouting her out; she helped me a great deal, and I don’t think she even knows quite how much. 

The doctor, who was so impressed with himself it was nauseating kept trying to put me on Lithium. I mean, what? Not a chance. This dude was seriously obsessed with Lithium. Almost everyone was put on it (no exaggeration), and shaking with tremors during group until they all had the dose lowered. Once, he literally said, “I love my Lithium!” and when I asked if he ever took it, he acted like I told him to go…be naughty with himself. I called my real psychiatrist, who agreed with me 100%, and they sort of did serious battle on the phone a bunch of times. I am doing exceedingly well on Parnate (an MAOI antidepressant), and what I truly need is some extremely serious, kick your ass therapy. You will not get that in the Partial Hospitalization Program at Payne Whitney, which I am still gob-smacked by. Also, my psychiatrist made myriad phone calls to the hospital’s DBT program, which went completely unreturned. How outrageously unprofessional! He was shocked and livid, and so was I. I definitely would not recommend this program, unfortunately, to anyone who wants a real challenge and to be understood—because that’s what you need to get well. Something really, really hard, and with diligence, getting better all the time; like anyone, a work in progress, always learning.

Also…I know this is kind of mean, but several of the Social Workers wore way short dresses and like, Lady Gaga-esk heels (that is not to say I don’t like Lady Gaga—I confess to loving her—but I like to keep my pop music dress and psychiatry separate, which I think is reasonable). I mean, it was kind of wild, and quickly became a joke between several of us 4oz. concentrated juice drinkers.

Thank goodness the psych hospital is also—so uniquely—full of solidarity and a humor beyond compare. It made the days feel okay enough.

SCORE: C+

The Brooklyn Hospital Center, Brooklyn, New York

Patient in: Acute Inpatient Ward

This is 100% non-fiction. I normally would not post on a psych facility I was at so briefly, but in less than 48 hours, the Brooklyn Hospital staff:

*Gave me a wildly incorrect diagnosis;
*Provided deliberately misleading information to my doctor via telephone about my condition and his hypotheses;
*Administered critically contraindicated medications, which triggered an adverse bio-chemical reaction (read: delirium psychosis with mania and ultimately catatonia) that lasted days, left me with serious PTSD, and landed me in the mental hospital;
*Rendered my blood officially “toxic” by injecting an overdose of Ativan (12mg rather than 2mg, plus Zyprexa, which is very dangerous when taken with Parnate (I take 80mg/daily);
*Broke my ulna in five places, my radius in one, and shattered my carpels;
*Patient advocate or Psychiatrist never returned my many phone calls.

Suffice it to say I would rather risk bleeding to death in my apartment while calling a taxi to take me to New York Presbyterian than have an ambulance bring me to this house of horrors again. No joke.

SCORE: F

PLEASE: DON’T WAIT FOR IT TO BE A CRISIS! RESEARCH YOUR AREA’S PSYCHIATRIC FACILITIES IN CASE YOU NEED INTENSIVE CARE. WE NEED AND DESERVE THAT LEVEL OF SAEFTY. ALWAYS.