What happens when I am admitted to hospital?
When you arrive at hospital, there will be a number of people you will meet and information shared with you.
Coming to hospital
When you first arrive at the hospital for your admission, you and your parent(s) or guardian will be met by members of your care team (also known as the multidisciplinary ‘MDT’ team. They will show you around and go through all the information you need to know. They will give you a welcome pack with some information about how the hospital works so you can read it later in your own time. Read more at the link Words you might hear
They will also ask you questions about things like your current symptoms and any medications that you are taking. During this process, your care team will take time to assess your needs so they can develop a care plan that will work for you. You will have an opportunity to ask any questions you have about your care and find out what will happen next. Sometimes this can be a bit overwhelming. That is okay and you may need to go back and ask questions later.
Code of Practice on Admission, Transfer and Discharge
The Mental Health Commission has a Code of Practice covering admission, transfer and discharge from hospital. It says that the hospital should give you information on admission to hospital like:
- information on your rights while in hospital - staff should check that you understand your rights.
- information on the care and treatment you can expect to receive.
The law (regulations) says that the hospital must give you information about the unit you are admitted to. This includes information about mealtimes, visiting times and how the hospital will look after your possessions.
Staff should also tell you about:
- your mental health difficulty.
- any medications they will give you.
- any advocacy services available to you.
You have a right to have things written down as well as explained to you. It is useful to have things written down because it will help you to remember what has been said. Some questions will not be simple ones for staff to answer and you may have to wait a little while for their reply. Remember that you have a right to an answer to questions you ask.
Your individual care plan (ICP)
Everyone must have a care and treatment plan. This is sometimes called an ICP (individual care plan). It will say what care and treatment you need, like individual therapy, group therapy, medication or family therapy. Read more at the link Words you might hear
The ICP will also list the goals that you want to achieve for your recovery. Staff will develop a care plan shortly after your admission. You and your parent(s) or guardian should be involved in developing your care plan and be given a copy of it. Your progress and care plan should be reviewed regularly, so that you and your care team can decide whether there needs to be any changes made to your care and treatment
See Support Tool 2 if you do not know what is in your care plan or you want more details about it.
Can I make decisions about my treatment?
Treatment means any medication, tests, therapy, nursing and other care given to you in hospital. The aim of this care and treatment is to help you feel better and recover so you can return home.
If you are under 18, in general, you do not have the legal right to decide whether or not to consent to (agree to) mental health treatment.
- If you are in hospital on a voluntary basis (where your parent(s) or guardian consent to your admission: see page 7), your parent(s) or guardian must consent to your treatment. This means that even if you do not consent to a particular treatment, your parent(s) or guardian can consent for you.
If you are in hospital on an involuntary basis (see webpage, Why am I in hospital?), then the doctors need to get permission from a Court to treat you. This means that the doctors do not need permission to treat you from your parent(s) or guardian. BUT the law does say that no matter what age you are, your care team should discuss your treatment with you. They should listen to your views before they decide if you should have a particular treatment. This does not mean that members of your care team must agree with you, but they should consider your views before they give you any treatment.
The law also says that your care team must tell you about your mental health difficulty and any medication they give you. This includes telling you about any possible side effects to taking it. They must do this in a way that is clear and easy for you to understand.
- If you disagree with your treatment, you can use Support Tool 6 to tell your team or parent(s) or guardian why.
- You can also use Support Tool 5 to help you learn more about your medication.
They must do this in a way that is clear and easy for you to understand.
Key Worker
Shortly after your admission, your care team will assign a key worker to you. Read more at the link Words you might hear
The role of the key worker is to co-ordinate all stages of your care, and they make sure that you receive the care that is described in your individual care plan. Your key worker will meet you at least once a week and have regular contact with your family or guardian. If you are not assigned a key worker in your first week, you should tell someone on your care team, so they can make sure that someone is appointed for you.
Can I choose whether my key worker is male or female?
Sometimes it is possible. If you have a good reason, then it is important that you talk with someone about it as soon as possible.
Can I still see someone from the team that looked after me when I was at home?
Sometimes. This will depend on where the unit or hospital you are admitted to is located. If it is far from your home, it may not be possible to see someone from your community team until after you leave hospital. It is likely that the people treating you in hospital will be a whole new team to the people you were seeing before. While this can be difficult and feel daunting, remember your new team really wants to help you recover and involve you in decisions about your care and treatment. Your new team will also have been sent notes about your situation from the professionals who were already working with you, including your GP, community team and others.
People you might meet in hospital:
You will meet staff and other young people while you are in hospital. You can talk to any of the staff. They may:
- help you to get your views heard
- help you get your rights respected
- answer some of your questions
- listen to you if you are worried about something
This is the nurse who oversees all activities on your unit. They coordinate and manage the operations of your unit along with the other nurses. You can speak to this nurse, or ask to speak to this nurse, if you have any issues or any feedback including compliments or complaints.
This person usually provides talking therapy and, over time, can hopefully help you find new ways of looking at what is happening to you and things that you might do to feel better. They usually ask about important times from your past and about key relationships in your life to try to better understand your thoughts, feelings and behaviour. They will support you to understand yourself better and to learn new ways of coping with problems. Clinical psychologists sometimes have the word ‘doctor’ in front of their name, but they are not medical doctors and cannot prescribe medication.
Dietitians may meet you and your family to discuss any dietary and nutritional issues you may have. If you have been admitted to hospital because you have an eating disorder, it is likely that the dietitian will manage your dietary needs. They will do this through dietary counselling, supplementing your nutrient intake and monitoring your nutritional requirements. In some very rare cases where it is needed, they may prescribe Nasogastric feeding (tube feeding). They will only do this if you are at risk of serious harm. The dietitian will aim to educate you, your family or guardian and other members of your care team about your nutritional needs.
This is a person who does not work directly for the hospital. They can give you information on your rights and options and can help you to get your views, wishes and feelings heard. They can also talk things through with you and can speak on your behalf if you need them to or help you contact relevant people.
This person is your point of contact on the team. They will co-ordinate all stages of your care, and they make sure that you receive the care that is described in your individual care plan.
Your nurses will be specialised in mental health and might be called psychiatric nurses or mental health nurses. They are part of the team responsible for your care, treatment and road to recovery.
Nurses will be in your unit at all times and will provide you with nursing care like giving and monitoring medication. They might also help other staff who provide therapy and group work sessions.
This person will encourage and help you to get involved in different activities while you are in hospital. They will look at your interests and your needs so you can do activities that make you feel better both in hospital and at home.
They are interested in all the activities you do in your day including self-care, leisure activities, school or your job. They will look at what supports or stops you from taking part in the activities you need or want to do. Occupational therapists will help you to develop the skills you need to return to meaningful activities when you leave hospital.
This is a medical doctor who specialises in mental health and can prescribe medication. They have overall responsibility for your treatment at the unit. A doctor’s role is to understand or ‘diagnose’ what sort of mental health difficulties you may be experiencing, and to recommend approaches to help you recover. These might be talking therapy, prescribing medication, or a mixture of these.
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Consultant Psychiatrist:
Consultant psychiatrists are medical doctors who have completed full specialised training in psychiatry. Every patient who is admitted to hospital will have a named consultant. Consultants are the most senior doctors that work in a hospital.
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Registrar:
A registrar is a medical doctor who is supervised in their work by consultants. They are sometimes known as Non-Consultant Hospital Doctors (NCHDs).
A psychotherapist is a trained professional that provides talking therapy. Psychotherapists aim to help you explore and understand why you feel the way you do, what’s behind the way you act towards other people and why some things happen to you. They try to bring about helpful change by doing this.
This person will be part of your care team and be involved in assessing and treating you. They will provide specialised support such as through the use of cognitive behavioural therapy (CBT ), individual work and group sessions.
This person will look at your language and social skills. This may be done during individual sessions or group activities.
Social workers provide different supports like helping you look at how your life at home may need to change to help you feel better.
Your social worker will meet you and your family to explore what your family strengths are. They will help you to build on them and to explore how you and your family work as a team. This can help because when we are stressed or worried it is easy to forget to talk to each other and can be hard to find the right words.
The social worker will meet you with your parent(s) or guardian and on your own. They will also meet your parent(s) or guardian on their own too. This gives everyone a chance to talk about their worries and their hopes for your time in hospital.
