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Inpatient Psychiatry

—Sue Deppe, MD, psychiatrist , and Therapy Dogs of Vermont Volunteer

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Mental disorders are common and treatable. About three percent of Americans have severe and persistent brain disorders. One fifth of us suffer a mental illness in any given year. Most are not hospitalized, but, if admitted, many patients welcome therapy dogs. Many survivors of trauma are major animal lovers! Depressed or anxious patients find great comfort in petting dogs.

On an open unit you are likely to meet people with depression, anxiety disorders, Post-Traumatic Stress Disorder, and personality disorders. In a locked unit, mania, psychotic depression, schizophrenia, and dementias are more common. Most psychiatric patients are up,dressed, and out of their rooms during the day. You will meet a lot of people in the hallways–avoid causing traffic jams!

Get to know the nurses and other clinical staff members. Follow their advice—they know the patients! (An activities therapist once tipped me off that a patient was getting agitated. Heike and I left before things got tense.) Occasionally a staff member will ask you not to visit because a patient is feeling out of control. Visit elsewhere and check in later. Despite stereotypes, most people with psychiatric disorders are not violent. They are far more likely to hurt themselves or elope from the unit than to hurt others. If someone seems angry, exit politely from the scene.

People with mental disorders may have unusual speech, thinking, emotional reactions, or behavior. This can take some getting used to. Psychosis (loss of contact with reality) has two major symptoms: hallucinations (e.g., hearing voices, seeing things that aren’t there), and delusions (fixed false beliefs). Some patients are talkative, some withdrawn. They may be confused, or their speech may not make sense. Don’t try to argue. Ask about pets or a favorite activity. Smile.

Don’t go into patient rooms until you have more experience. Don’t interrupt if a patient’s door is closed or staff members are there. Leave doors open while visiting.

Each floor has activity and group therapy rooms. Therapists may be leading groups; don’t interrupt if the door is closed. If the therapist waves me in, I come; if she shakes her head “no” or ignores me, I move on. It is fun to hang out while people are doing their artwork, games, or exercise group. If no group is going on, I poke my head in and ask if anyone wants to see my dog.

REMEMBER

  • Confidentiality is crucial!
  • All of the hospital therapy dog rules apply (infection control, etc.)
  • Let the nurses or activities therapists know when you will be coming.
  • When you arrive, check with a nurse to find out whether there are patients you should not see.
  • Always let people choose whether to meet your dog.
  • Find out the group schedule, so you can come when patients are free, or during groups where your dog is welcome.
  • Trust your own emotional reactions. If you feel uncomfortable, politely leave the scene.
  • Consider making your first visits with someone who is comfortable in the psychiatric unit.
  • Don’t interrupt therapy or activities unless you are invited in by the therapist.
  • If you have questions, ask staff members.
  • Everybody appreciates kindness and respect.