Editor's note: It is rare that we publish an opinion piece anonymously, but we are honouring that request for two reasons. We acknowledge the risks this woman would be taking in identifying herself, and such an articulate and self-aware piece of first-person writing on this subject has never crossed this desk.

In the 1970’s, nine psychologists entered psychiatric hospitals in the United States to conduct what is now known as the Rosenhan experiment. They entered these facilities pretending to be patients and the study famously concluded that “it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.”

I recently was admitted and released from the psychiatric floor at the Owen Sound Hospital, and while my symptoms were very real, I cannot help but think of the Rosenhan experiment, the mishandling of my admission, and the systemic issues that plague our mental health institutions.

This was not a pleasant experience for me, but as a doctor during my stay told me, “Nobody wants to be in the hospital.”

Being ill is never a pleasant experience. However, it is obvious that the level of care mental health patients receive differs from those presenting with other adverse health symptoms.

This difference in care likely exists due to stigma and a mental health sector that is overworked and underpaid, but I will not be tackling the systemic reasons for the care I received in this article, though it is important to recognize, as the purpose of sharing my experience is not to discourage others from seeking out care, but to bring awareness to the current inefficiencies of our mental health system.

Advocacy has advanced so far that mental health, depression, and anxiety, are now buzz words in the media, capitalized on by corporations like Bell with their Let’s Talk day. But awareness is not enough when the treatment options are inadequate.

The symptoms I presented with at the hospital are typical of patients experiencing bipolar II disorder. Following a bout of hypomania, I experienced a long and intense depression that left me virtually nonfunctional.

When I decided to go to the hospital, I was not a danger to myself or others, but I was, nevertheless, in a state of needing emergent care, as any person experiencing loss of functionality due to physical health issues would be.

Upon my arrival, the hospital staff was kind. The reason I arrived, I told them, was for “some kind of mental health crisis.” In the waiting area I was visited by a staff member who assured me I had not been forgotten. I only waited for about an hour, which seems a very short time, considering the hours I have waited for other illnesses, and the reputation of long emergency department wait times that most Owen Sounders are familiar with. I felt optimistic.

After speaking with a crisis care worker, I was asked if I would like to be admitted voluntarily. The doctor assured me I would not be in a lockdown unit and would be allowed privileges, such as my cellphone, my own clothes, and the personal items I came with. I agreed to this.

Privilege is a word I feel is important to discuss here, because I know of others who have presented with the same symptoms and have not been admitted. I cannot be certain of the reasoning for this, so I will not discuss that in great detail, but it should be noted that I am generally, (and was on this day) an articulate person with a calm demeanour upon being admitted. I am not sure if this contributed to my treatment, but it should be considered that others with different life experiences and abilities may not have been treated the same.

A nurse and two security guards escorted me to the elevator and up to the fourth floor. I was somewhat concerned, as this seemed excessive, but I was assured that this was just standard protocol.

I was shown to my room and by this time, I realized that I was in fact, in a state of lockdown. I could not leave the floor during my stay.

I did have my cellphone and personal items however, and I was not searched upon arrival. My boyfriend visited me later to bring my laptop and other personal items. I was not allowed to keep my makeup bag, because of the tiny mirrors in the blush containers.

There were blinds on the windows leading to the hallway and the room with which I shared a joint bathroom that could not be opened from inside my room. I asked my boyfriend to go into the hall to see if they could be opened from the other side. (They couldn’t.) He stayed with me for a while and I talked about leaving but decided it would be best to stay.

One of the personal items I was not allowed to keep was irreparably damaged by hospital staff. I received an apology and told the staff member it was no big deal, even though the item was expensive, as I understand accidents happen and was afraid that if I acted upset in any way my voluntary stay could turn into an involuntary incarceration. It already felt that way, as I hadn’t agreed to be locked on a hospital floor that I was not allowed to leave, without access to my personal items. No compensation for the item was offered.

At some point a man about my age entered my room with an “administrative questionnaire.” The questions ranged from asking about my place of residence, to whether I had ever been sexually assaulted, as well as “when” and “by whom,” and whether I had ever sexually assaulted another person.

I answered “no” to the last question and made some kind of weirded out face, because the man with the questionnaire said, “I like the look you gave when you answered that,” which seemed inappropriate, but he was as awkward asking the questions as I was answering them, so I assumed he was new at this, and just as unprepared to ask the questions that seemed much more personal and trauma related than simply administrative, as I was to answer them.

It was at this point that I became acutely aware of the probability I was locked on this floor with people who had committed sexual assault. Maybe the man in the room a few doors down who only wore his underwear and whose door always seemed to be wide open – a sight any medical professional would be accustomed to, but a frightening one for a sexual assault survivor. (And by stating this, I do not mean that the man was definitively dangerous, or undeserving of his own care, just that there should be some additional care taken for sexual assault survivors so they do not have to fear for their safety, whether the threat is actual or perceived.)

I chose not to leave my room during my stay. However, at mealtimes, I was told we were expected to walk to the cafeteria area to get our own trays and to return them. I would wait until the line dissipated and speed walk down the hall.

Once I had a question for hospital staff and approached the nurse’s desk. The person at the desk was on the phone. I patiently waited. She made brief eye contact before putting her head down and continuing the conversation. When she hung up, I said “hello,” and she moved to the other side of the divider without acknowledging me. I assumed she had some follow up to do and continued to wait. She came back to the desk, made eye contact again, but put her head down and started writing. I waited for what felt an unreasonable amount of time, feeling invisible. “Hello,” I said again.

She looked up, “Do you need something?” I wanted to do laundry as I was told we were able to on the floor. Doing laundry, I thought, would make me feel normal and give me something to do, other than sit in my room. She told me there was a long wait for laundry. I definitely couldn’t do it today – maybe not even tomorrow. I didn’t do any laundry during my stay.

I spent my days in my room, trying to get caught up on some of the work I had missed. I talked to the psych doctor on the floor each day for ten minutes or less. I was given a tentative diagnosis and offered three options for medication. I was told I could research them and choose which one seemed best. I chose the least expensive option, because I do not have health benefits or a drug plan.

During my research, I also read that one of the adverse symptoms is suicidal thoughts, and it is one of the medications most commonly used in intentional overdose suicides. Medication was really the only the treatment I was offered during my stay. After days of this, I informed the doctor I was ready to leave. I was told they would prefer that I stay. “What has changed in your mood that makes you feel you are ready to go?” I was asked.

“Do I have to be sane to leave?” I thought. Had I not been sane this whole time, despite the lack of care I received? Despite being ignored and asked potentially retraumatizing questions without any support, had I not remained calm and committed to my wellness, even if no one else was? How would they know anything about my “mood” anyway?

The only person who bothered to speak to me was a member of the cleaning staff. She was, at this point, a saving grace. I think many of us can remember from the Covid days what it’s like to be alone for long periods of time. It’s not good for your mental health.

But there I was, alone, in a mental health treatment center. Truly institutionalized. At this point, I had not talked to a therapist, or had any group therapy, and had been there for nearly a week. Nothing had changed, but at least I had medication and would have access to outpatient service when I left. At least I would have my autonomy and not have to wait for hours for my makeup bag after asking for it, or for days to do laundry, or worry about my personal items that were involuntarily taken from me being damaged. At least I could try to do things that made me feel well, instead of being confined to my room because I was afraid of other people that may be on the floor.

I was moved to a different room that evening. I forgot my jacket in the closet and when it was brought to me, I realized it still had my cigarettes and a lighter in the pocket. Certainly these items were not allowed on the floor. I told the nurse before I left. It was a mistake that I was not searched. I was thanked for not smoking. It was also an error that I was not informed about the rules, or activities available on the floor.

A social worker visited me the evening before I left and gave me a binder that included all the rules, one of them being that group therapy was mandatory. I was also visited by a nurse that evening who said I looked “so comfortable” with my laptop set up to watch TV, and that she wished she was me right now. I couldn’t imagine anyone wanting to be in that position.

For the week I was admitted, only a nurse on my second last day told me that a therapy session was occurring, and nobody told me I had to go to them. The focus seemed to be on confinement, rather than wellness.

Maybe the staff all thought I looked comfortable. Maybe they were busy with other patients. Maybe my proximity to mental illness made me virtually invisible. But at least I left with a treatment plan. At least I was admitted at all. I know not everyone has been so fortunate.

My treatment plan included my new medication and therapy – therapy that I had to seek out and pay for on my own. After leaving the hospital, I signed up through an online service to see a therapist using Zoom that offers a sliding pay scale for people without benefits. I pay $100 per month for two sessions. Even this is almost unaffordable, and ideally, I should be attending therapy weekly, or more.

Once I forgot to take my medication, and on an upwards mood swing, I considered whether I need to continue taking it at all. This is one reason talk therapy is important for people who experience periods of hypomania/mania. In a state of euphoria, it is easy to believe you have been cured, or that the medication is keeping you down, when really it is keeping your mood regulated.

Another reason is that having someone trained who is able to monitor your behaviour is often essential. As I previously stated, the medication I was prescribed is often used to commit suicide and the adverse health effects of many anti-depressants / anti-psychotics are suicidal thoughts. While the amount of therapy I am able to afford is not enough, attending these sessions at all is a privilege. Many people are simply sent home with medication and a treatment plan – a plan they cannot afford and is difficult to put in place for themselves.

I can’t help but wonder – if this is how I was treated, what happens to people who are not able to advocate for themselves? Or people who are perceived to be a threat to themselves or others?

I am an articulate person with a calm demeanourr, which surely affected the way I was treated by hospital staff and after leaving, I had little difficulty accessing resources when I was feeling well.

Yet following my treatment plan has been difficult.

After admission to the hospital, I somehow fell through the cracks and was offered little that would contribute to my mental well-being. Instead, I felt incarcerated and frightened.

I am a person who is able to advocate for myself. Many people in mental health crises are not.

I am a person who has a lot of support from family and friends. Many people in mental health crises do not.

I am a person who felt unsafe in the only mental health treatment option available to me. I am a person. And I am ill.

And so is everyone experiencing a mental health crisis. Yet, instead of being treated like a person with an illness, during a time when I was most vulnerable, I was left feeling dehumanized, with little in-hospital care.

This is my story, and I know comparatively it is far better than many others’. When we talk about mental health advocacy, we must also talk about the inadequacy of our mental health system.

We must talk about treating people with dignity, regardless of their socio-economic status or the presentation of their mental illness.

We must do better.