Mental health hospitalizations happen very rarely at MIT. For example, in the most recent academic year for which we have data, only 43 of more than 1,900 students seen in Student Mental Health and Counseling were hospitalized. Twenty-six of those students—nearly two thirds—returned to school quickly after being discharged from the hospital. It’s also important to note that most mental health hospitalizations are voluntary. This means that the patient agreed that he or she was at risk and would benefit from intensive treatment.
In Massachusetts, a person can be hospitalized involuntarily only when there is a serious risk of harm to self or others.
To assess risk, the clinician weighs a variety of factors that might increase or decrease risk for a particular patient. These factors include the patient’s current situation, past history, mental status, and available supports. For example, someone who currently shows signs of depression, has previously attempted suicide, has a specific suicide plan, is intoxicated, or has a history of not being able to control violent impulses would be considered at higher risk. But the clinician also considers factors that could reduce risk, such as the availability of social supports in the form of family, friends, housemasters, clergy, or others. For the clinician, the most important considerations are the individual’s safety and the safety of others.
Sometimes. Each inpatient unit has its own policies about the use of phones and the Internet, and access may not always be available. Since patients are there for treatment, some facilities restrict activities that may interfere with this work. On the other hand, therapists also recognize that maintaining contact with the outside world is important for a person's mental health—and that this is particularly true for a student.
Usually. Most psychiatric inpatient units will allow a patient to have visitors during specified visiting hours, but it is up to the patient to say if he or she wants to see those visitors.
Hospitalizations can last anywhere from one or two days to several weeks, but most are less than a week. The length of a hospital stay is determined by several factors:
- Severity of illness
- Patient’s participation in treatment and insight into his or her condition
- Patient’s mental status and improvement since admission
- Situation into which the patient is being discharged—in other words, whether the patient will have a supportive environment with appropriate outpatient treatment after leaving the hospital.
The attending psychiatrist in the inpatient unit has the final word on discharges, but the decision is usually made in consultation with the rest of the inpatient team and the patient’s outpatient care providers, including those at MIT Medical. A patient is discharged when the hospital staff believes he or she can live safely in his or her home environment and can receive the treatment that he or she needs.
Sometimes a student may no longer require hospitalization but may still need more support than he or she can get at MIT. Or the student may not be quite ready to plunge back into his or her previous academic and social life on campus. In this situation, the student may consider a “leave from MIT for medical reasons,” which will give him or her more time to recover before resuming his or her studies. See FAQ: Medical leave from MIT.
The first step is to discuss the situation with your case manager or primary clinician, who can discuss the situation with your treatment team. Most times, these situations can be resolved through discussion and negotiation with the treatment team.
If this isn’t effective, you can ask to speak to the hospital’s human rights officer, or you can sign a three-day letter of intent to leave. Either action starts a legal process that will result in your discharge unless the hospital applies for a court hearing to keep you against your will.
But leaving the hospital earlier than the staff recommends doesn’t mean that you may immediately return to school. That’s a separate administrative decision made by MIT’s senior associate dean for students after conversations with the hospital staff, Student Support Services, and clinicians in MIT Medical’s Student Mental Health and Counseling Services.
The most important thing you can do is to be supportive and stay in touch as much as possible. Some patients may want more privacy at the beginning of a hospitalization but more contact with friends as time goes by. You might show that you care by offering to bring your friend things he or she needs, like shampoo or even problem sets. Gestures like this can be very important, especially because some students worry that they will lose their friends because of the perceived stigma attached to psychiatric hospitalization.
You can ask the hospital staff for information, but it may be some time before you get a reply, because the staff will have to ask your friend’s permission before giving out any information. Likewise, MIT Medical clinicians and counseling deans cannot give out information without the student's permission. But someone, such as a housemaster, may have discussed with the student what information he or she would like to have conveyed to friends and can provide that information when asked.