The Psychiatric Hospital Part 2 - The Schedule

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Recovery is all about routine.

Visit any psychiatric ward, anywhere in the country, and you will find patients and caretakers following a daily routine. Why are vitals taken each morning? Why are meals served at precisely the same times? Why are groups part of every day?

Because in the throes of withdrawal or with someone not long after a suicide attempt — the mind is shattered.

USS Constellation - I ran By It most mornings when I lived in Baltimore.

USS Constellation - I ran By It most mornings when I lived in Baltimore.

Imagine your mind as a ship. You are the captain of the ship, but you are also every officer, every deckhand, and even every piece of wood and rope making up the ship. Then a storm comes, a massive wave crashes onto your masts. They splinter into jagged pieces that crush through the deck. The ship pitches into the sea, taking on so much water that it sinks. You reach out, grab hold of a floating plank, and desperately try to keep your head above water in the heaving seas.

The ruined ship pitches further downward into the abyss, and you become the captain of the wood plank to which you hold onto desperately.

Here’s the raw deal of this visualization: you are the broken, sinking ship and the final survivor holding onto the single piece of your remaining sanity simultaneously. The storm came, and while you survived you are diminished. Less likely to survive in an unforgiving environment because you have no safe harbor and severely limited means of improving your situation alone. Restoration of the ship (you and your mind) can only occur with the coordinated effort of experts.

Routine is the starting process for rebuilding the ship. You don’t throw wood and nails into a dry dock and expect a ship to come together without a plan. Nor should you expect that to happen with your mind. This is why most hospitals follow similar routines:

Vitals are taken every day so the nursing staff and doctors can notice any significant changes in a person’s physical health.

Vitals are taken every day so the nursing staff and doctors can notice any significant changes in a person’s physical health.

  • Morning

    • Wake up, vitals, meds

    • Breakfast

    • Group session

  • Afternoon

    • Lunch

    • Group session

    • Break

    • Meet with care team

  • Evening

    • Group session

    • Dinner

    • Meds

    • Bed time

The routine is dull, uninteresting, and unexciting — by design!

Imagine you’re desperately gripping the wooden plank, and, by some miracle, a party cruise liner breaks over the horizon. You are rescued and immediately thrown into a world of bright lights, loud noises, and foreign languages. You’re grateful to be out of the water, certainly, but you have a whole new host of issues to navigate.

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Now imagine you’re saved by the Coast Guard. Everyone is wearing the same uniform, everyone fits into a particular role, everyone is calm in the face of danger. A medic checks you out, you’re given a blanket and a cup of coco, and told where you will next be taken. You’re just as grateful to be out of the water as you were in the first scenario, but all of your potential concerns are taken care of for you.

That is the magic of routine. It gives a mind in chaos something to hold onto. Something that makes sense. Something that can be counted on.

Recovery after a crisis begins with routine.