5 Things Movies Don't Tell You About Mental Institutions

Everyone knows that mental hospitals are horror movie prisons for crazy people, with padded walls, flickering lights, and evil nurses wearing tiny hats. Well, everyone might want to get their head checked, because psychiatric hospitals are nowhere near as exciting as all that. Most look more like college dorms with extra locks on the doors. I should know: I've been in six psychiatric facilities in three states, from the fancy McLean Hospital (aka the Girl, Interrupted place) to crappier state-run facilities. I've been diagnosed and misdiagnosed with everything from major depressive disorder to borderline personality disorder to schizophrenia. But I'm better now, and I swear that all this shit is true.

#5. They Don't Use Straitjackets

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It's actually a legal requirement that hospitals use the least restrictive restraints they can. Instead, hospitals use chemical restraints (that's a fun term for drugs, as well as a pretty bitchin' band name) or a four-point cuff system. Those are called leathers, because they've traditionally been made of leather -- it makes them harder to bite through. Leathers are supposed to be impossible to get out of, but I routinely did. The problem was my wrists. Make the restraints too tight and they cut off circulation; make them too loose and I'd get out in seconds. The real trick was hiding my new Houdini-like skills from the doctors.

Once, I was sitting in leathers in the ER, restrained to a hospital bed with a security guard outside my door. I was reading a book, but it was impossible to turn the pages with just one hand. I slipped out one hand to turn the pages, then sneaked back into the cuffs and played dumb when the nurse came in. All innocently: "Could you flip the page for me? I've been stuck on this one for like 10 minutes!"

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You can insert your own sinister chuckling.

Once the staff caught on, they still didn't switch to movie-style straitjackets. They just started using leathers and chemical restraints together. Think about it: Which is easier, lacing up an elaborate crazy-girdle on an unwilling participant, or slamming a syringe full of Ativan into a thigh? Option 2, of course. Which was fine with me: Being knocked into dreamworld was much more fun than drawing myself as a tree in art therapy -- again.

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Pastels just don't have that characteristic buzz of narcotic-y goodness.

#4. It Isn't Like a Jail

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You're allowed to bring your own stuff into a mental hospital. You're not going to be sitting in a hospital gown, barefoot, in a barren room with nothing but your pixie cut and a big Native American dude for warmth. The hospital will give you socks, at least.

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Whether you get the Native American dude depends on your HMO.

Virtually every place lets you bring your own clothes, with some restrictions. No belts, shoelaces, drawstrings on hoodies or sweatpants, nothing with violent images. No Manson T-shirts or gang colors. But you can totally wear a suit or cocktail dress if you really want.

You're allowed to have visitors, and they can bring you things like books and edible food (of course, the staff searches the bags first). At the state-run hospital, I was only allowed to have three books at a time, but they kept five books behind at the station I could trade in. That particular hospital also gave me a plastic baggie with a toothbrush, deodorant, and assorted toiletries from random hotels. Nothing says luxury like JW Marriott shampoo next to the biohazard disposal container.

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All the comforts of a home with an unusually high risk of biological contamination.

At one private hospital, I could bring my laptop and keep it in my room, cord and all. I'd do my homework and keep up with class assignments with the hospital's free Wi-Fi. I could also order delivery and have it buzzed through to the floor. You're not treated like a criminal, because you're not criminally insane. Movies often lose the distinction between the two -- normal people with mental issues aren't going into some dystopian crazy-prison, because they've done nothing wrong. They're sick, and the whole point is to help.

#3. You Know You Need to Be There

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To get into a mental institution, you first go through a psychiatric evaluation at the ER. Then if you pass (or fail?) you're shipped out to a psych-only facility. Sometimes treatment is involuntary at first. The specific laws depend on your area, but most hospitals can hold you for 72 hours for psych-related reasons without your permission. Even if you're truly OK, the hospital needs to ensure that you aren't going to leave and immediately have another episode in the parking lot.

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It's for your safety, and the safety of all those easily breakable faces around you.

After three days in a psych ward, you can leave ... if the doctors say you can leave. If there's a disagreement between you and your docs, you go to court. But most people use the third option: voluntarily signing themselves into treatment.

Movie mental hospitals are filled with clearly-just-eccentric people held there against their will, either planning to escape or gaming the system as best they can to get "released." Maybe that was accurate 40 years ago, but shorter stays combined with a better understanding of mental illness means functional people aren't locked up for years.

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Hooray for progress! Eventually!

The hospitals I stayed in were filled with people who knew they needed help. One person flew across the country in order to take advantage of the facilities at McLean. We'd compare notes among ourselves about the various hospitals: which had the nicest psychiatrists, the best after-care programs, the worst food, the most affordable payment plans.

During each of my 10-plus stays at six hospitals, I signed myself in voluntarily, and I don't remember hearing about anyone who didn't do the same thing. Mental illness is an illness. Sure, there's the odd nutbar version of Typhoid Mary who just refuses treatment. But most of us sick people just want to not be sick.

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If only it were that simple.

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