Would you visit an old friend in a psychiatric intensive care unit?

[Otins]

An old friend from 20 years ago - we make online contact a couple of times a year and I haven't seen her in person for 10 years, has made contact via Messenger. She usually lives the other side of the country to me, but she said she is in hospital about 1hr away from me.

I immediately said I could visit...and she was very excited and gave me the details. It is a psychiatric intensive care unit (PICU) I had naively assumed she had broken her leg or something and was in a general hospital.

I am aware she is bipolar and she has been sectioned once before in the last 10 years.

However, I am very unsure about visiting her on the PICU. The list of rules and contraband items is huge.

I rang the unit today to try to find out any information about what visiting would be like, and explained I am unwilling to visit without some sort of indication as to how she is. I explained I am not a close friend, but I am local-ish. I explained I have no experience of being around someone experiencing a severe mental health episode and I would like some idea of what to expect.

They naturally couldn't tell me anything about her condition or health, but they said I could ask her to give her permission to share information with me. They they said about support and bringing in supplies/clothes for her if I were to visit. I said that I cannot offer any support, but I would possibly be able to visit, if I were able to find out a bit more about what I was potentially walking into. All they could say was that they wouldn't authorise any visitors if they though anyone would be unsafe (24 hrs notice is required for any visits to arrange a room and staff)

If I ask my friend to give them permission to give me information I worry that I will be some kind of de facto contact / next of kin (as far as I know she is not in contact with any of her family and hasn't been for years) I don't want to be at risk of getting a phone call in the middle of the night as she has absconded, or worse.

But it feels mean to not visit when she is so close and she doesn't have anyone else?

She said in her message that she is not ill, and that it is a long story. A couple of things she said in the message make me think she is very ill (and I assume she wouldn't be there if she wasn't)

What would you do?

You can immediately leave at any moment if the visit starts to feel too unpleasant.
Be assertive for yourself in deciding a swift departure is fine if you need that.
The visit probably means a huge amount to her & I would go.

I would definitely go. Find out if she needs anything.

I’d visit, it could mean the world to her. They have security and you could always leave if you felt the need.

I would go and support my friend as much as I felt able
And leave if I felt unsafe or uncomfortable
And I’d hope someone would do the same for me if I became unwell.

Yes. It's not easy but as you have promised I think you should visit. Be cautious about promising further visits though.

If it were me I would make a visit. I wouldn’t overthink it. She may be more manic or more low than you have experienced her before but there is nothing to suggest she poses any risk to you. Seeing her unwell is likely to be sobering but she is likely to really appreciate the connection to the outside world.

I think you should go. Especially has you’ve already told her you would. As others have said you can leave if it gets too much.

I would go, you’re just visiting an old friend who is unwell not signing up to be her carer.

Yes, and I have done so more than once. Just follow the rules and don't worry about the locked doors. Be respectful to staff and don't stare at other patients.
Most of all, just be there to support your friend - listen and don't judge.
If you're not sure about gifts, ring the ward in advance, or go empty-handed - being there is the important thing.

I'd take a nice shampoo, conditioner, body wash or shower gel, and chocolate (assuming no allergies).

Members of my family have been sectioned for psychosis related to bipolar disorder and that's what they would suggest.

I would do it.

Who else is in her life ? If you don't want to be her contact you can absolutely say no. Take her a few bits of toiletries and maybe some squash and a sweet thing, give yourself a 30 minute limit so you know if it gets too much you can leave,

My aunt had bi polar and we visited her if she was in hospital i took my mum because she was wary, it was ok the staff were around,

Be prepared for her to be very unwell if she’s in PICU (I work in one) especially if she’s telling you she’s fine. In our unit they monitor visits and they wouldn’t allow the visit if it was deemed unsafe or destabilising for the patient. It’s really awful for those who don’t get visitors so yes I’d go, and as suggested above taking some nice bits would be lovely, it’s likely she went in with nothing and if they’ve asked about getting some things for her it suggests to me she’s in need of some basics, they wouldn’t ask otherwise.

I’d go and visit and take a few things in if I could. It’s awful being mentally unwell so I’d want to help. I’d make it clear that you aren’t ongoing support though and just an occasional visit. She might be very low or manic - which could look like very talkative, overfamiliar, elated or irritable etc. if she’s on a PICU that usually means someone is quite unwell and there are risks. Visits will happen in a specific room usually and there might be some staff present if deemed necessary. You can end visits at any time. You won’t be able to take anything in that someone could self harm with, so no aerosols, no razors/sharps, nothing that could be used to tie around a neck (so no belts, scarfs etc)

It's likely she will be on medication if she is in hospital. They say that if a person is experiencing delusions, it's still helpful to be empathetic towards their feelings (e.g. "That sounds really frightening for you") without either agreeing that their delusion is correct or trying to persuade them that it's not (which can upset them).

Taking her some nice self care bits sounds like a kind thing to do.

Thanks for the replies so far. In response to a couple of people, I have never experienced her being manic or low before. When I knew her well (we were work colleagues in our 20s and socialised a lot together) she didn't have any mental health issues. This was nearly 30 years ago though. So this is all totally new to me.

Re the list of contraband, I didn't comment on this as I didn't know what I could take in as a gift I commented on it because the fact you can't take in a mobile phone, or keys, or smart watches, or anything vaguely sharp or string-like, or long, made me think that the patients must be at high risk of self harm, or harm to others.

Thank you HippeePrincess I think I will ring the unit again tomorrow to ask to be talked through exactly what might happen if I were to visit - the process that is in terms of going through security, where the meeting would take place, who would be present, what can I do if I feel uncomfortable/unsafe etc. (I realise they can't tell me anything about how she might behave as that is giving me medical information) I can't go until next week anyway as I am away , so there is time to think about it.

BertieBots - that is another fear. I have no experience with those suffering a mental health episode. What if I say the wrong thing?

If a friend asked me absolutely. Do her a little care package up to take

What info do you think you need from her, she's obviously unwell if she's in picu and doesn't think she's ill. If she contacts you again, ask her if she needs anything, take toiletries and a treat, if she has a carer, social worker or cpn they can fetch her clothes and personal items from home. Don't mention to her about any support and tell the staff they are not to contact you or have you down as a contact . She'll be appointed a sw, advocate or representative so there's no need for you to get involved.

I’m going to say no, and that’s from recent experience of daily visits to such a place.

firstly, she may (well) be psychotic and not really inviting you into visits in the way you see it at face value. She may be randomly messaging people, not retaining much memory of it, desperate someone to respond and help (my person did a lot of this- and couldn’t remember much of it)

secondly, I’m afraid these are unpleasant places to visit and can be very stressful- and frightening. It boggles me that anyone but immediate family would visit. Patients are generally allowed a few hours release fairly quickly after admission so you could meet nearby for coffee etc - so if she can’t do this I suspect she’s in the throngs of cries

there is no way I would visit for a distant friend- the visits were so awful I still feel panicked when I remember them. The first visit I went into shock after I left.

you will not get any “pleasure” from visiting, and you are highly unlikely to be able to offer your friend much in terms of genuine support.

i would offer to drop off any clothes, toiletries or food she wants at reception.

It would be a lovely kindness to visit and they genuinely wouldn’t put you at risk at all, if she’s not up to having visits they wouldn’t let you in. A clean pair of PJs would be a great gift if you can afford it. You’ll most likely just meet her in a separate family/friends lounge area and you’ll probably be the only two in there maybe a nurse depends how she is. you can leave at any time if you get uncomfortable.

don’t let it ruin your holiday though, enjoy your time away and if it feels too much then don’t go, don’t make yourself poorly over it. Though it sounds like you want to try

The nurses or doctor will decide if she's up to having a visitor, I'd just ask them that, I wouldn't go into great detail. Just see what they say, if they say it's OK then just go for half an hour, let her do the talking or not talking, she may well be medicated,

Tbh I imagine they’re unlikely to have the time to walk you through what the visit will be like in advance.

the staff on the ward are incredible but dealing with a lot of difficult patients.

Home is 6 hours away though...would they actually do that?

And as for what info do I think I need...well obviously she isn't well but I don't like going unprepared into unknown situations, so knowing if she is likely to be manic or depressive, whether she is likely to have delusions or be full of conspiracy theories, or be at risk of self harm (or indeed if she has self harmed and has visible bandages etc) would be good to know in advance.

I have bipolar and bpd and have been sectioned a few times. Don't worry about saying something wrong or watching what you say she's still the same person just talk about the same things you would if you met in a coffee shop. The gifts, just things a person can't hurt themselves with so things like snacks, a book don't take anything like razors. If you are talking to her ask if there is anything particular she needs.