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?

I wouldn't visit. You don't sound particularly close if you haven't met up in a decade!

I would keep the conversation light and connect over your 20s and the usual things you discuss online. I wouldn’t be too worried about saying the wrong thing. This is always a risk in any situation. But she feels that seeing you will benefit her and if she wasn’t up to meeting she would probably not have not reached out.

You'd have to check what's allowed to be taken in. I worked on a psych ward and there are strict rules regarding this.
They won't allow you to visit if deemed unsafe anyhow or will have someone in the room with you depending what level of obs she is on.
You won't automatically be made next of kin. There is a list that goes in order of whom is allowed to be next of kin.
I'd go and see her. The fact that she is on PICU and not a regular locked ward (where she will be transferred to once she has stabilised) means she is quite unwell and either at risk to herself or others. However, she might be almost ready to be moved over.

It's good that you've been honest with the ward staff about your fears. They will be used to that and will support you whilst you are there. You can leave at any time. I think you're being very thoughtful.
I hope your friend gets better soon. MH is so misunderstood and scary for people without any experience of it.

I would definitely go. Re conversion, just let her lead, don’t be afraid of any emotion, and say noncommittal things such as ‘That sounds really hard’, ´I’m sorry to hear that’ etc and don’t try to correct her even if she’s saying unreasonable, unfair or untrue things. If the visit isn’t a success it just means she’s still quite unwell and isn’t her fault or yours. Don’t take anything personally, she can’t help it. Just being willing to go and see her is a very kind thing. Well done for being a good friend and considering going 💐

You sound very judgemental tbh.

Going against the grain here, but having spent a lot of time visiting a sibling in various mental health wards I would not do this.

She’s an old/distant friend, not somebody you now know well or spend a lot of time with. She’s an hour away. She’s telling you she’s fine when clearly she’s not, and her behaviour may be upsetting, difficult to witness, frightening. I have seen/heard a lot of things I found upsetting over my visits, and at times it’s been a significant extra stress in my life.

For somebody who’s so distant a part of your life personally I wouldn’t give up a day and put myself in an uncomfortable position by visiting. You could - if you feel like it - try and have a phone chat to suss out a bit more about how she is before you make any decision.

The fact that you’re needing multiple phone calls with staff/reassurance about what to expect suggests that you feel anxious about this or uneasy about it, and I’d follow your feelings and protect yourself on this one.

As a mental health care professional I don't think it's appropriate for anyone other than close family to visit a person in PICU. For her dignity if nothing else. This person is clearly very unwell or they wouldn't be in this setting. It's not a time for a reunion of a past friendship. I would say that you will wait until she is transferred to an acute admissions ward at which point she will have made some improvement.

As above.

she is in an acute bed now and it’s not appropriate to visit unless very close friend or family.

wait till she is transferred to an acute bed. She will be more stable and the rules will be less restrictive.

How close is this friend? I would only visit an extremely close friend or family member in this situation. Having to deal with it at the moment for a family member we act as NoK for and honestly, it is fine but not for the faint hearted if you don't know (and can't find out) what you are walking into. It isn't that you don't care, and there are multiple ways you can show you care without visiting. Some units will allow you to drop off care packages, or even post them. You can often send cards and notes too. Speak to the PICU team and see what they suggest.

No, I wouldn’t have agreed to visit.

I understand why you’d want to and that your heart is in the right place, but …have you ever been to a PICU before? She must be extremely unwell and vulnerable to be in there right now.

If you haven’t seen her for years, have no idea what’s been going on for her and why she is there, and haven’t been to a PICU before, I absolutely would not go. These places can be quite shocking and distressing for the uninitiated, and it isn’t the right setting to pick up on an old friendship.

If you wanted to send her (or drop off for her) a thoughtful gift and a card with a message, lovely. But I would wait to re-establish this friendship when she is stable and well.

I say this from personal experience of PICU.

Agreed with this. When she’s better she may well be mortified to think that you saw her at a time when she was very unwell.

It's easy to say 'of course you must visit your friend in her hour of need', but that's not really the situation here.

For one thing, you've had minimal contact since being work colleagues 20 years ago, so you're not exactly friends. More to the point, she didn't tell you what she was in hospital for. Maybe that's something someone with bipolar in a PICU might forget to mention, I don't know. But as people with actual experience are advising you against visiting, I'd listen to them - and your instincts. Don't let the pressure to 'be kind' railroad you into something you aren't prepared for.

Surely she wouldn’t be allowed visitors if she was too fragile?

I have done. Was taken to a small room, drank tea and chatted to my friend.

@MyTakeIsntYourTake that is not correct. You're thinking of "nearest relative" which is a completely different kettle of fish.

OP, I've been on the other side. You may wish to place weight upon what others are saying in terms of waiting for an acute bed rather than PICU. I was mortified that a colleague saw me there, much, much later when I found out.

Please don't assume that your friend will inevitably be dangerous/violent.

Please don't say someone "is" bipolar/psychotic/ whatever. I'm more than my diagnosis.

Listen to what others are saying and think about what she would have wanted when in better health.

If I would go for a physical illness I would go for that.

I’m sorry what a sad situation. I would visit her, message to ask if she needs anything before. If it was unsafe they wouldn’t let you visit, as they said. And if it turns south you can leave and don’t have to go back x

I’d have no issue with this but I have 20yrs experience of working in acute and forensic psychiatry.

It’s best you don’t visit really, if all you are concerned about is yourself - how you’ll be feeling and whether you’ll be further inconvenienced by what she might need. Honestly, set her free to find new friends in the future that can offer her more, so that she’s not always wondering why friends are not there for her.

No, I'm not thinking of nearest relative. There is an order for NOK. Just been on a training course about this but that's ok as you may not be aware of that. Its a legal aspect many aren't aware of as don't need to be.

The remainder of your post I agree with esp where people aren't what they would regard as being themselves. I'm sorry you went through that. Must have been difficult to find that out afterwards. Hopefully your colleague was able to understand that you were unwell and was able to be empathetic.

id go to learn about the institution

I am an Independent Mental Health Advocate and have worked with hundreds of inpatients in psychiatric hospitals over well over a decade. There is no one size fits all - everybody is different and their presentation will vary according to the type of illness they are experiencing, and how it affects them. I have come across very few inpatients who don't want visitors, and ward staff will advise you if they are too unwell to be visited. Yes PICU wards can be very intense, and if your friend is very unwell it may be better to wait a couple of days. My advice would be to contact her by phone. You can ring the ward and ward staff can then ask her if she would like to speak to you and give you the patient phone number or get her to contact you. Bear in mind she could be very unwell and don't take it personally if she would rather not speak at this time. Don't just turn up unannounced - think about how you would feel in that situation.
Your post does seem centered on your own fears and how the experience will affect you rather than the welfare of your friend. Bearing in mind the relatively small amount of contact you have had up to now, you may well want to wait until she is moved to a different ward or is less unwell. My experience of meeting with patients soon after they have been admitted and before they are successfully treated is that they often don't remember your visit, and as others have said, consider whether you would want others to see you when you are very unwell.
If yours is the sort of friendship that can weather the storms of a mental illness then you should definitely visit - if not I'd wait a bit. Either way talk to her by phone first. If you're not close friends I probably wouldn't visit at all.
You will not be under any obligation to provide contact details to ward staff (though you might want to let them have your phone number if you'd like your friend to contact you.

I think it is upto you. Interacting with a bioplar person can be a task though. They dont pay attention to what we say half the time. I would visit but not much as very often.

I agree with all of this. Had to visit a relative once here and it really affected me.
It was depressing and scary and I just came away feeling very disturbed by the environment.
also, what if it are not comfortable and you need to leave. Would it affect her in any way? Make it worse for her?
For someone that I have not seen in 10years and speak to a handful of times a year, I wouldn’t put myself out in this way.

Sorry you had such an awful experience. But I think it would be better not to visit at all than drop stuff at reception. Imagine how awful it’ll feel for her, knowing that her friend came to the hospital but didn’t want to see her :-(