Guide to Inpatient Care at McLean Hospital
Helpful Information for Patients, Families, and Friends
Welcome to McLean Hospital.
We are here to help you. Each member of the McLean community strives to achieve our mission of improving the lives of our patients and their families, and we dedicate ourselves to providing you with compassionate, respectful, and specialized psychiatric care. You are a vital member of our team. Together with you, we seek to chart a path toward your recovery and well-being.
We will work closely with you to develop an individualized treatment plan to ensure that you receive effective and compassionate care. Our staff will work with you and your family to provide you with guidance and tools to help you better understand and manage your illness and symptoms, strengthen your resilience, and improve your mental health going forward.
We have prepared this guide to provide an overview of what you can expect at McLean and to address questions and concerns that you and your family may have about your hospitalization. It was written with valuable contributions from McLean’s Patient and Family Advisory Council. We hope that you find the information helpful.
Thank you for placing your trust in McLean Hospital. Your health, comfort, and well-being are our highest priorities.
View these sections to learn more about inpatient care at McLean:
- Inpatient Care
- Treatment Team
- Patient Rights
- Services and Amenities
- Health and Safety
- Patient Responsibilities
- Financial Information
- Advance Directives
- McLean Patient and Family Advisory Council
- For Families and Friends
- McLean in Brief and Printable PDF
Each day, you will meet with members of your treatment team, including your doctors and a clinical social worker. You will attend group sessions to help you better understand your illness and manage your symptoms, learn strategies and skills to assist in your recovery, and work on lifestyle and safety plans for maintaining your recovery and wellness.
Your treatment may include medication evaluation and management, group and family therapy, education, and support. Group psychotherapy provides you the opportunity to interact with others at your own pace and comfort level and, in so doing, contributes to a caring and supportive environment—an essential factor in your recovery. You will receive a copy of the group schedule at your program so you can plan when to participate. Group meeting times and schedules are also written on the whiteboard near the nursing station.
Your nurse will be available whenever you have questions during the course of a day. Your nurse is also responsible for providing you with your medication. Throughout the day, you will have opportunities to meet other patients who may be dealing with similar issues and challenges. They can offer valuable wisdom, support, and insight and can help you in your recovery.
In an effort to promote sleep, patients are encouraged to be in their rooms between 11:30pm and 6am. A good night’s rest is important not only for your mental health, but your physical health as well. Getting up at a reasonable time in the morning is helpful to ensure that you have a substantial breakfast and will be alert and ready for group programs and other treatments.
Meals are served in a dining area at each program. Breakfast is served between 8 and 9am (varies by program), lunch at noon, and dinner at 5pm. McLean’s Clinical Nutrition Services accommodate diets for patients with medical restrictions (e.g., diets appropriate for patients with diabetes or food allergies). Clinical Nutrition Services can also provide meals for vegetarians and vegans and meals based on religious principles (e.g., kosher). Please let your physician know of your dietary requirements.
Visitors may bring you food and beverages as long as these items do not adversely affect your health. Alcoholic beverages are not allowed. In many instances, we ask that you do not consume energy drinks or other high-caffeine beverages that may affect your metabolism. Additionally, certain foods pose a risk to your health if you are taking a class of medication known as MAO inhibitors. Your physician and nurse will instruct you about food or beverage restrictions related to your medication. Ask your nurse if you have questions or concerns about what you should or should not be eating and drinking.
All inpatient programs are locked, and all patients are seen by staff at regular intervals to promote a safe environment. Some inpatient programs allow patients to leave with family or friends. Please check with your treatment team.
McLean’s inpatient programs are located on the hospital’s main campus in Belmont, Massachusetts, and at McLean SouthEast in Middleborough, Massachusetts. Please visit Maps & Directions for more information on directions, parking, and local accommodations.
You may want family and friends to visit you. Check with the staff about visiting hours as these hours vary by inpatient program. Visiting hours are also posted at the program.
Sometimes visitors can only come to the hospital during a certain time because of work, family, or other obligations. Visitors who need to come outside visiting hours should call the nursing station to check with the program staff about special arrangements for visiting. You have the right to refuse visitors.
Visitors may also bring items that you might want or need during your stay. See the checklist found in the Guide to Arriving at McLean Hospital.
All inpatient programs are handicap accessible. Interpreter services are available at no cost for non-English speaking patients and their families. Telecommunications devices for deaf and hearing-impaired patients also are available. Please let a staff member know if you need these services.
What Is Admission Really Like at McLean?
Watch this video and read more about the admission process via McLean’s Clinical Evaluation Center. Learn what it’s really like to be treated at one of our world-class inpatient programs.
Your treatment team includes clinicians responsible for your care during your stay at McLean. They work together to provide excellent, compassionate, and effective care, and work with you to decide on the best treatment plan.
As with all health care, collaboration between you, your family, and your treatment team is crucial. We encourage you to learn as much as possible about your illness, including your symptoms, recovery, resilience, and wellness. Your treatment team needs to know about you—your strengths, your interests and abilities, the history of your illness, and your symptoms and behavior. While at McLean, please ask questions and express concerns about your health and treatment. Learning about your illness will help you in your recovery.
“I can’t say enough about the people at McLean and how supportive they have been.”– Former McLean patient
You can identify staff members by the identification badges that they wear, displaying their name, photo, and department. All staff members must wear McLean Hospital photo identification badges at all times. If anyone without an identification badge approaches you, ask that he or she display his or her badge.
The McLean Hospital medical staff consists of psychiatrists, internists (primary care doctors), neurologists, and other specialists. There are experts on staff at McLean from almost every psychiatric specialty and subspecialty. Emergency coverage for all patients is provided around the clock by physicians.
Psychiatrist in Charge (PIC)
Also known as the clinical staff associate or attending psychiatrist, the psychiatrist in charge sees you regularly and is kept informed of your progress by other staff. At some inpatient programs, you may also be seen by a resident psychiatrist (also called a “resident”) who is a psychiatrist in an advanced training program at McLean.
Registered nurses administer medications, provide counseling and support, help coordinate your care, provide information to you and your family, and answer many of your questions. Each day and on each shift, a specific nurse is assigned to your care. Student nurses sometimes assist registered nurses in providing care.
Mental Health Specialists
Mental health specialists assist the nurses in monitoring your symptoms and functioning, taking vital signs, supervising meals, organizing activities, leading groups, and maintaining patient safety.
Clinical Social Workers
Clinical social workers help coordinate your overall care (referred to as “case management”). They communicate with family and outside caregivers, lead family meetings, help with aftercare plans, and arrange for follow-up care. Your clinical social worker also helps you understand and manage your illness and provides support for your recovery.
Psychologists are not as active for inpatient care as they are in other McLean programs. You may work with a psychologist who does psychological testing, facilitates group therapy, or serves as your case manager.
Expressive therapists lead educational and art therapy groups. These groups help you learn skills, gain insights about yourself, and connect with other patients.
Belmont Evening, Weekend, and Holiday Clinician Coverage
On evenings, weekends, and holidays, psychiatric and medical consultation is available as needed. Weekend social work case management is available at some programs.
When coverage is available, the clinical social worker will meet with newly admitted patients and their families as needed.
An experienced group psychologist (called a “group rounder”) offers a group psychotherapy session on weekends that focuses on interpersonal relationships and creating connections that support recovery and wellness.
McLean SouthEast Evening, Weekend, and Holiday Clinician Coverage
A psychiatrist is present at the McLean SouthEast campus on evenings, weekends, and holidays. An internal medicine physician or psychiatric nurse practitioner is also available for consultation and to provide physicals for newly admitted patients. Clinical social workers are available on many weekends and meet with newly admitted patients and their families as needed.
It is important for you to know your rights as a patient. Please talk to a member of your clinical treatment team if you have questions or concerns.
For more detailed, legally binding information on your rights as a patient, refer to the publication Your Rights as an Inpatient at McLean Hospital and to the Mass General Brigham Notice for Use and Sharing of Protected Health Information.
Privacy and Confidentiality
McLean Hospital policies and state and federal law protect the privacy of patient identities and information. In general, any disclosure of clinical information requires a written consent from you, or, if you are under the age of 18, a parent or guardian. There are additional specific privacy protections under state law for persons with HIV and for those who are participating in alcohol or drug abuse programs. Disclosures, however, can occur without written consent in certain specific circumstances, such as by judicial order or in a medical emergency.
All communication with your clinical treatment team is strictly confidential. Unless you give permission in writing, no one at McLean can disclose information about you or your treatment to your school, your employer, your friends, or even to your family.
McLean staff are “mandated reporters” for child and elder abuse and have a duty to warn if it is felt that you are a danger to yourself or to someone else.
You may obtain a copy of your medical records by submitting a written request to McLean’s Health Information Management (Medical Records) department. A member of your treatment team can provide you with a request form. Copies of discharge summaries are provided at no charge. There is a copying charge for more extensive parts of your medical record. You can reach McLean’s Health Information Management at 617.855.2447.
Consistent with current law, McLean Hospital allows only you, your legal guardian, or your health care agent to request permission to read a hospital record or to obtain a copy of the discharge summary. In psychiatric facilities, health care agents can only access records if your health care proxy has been activated and you are unable to make health care decisions for yourself. Access to a record may be denied if it could result in serious harm to you.
Information regarding civil rights is provided to all patients. You or your family members are encouraged to contact the McLean civil rights officer on the Belmont campus at 617.855.3406 or at McLean SouthEast at 774.419.1015 with questions or concerns. All calls are returned as soon as possible by the hospital’s civil rights officer and are handled in a confidential manner.
It is the policy of McLean Hospital to affirmatively provide treatment and care to patients without regard to their race, religion, color, national origin, sex, age, ancestry, disability, sexual orientation, or any basis that would be in violation of any applicable law or regulation.
Under no circumstances will patients or patient-related issues be discussed with the media without written consent by you or your legal guardian.
Research Studies—It Is Your Choice to Participate or Not
McLean is a teaching hospital of Harvard Medical School. During and after your stay, you may have the opportunity to participate in clinical research studies. You may consent to participate in research, but you are not required to do so. You may decline to participate in research or discontinue participation without consequence to your treatment.
Your records may be used for approved research purposes, but your identity and any identifying information are never disclosed in research-related publications.
Information about participation in research can be obtained from the civil rights officer at McLean Hospital at 617.855.3406.
Services and Amenities
An automated teller machine is available in the lobby of the de Marneffe Building on the Belmont campus.
A cafeteria that offers a variety of hot and cold items for purchase is located in the de Marneffe Building in Belmont and on the McLean SouthEast campus. In addition, vending machines are located throughout each campus, offering snacks, candy, water, juice, and soft drinks.
Fitness and Recreation Center
Located in the Recreation Building on the Belmont campus, the Fitness and Recreation Center is open to all McLean inpatients. The center features training equipment with integrated TV and radio including treadmills, stationary bicycles, and elliptical machines. Additionally, the center has resistance training machines for all the major muscle groups: biceps, triceps, shoulders, chest, back, and legs. Free weights and other minor training equipment are also available.
You may use the center’s resources if your treatment team has determined that you are able to use the equipment safely. A nurse or program counselor who has received Fitness Center orientation must accompany you when the fitness coordinator is not present. Talk to a member of your treatment team if you wish to exercise at the Fitness and Recreation Center.
Hairdressing services are available to patients in Belmont. Appointments are preferred but not necessary. Call 617.855.2492.
Patients may send and receive mail. Letters and packages sent by U.S. Mail are delivered to and picked up from inpatient programs on a daily basis Monday through Friday.
You may park your car on hospital grounds. Please register your car on the Belmont campus with Security at 617.855.2121. Parking is free and available in any of the lots or designated visitor spaces. Please observe parking restrictions, which are clearly marked. Illegally parked vehicles will be towed at the owner’s expense. Idling of motors is not permitted. Parking at McLean SouthEast is also free. Vehicles do not need to be registered in Middleborough.
On the Belmont campus, taxi service is available by calling 617.484.1600 (Yellow Cab) or 617.484.2000 (Belmont Cab).
McLean Security operates a shuttle between Waverley Square in Belmont and the Admissions and Administration Buildings on the Belmont campus. The McLean shuttle runs regularly throughout the day and is also available on request by calling 617.855.2121.
Public restrooms are located in every hospital building.
There are public telephones at all inpatient programs, as well as near the cafeteria in the de Marneffe Building on the Belmont campus.
All calls from McLean, whether from staff or patients, are automatically identified as “blocked,” meaning the number is not identified to the person receiving the call. This is for confidentiality and privacy. Calls will not go through to lines that do not accept blocked calls. Therefore, family members should give the treatment team at least one unblocked phone number where they can be reached in case of an emergency.
Wireless Internet Access
Wi-Fi service is available throughout the McLean Belmont campus. It is not available at McLean SouthEast.
“I am so grateful for all the skills McLean provided me to live a happier and healthier life without alcohol.”– Former McLean patient
The McLean Pharmacy is committed to educating you and your family about medication uses, side effects, contraindications, and interactions with foods or other medications. A member of your clinical treatment team can provide you with information sheets about your medications.
Mental Health Sciences Library
McLean’s Mental Health Sciences Library on the Belmont campus offers an extensive selection of books, journals, and audio and videotapes on mental illness and its treatments. McLean staff often borrow these materials from the library for educational discussions with patients and families.
You and your family are welcome to use the printed library materials for your own research. The library staff does not provide reference assistance beyond identifying what is in the collection. More detailed reference assistance may be found at the Cole Consumer Resource Center.
Borrowing privileges for you or your family members must be arranged in advance. For more information, please contact the Library at 617.855.2460.
Health and Safety
Your safety is important to us. Please let a staff member know if you feel unsafe or threatened in any way at any time.
Please act in ways that are respectful to yourself and others and avoid behaviors that may be harmful.
Alcohol and illegal drugs are taken away and discarded if brought to the hospital. Weapons are not permitted and will be immediately confiscated.
For the health of all patients and staff and to comply with state and federal regulations, smoking is not allowed in any hospital buildings.
On the Belmont campus and at McLean SouthEast, smoking is permitted in a few designated outdoor areas for patients who are permitted to smoke and to leave the program without being accompanied by a staff member. Smoking policies vary by program.
If you are a smoker, we would like to help you quit. Please speak with the clinical staff about the availability of nicotine gum or patches as an alternative to smoking.
In the case of a fire, immediately alert a staff person who will activate the alarm. Staff will then direct you and others to safety. Fire safety routes and evacuation sites are posted on every floor.
Infection Control Guidelines
The following guidelines will help prevent the spread of infections in the hospital and keep patients, staff, and visitors healthy.
- Wash your hands thoroughly after using the toilet, touching wounds, blowing your nose, sneezing, coughing, smoking, or eating. Wash your hands before handling food.
- Use the plates and utensils provided for each meal and avoid sharing food and drinks with others. Please throw away or wrap, label, and store any food that you have partially eaten or handled.
- Do not share personal items such as makeup, earrings, razors, and nail clippers.
- Keep personal hygiene items such as toothbrushes, soap, combs, and hairbrushes, in your own room and do not share them.
- Do not share cigarettes.
- Wash your clothes if they become soiled with blood or other bodily fluids.
- Let staff know if linens become soiled with blood or other bodily fluids. They will replace them with clean ones.
At McLean Hospital, you have the responsibility to:
- Provide accurate and complete information to the best of your knowledge about your present medical and psychiatric concerns, past illnesses, hospitalizations, medications, advanced directives (health care proxy), as well as changes in your condition.
- Ask questions when you do not understand what you have been told about your care or what you are expected to do.
- Follow instructions regarding your care or treatment and inform staff of concerns you have about following these instructions.
- Recognize that not following the recommended care or treatment may result in your health not improving or possibly even declining.
- Follow the hospital’s rules and regulations on patient care, safety, and conduct.
- Be considerate of hospital staff and property as well as the property of other patients.
- Meet financial obligations that you agree to make with the hospital.
- Talk respectfully to staff and other patients.
- Act respectfully toward others.
- Respect the confidentiality of other patients.
- If you have questions, problems, or concerns about your care or treatment, please talk to a clinical staff member.
Please direct questions about insurance benefits or billing to a patient accounts representative in Patient Financial Services at 617.855.3304.
McLean has a limited amount of funding available to assist patients (or financially responsible parties) in paying for hospital care. Requests for financial assistance should be directed to Patient Financial Services at 617.855.3304. Each request is considered individually.
For more information, please visit mcleanhospital.org/patient-billing.
Financial Responsibility Policy
McLean Hospital accepts Medicare, Massachusetts Medicaid (which limits coverage for substance abuse services to outpatient care), Blue Cross, and many other private health insurance plans. The hospital also has working arrangements with many managed care companies. Most health insurance policies provide benefits for psychiatric services. However, access to these benefits is often restricted or limited, particularly for certain types of comprehensive care. In general, short-term inpatient, partial hospitalization (day treatment), and outpatient services are covered by insurance, while benefits for residential and long-term care may be limited. Most insurance companies also require precertification for inpatient and partial hospitalization (day treatment) services.
McLean’s policy outlines that the individual accepting financial responsibility for a patient’s treatment is responsible for payment and is expected to keep the account current for self-pay balances.
We will work with you and your family prior to admission and throughout the course of treatment to determine the most cost-effective treatment that meets clinical needs. If you have any questions about the extent of insurance coverage, we strongly recommend that you contact your insurance carrier to determine potential coverage available for treatment.
Rate reductions are available for some services for self-pay balances and treatment provided on a private-pay basis. In general, rate reductions may be available for inpatient, partial hospitalization, and outpatient treatment, but not for some of our residential care programs. Rate reductions vary depending on financial need and available resources.
The information that follows may be useful in answering questions from insurance companies. McLean is:
- A private, not-for-profit psychiatric hospital.
- Licensed by the Massachusetts Department of Public Health and Department of Mental Health.
- Fully accredited by The Joint Commission.
- Operated with internal medicine services but without surgical services; has transfer agreements with Massachusetts General Hospital and other nearby general hospitals.
When speaking to your insurance carrier, it may be useful to inquire how insurance benefits cover room and care rates, physician or other professional fees, and the amounts of self-pay balances, co-pays, and deductibles.
In some instances, particularly with managed care organizations, we may be able to assist you with your insurance questions. For more information, please call our Patient Financial Services representatives at 617.855.3304. Please provide us with information about your insurance benefits and a telephone number for your insurance carrier so that we are able to obtain verification of benefits. Please have your insurance card available when calling for information and always bring it to the hospital.
A health care proxy (also known as “advance directive”) is a written document by which you may appoint an individual to make health care decisions in the event you are unable to do so because of physical and/or mental incapacitation.
For details on health care proxies, refer to the McLean publication Information on Advance Directives.
The health care proxy states your wishes about types of medical treatment and guides the person you have chosen to make decisions about your health care on your behalf. This person will consult with health care providers to consider acceptable medical alternatives regarding diagnosis, prognosis, treatment, and side effects and to make decisions based on your wishes. If your wishes are not known, the person will assess what is in your best interests and what is consistent with responsible medical practice. To assist in making informed health care decisions on your behalf, he or she is empowered to receive the same information that you would receive, including confidential medical information.
“Just having someone who understood made a world of a difference.”– Parent of a patient treated at McLean
You may establish a health care proxy if you are 18 years or older and considered competent to handle your own affairs. When establishing a health care proxy, you may grant broad authority over all health care issues or limit the range of authority. For psychiatric purposes, it is recommended that you establish clear guidelines concerning the following: psychiatric care and treatment including admission to a psychiatric hospital, the use of medications, the possible use of electroconvulsive therapy (ECT), and possible participation in research.
A health care proxy goes into effect only if and when a physician determines that you are not competent and notifies both you and the person you have chosen to make your health care decisions of this determination. A copy of the determination of incapacity and the health care proxy will be placed in your medical record.
McLean Patient and Family Advisory Council
The McLean Patient and Family Advisory Council (PFAC) serves as a forum to promote excellent patient- and family-centered care across McLean. PFAC supports collaborative partnerships among providers, patients, and their families built upon a foundation of dignity, empathy, and respect. Core tenets include recognition of and respect for differences and preferences of patients and families with respect to culture, ethnicity, and abilities as well as communication, education, and collaboration in support of shared decision-making and patient empowerment.
The objectives of the McLean Patient and Family Advisory Council are to provide and communicate the perspectives of patients and their families regarding the care experience at McLean and to work in an advisory role to enhance the care experience.
If you are a patient or a family member of a patient who has received services at McLean within the last three years and you are interested in becoming a member of PFAC, please ask program staff for an application.
For Families and Friends
Visiting a family member or friend who is a patient at an inpatient program in a psychiatric hospital is different from acute care hospital settings, where visiting hours are more flexible. Formal visiting hours at McLean vary by inpatient program and are posted in each program.
A patient, together with his or her clinical treatment team, decides on the nature and frequency of visits. The decision is made based on what is best for the patient and his or her recovery.
For safety reasons, we restrict access to all inpatient programs. You may enter and leave the inpatient program only with assistance from staff who can unlock the door for you. All programs have door buzzers to notify staff that someone is at the door.
When visiting, please be aware that most rooms are semiprivate. Visiting a family member or friend at a McLean inpatient program often, but not always, takes place in a common area.
As with visiting, calls to patients are allowed only from family and friends with whom the patient wishes to speak. Each program has one or more telephone lines that can be called to speak to a person who is being treated at that program. Because the phone is in a common area on the program and does not have an attendant, it may not always be answered by someone. Patients on the unit may also use this telephone line to make calls within and outside of McLean.
See the checklist in the Guide to Arriving at McLean Hospital for a list of phone numbers at each program.
On the Belmont campus, the cafeteria is located on the first floor of the Francis de Marneffe Building. It is open to visitors Monday through Friday, 6:30am-6:30pm and on weekends and holidays, 11am-2pm. Vending machines are located throughout each campus, offering snacks, candy, water, juice, and soft drinks.
Patients who are 18 years old or older are legal adults with legal privacy rights. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits clinical staff from sharing treatment information without a patient’s written consent.
All health care providers must comply with these federal regulations, which means that they must obtain formal permission to share information (including diagnosis, treatment, and prognosis) with you, or anyone else, even if you are a spouse, a parent, or a guardian of a patient. A patient provides permission by signing a release of information form.
Release of information forms are normally signed during the admission process, but may also be completed at the program. If the patient has not signed a release for the clinical staff to give you information, they cannot share this information. Please note, however, that you may share with clinicians any information that you think is important for the patient’s treatment and recovery.
Point of Contact
A clinical social worker is assigned to the family of each patient and addresses a family’s initial questions and concerns.
We ask that one member of the family or a friend serve as the point person to the clinical social worker. This simplifies the communication between the clinical treatment team and the family. The patient and the clinical social worker decide who should be asked to serve as point person. Often, it is the family member or friend who is the patient’s primary support. The clinical social worker normally calls the point person within 24 to 48 hours after the patient’s admission to McLean.
While email is a popular means of communication, because of confidentiality concerns, we ask that communication between the clinical social worker and the designated point person take place by telephone or in person.
The designated point person should contact the patient’s clinical social worker to set up a family meeting. The clinical social worker will be in touch with the family when a release of information has been signed and it has been determined who will be involved in the patient’s treatment and aftercare.
Family Care and Support
Being a family member or close friend of someone with a mental illness can be emotionally and physically stressful and, depending on your relationship, financially stressful as well. Although you are focused on your loved one, you should find ways to take care of yourself so that you can be well enough to support and care for others. Caregiver fatigue is a real concern.
A few preventive measures can help prevent you from burning out. You and other family members may benefit from learning more about mental illness and the struggle involved in recovery. For some people, seeking professional counseling during a crisis period can be very helpful. Sometimes, speaking with someone who can relieve fears and worries can be reassuring and informative.
The Family Transitions Group at McLean is a support group for families and significant others of adults with mood disorders, such as depression, who are transitioning out of the hospital. This ongoing group, which meets on the Belmont campus, focuses on providing support to families of people with mental illness through camaraderie and education. There are additional family groups that may be appropriate and helpful for you. Please ask your clinical social worker for more information about the Family Transitions Group and other diagnosis- or program-based groups.
Family Involvement in Treatment
Support from family and friends is often very important for a patient’s recovery. The role of family and friends can vary. Your role will depend on your relationship with the patient, the circumstances of his or her illness, and other considerations.
In general, the clinical social worker is the best person to help you understand a patient’s illness and diagnosis, symptoms, treatment, and prognosis. Other clinical staff may help you understand and learn as well.
Although government and hospital policies and regulations preclude McLean’s clinical staff from sharing information with you without a release of information form that has been signed by a patient, you are not restricted from sharing your observations and insights with our clinical staff. It is often very helpful for the clinical staff to learn important information about a patient from family and friends, such as:
- Changes in behavior, speech, and functioning, including the extent of these changes and over what time period. Have there been changes in eating or sleeping patterns? How would you describe the patient’s usual personality and what changes have you noticed?
- Changes in physical health.
- Changes in social interactions and friendships. Has the patient become withdrawn or less communicative? Does he or she have friends and have those friendships changed recently?
- Substance use. Does the patient have a history of alcohol or drug use? Have there been recent changes in the use of alcohol or drugs?
- Family history. Is there a family history of mental illness or misuse of alcohol or drugs? What is the nature of this history?
- Trauma or abuse. Has the patient experienced severe trauma or any form of abuse?
- Medication compliance. Does the patient take medication as directed or not? Has this changed recently?
- Safety concerns. Are you concerned for the safety of the patient? What are those concerns? Has the patient ever attempted suicide, harmed him or herself, or threatened or harmed others?
- How would you describe the patient’s strengths or resiliency?
- Treatment goals. What are your hopes and expectations from hospital treatment?
What is helpful to say to a patient who is my family member or friend?
Watching a family member or friend struggle is upsetting and distressing under any circumstances. As painful and difficult as this situation may be for you, it is the patient who is suffering and at risk. Remember, a patient who is your family member or friend has been hospitalized because he or she was not safe within their previous environment. Your loved one is ill and cannot help him- or herself out of this situation without professional care and treatment. This situation is not voluntary.
The best responses are those of support and reassurance. Try to use phrases such as:
- “We are here for you.”
- “Take it one step at a time.”
- “Good for you for taking steps to get the help you need.”
- “Take the time you need to work this through.”
- “You will get through this.”
- “We’ll figure this out.”
- “You will feel better again.”
What might I say to others?
Each family member and friend of a patient handles this question in his or her own unique way. There is no right or wrong way, other than to be sure to respect the decision of a patient. Though mental illness is nothing to feel shameful about, a patient’s life is personal—his or her own business. Your responsibility is to respect a person’s wishes with regard to disclosing personal information. You are under no obligation to share details with anyone.
McLean in Brief and Printable PDF
Founded in 1811, McLean is a leader in psychiatric care, research, training, and education and is the largest psychiatric teaching hospital of Harvard Medical School.
Read more about McLean’s mission and values and our commitment to putting people first in mental health.
Our locations throughout Massachusetts and on the coast of Maine provide serene settings for patients to focus on treatment and recovery. For more information on our programs or for campus maps and directions, visit Maps & Directions.
It is the policy of McLean Hospital to affirmatively provide treatment and care to patients without regard to their race, religion, color, national origin, sex, age, ancestry, disability, sexual orientation, or any other basis that would be in violation of any applicable law or regulation.
Additional information can be found in this printable PDF of the Guide to Inpatient Care at McLean Hospital.
These materials were written with valuable contributions from McLean’s Patient and Family Advisory Council. Please contact us, if you would like to offer feedback or suggestions for this guide.
This guide is also available in Spanish.