If the person needs to be treated in hospital

Some episodes are more severe than others. While many people can be treated at home, sometimes people with bipolar disorder need to be treated in hospital.

When may the person’s clinician recommend hospital treatment?

The person’s clinician may recommend hospital treatment if:

  • There is a bipolar crisis (e.g. the person is severely ill, can’t do the daily tasks or they are in danger of doing something with damaging or life threatening consequences).
  • Treatment and support does not seem to help the person’s symptoms.
  • Changes to their treatment require close supervision by medical staff.
  • In addition to their bipolar disorder, they need help with alcohol or drug problems.
  • The person has symptoms that have a disruptive effect on their life, and they need timeout to get well.

If the person you care for has severe symptoms and is finding it hard to function, encourage them to talk to their clinician about whether treatment in hospital may be helpful. In some countries there are halfway houses, which offer a peaceful and contained environment for people who are not too severely ill. This may also be an option for the person to discuss with their clinician.

If the person is too ill or refuses to talk to their clinician, call the person’s clinician to express your concerns about their wellbeing. However, if a bipolar crisis occurs you may need to contact emergency services (e.g. ambulance, hospital emergency department or police) directly.

Voluntary and involuntary hospitlization

If the person’s clinician recommends hospitalization:

  • Encourage the person to seek voluntary admission to hospital rather than to be admitted against their will. Discuss with the person that going to hospital may be an opportunity to take time off to get well, away from stressful demands.
  • In extreme situations involuntary hospitalization may be recommended. Occasionally, a person gets so ill that they are at extreme risk of damaging or life threatening consequences but they don’t recognize they need treatment. Laws about admitting people to hospital in these extreme situations differ depending on where you live.  Your local mental health service or clinician should be able to offer more information on involuntary hospitalization. This can be a difficult time for all concerned. If possible, confirm with the person when they are well that actions that you have both agreed upon about obtaining involuntary hospital admission are acceptable to them and will not damage your long-term relationship.
  • Making plans with the person in advance about what to do if they become very ill can help to give the person some advance control over events if they need to be treated in hospital in the future.

If the person you care for is admitted to hospital:

  • If necessary, provide information to assist with treatment (e.g. about the person’s recent symptoms or medications).
  • Tailor your contact with the person to what the they are comfortable with, as the person may feel vulnerable about social contact.
  • Take time to rest while the person is being cared for in hospital.

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