Several weeks ago I was hospitalized on an open mental health unit. The hospital had both a secure unit and open unit, and most patients started on the secure unit before being moved to the open unit. I realize though that having both or even an open unit at all is extraordinarily rare. Because an open unit is so rare, I wanted to talk about my experiences and what it was like.

What is an open unit?

First, what is an open mental health unit? This is still an inpatient unit at a hospital. So just like on a secure unit they check your vitals every day, you meet with a doctor every day, you sleep in a hospital bed, and you eat hospital food. You aren’t allowed your cell phone for privacy reasons, and you can even wear scrubs they provide if you don’t have a change of clothes. A lot of it was remarkably the same to what I experienced in a secure unit. After all, it’s still a hospital.

How does it differ from a secure unit?

There are of course several huge differences. The main difference is quite literal: it’s not locked. There was a boundary I wasn’t supposed to cross, but if I really wanted to walk right out the door I probably could have. They trusted that I wouldn’t, but it was possible. On the secure unit there were two sets of locked doors to the exit, and an alarm would have sounded if anyone tried to open them without permission. There was no chance I was getting out before being discharged. In contrast, on the open unit I was even permitted to take 15-minute unattended walks off the unit if I asked, whereas on the secure unit we could only take supervised walks off the unit and only when on a certain level of clearance.

Other big differences relate to security. At the open unit I was allowed to have my backpack, my scrunchies, and clothes with strings. They even have plastic knives you can use, something definitely absent on a secure unit. My bathroom door wasn’t kept locked the first 24 hours. “Checks” were only every half hour or so, rather than every 15 minutes. Doors had normal handles, rather than the modified safety handles of most secure units. It wasn’t that they didn’t value our safety. It was that they trusted us to value our own safety and to come tell staff if you felt unsafe.

Likes? Dislikes?

I will be the first to tell you that being hospitalized on a mental health unit is not fun. You still have to follow a ton of rules, are there for treatment, and obviously don’t feel well. But if I had to choose between the two, and open or a secure unit, I would choose the open unit in a heartbeat.

Yes, there were rules, but I had considerably more freedom and privacy. This made me feel less like a prisoner and more like a patient. More so, a lot of things were expected of you rather than done for you. In the same way it was expected of you to tell staff if you felt unsafe, you were expected to wake up on your own, rather than being woken up by a nurse. You were expected to go to the nurses for your meds, rather than having the brought to you. You were expected to order and eat your food. You were expected to go to groups. I think this made all the difference in my recovery. When I got to the hospital I wasn’t functioning well, but now it was expected of me to function. I had to take responsibility to my own safety, while still in a relatively safe place and surrounded by medical personnel. Obviously they don’t expect perfection and are willing to help if you need it, but it pushes you to fight for your own recovery.

Final thoughts?

Overall, I’m extraordinarily grateful for having access to treatment and for my experiences on the open unit. The staff was amazing, and it was the spring board to getting my recovery back on track. A big thank you to all the nurses, doctors, and therapists out there who work in mental health units from a patient whose life you helped save and turn around.

Morgan