What do mental patients experience on a day to day basis? What forms do treatment and counseling take? What special care is taken to ensure that patients do not attempt to harm themselves or one another?
I personally have found that private mental health hospitals and mental health wards in private hospitals are not the dull or frightening places that they seem to be in movies. Since the early 1960s, I’ve been in four private hospitals and one state hospital.
I did not feel that I was in any danger from another patient during any of that time. I’ve never seen a fight break out or a patient attack anyone. Apparently, if a patient is a danger to anyone, she or he is kept separate. Generally, the other patients aren’t “spooky.” Often patients become very close and very open with each other. I have loved some of these people more than I can ever explain. There isn’t much pretense when you’re in a mental hospital.
You sure don’t get to lie in bed all day. They may give you a lot of medicine and expect you to stay awake. There may be a group counselling session sometime during the day. You will probably meet with your psychiatrist almost every day. There may be a chance to do some exercises or work out in a gym. You may be taught some relaxation techniques.
The kind of therapy you have will depend of what you and your psychiatrist decide. I’m not sure what all is even tried these days. I know that a lot of it is talk therapy and medicine.
A lot of your healing may come through talking with your fellow patients. Sometimes you will find that the advice you give them is the advice you need to hear yourself. And strangely, there is a lot of laughter among the patients. You haven’t lived fully until you’ve played Truth or Dare with Nothin’-Left-To-Lose Mental Patients!
You may have marital counseling on somedays if that is indicated.
There is also a lot of free time to play cards, shoot pool (perhaps), talk on the phone, watch TV, do your laundry, shower, etc.
Some nights there may be special activities planned such as BINGO. On other nights you will be allowed to have visitors. Meals are usually taken together. And there are probably going to be some snacks around.
There probably will be some sort of general meeting of all patients and staff together to work out any problems and to say goodbye to patients who are being discharged.
The amount of time spent in the hospital varies for a few days to months.
I think of the hospital as My “safe place.” I used to be able to find ways that I could hurt myself if I set my mind to it. But the last hospital that I was in was as safe as could be imagined.
The hardest part is when you first go in and you don’t know anyone and it all seems so sad and useless. But that doesn’t last long. Others will reach out to you. You can just let go.
I hope that this helps. There are several Dopers who have had experience with mental illness. Some of us will admit it. 
All I wanted was a Pepsi…
I’ve worked the floor of several urban Psychiatric Hospitals and units. These things vary greatly according to facility, state regulations, and acuity level, but a typical inpatient locked-unit has on average of 15 to 35 patients. Census numbers get lower in warmer months, or if the facility is having trouble filling the beds. On units I’ve worked, I would say about 1/3 of the patients are 302’s (involuntary admissions) which means they were deemed a danger to themselves or others, and are being institutionalized for safety purposes. The other 2/3s were 201 admissions, which voluntarily sign themselves in for treatment and can leave, but must give 3 days notice to do so.
On a typical unit, the psychiatrist will see the patients on admission, and every other day or so after that. They set the plan of care, do assessments, and order medications and tests. The nurses do their own assessments, administer medications, and report back with changes. Techs patrol the units, escort patients to the cafeteria or gym, do body searches on admissions, and sit on the levels.
As for the day to day patient experience; In a locked unit, the patient can't leave the unit, unless under escort by a staff member. Every door in a psych hospital is locked, so even if patient manages to elope from a unit, they still have another two locked doors to go through. The patients stay 2 to 3 to a room, and are woken at about 7, and will go down to the cafeteria at about 8 for breakfast (unless they have been violent, or are an elopement risk, in which case their tray will come to the unit.) There are medication passes where the patients wait in line and go to the nurse for their pills. Through out the day there will be group therapy sessions, where people talk about their problems or do activities. Attending these sessions is strongly encouraged, but not mandatory.
One interesting thing about a psych ward is the smoke breaks. This is the only area of health-care where smoking is allowed and sometimes even encouraged. They have smoke breaks every hour or so, and nearly every patient on the unit smokes. Cigarettes are the only real bargaining tool we have with the difficult patients, and it is amazing how many of them start behaving when their smoking privileges are in jeopardy. We never actively discourage it because a lot of these people are coming off suicide attempts, hard drug addiction, life-shattering depression, and it would be unrealistic and cruel to take away one of their few coping mechanisms (other than that, I take the standard, health-provider line on tobacco.)
I would say that the bulk of the treatment is pharmaceutical. The most common drugs are anti-depressants, anti-psychotics, sedatives, and mood stabilizers. Patients are to be observed by the nurse while taking their medication, and even some will still 'cheek' their medication, which means they hide the pills in their mouth. They then later discard them in the trash (usually), or spit them out to save them and hoard them to overdose later. For those patients we have versions of medications that dissolve in the mouth so cheeking them is impossible. If a patient is entirely non-compliant and is having behavioral issues, they may be given intramuscular injections (usually in the upper buttock). There are versions of medicines which only require one injection a month
Injection (medicine) - Wikipedia.
The behavior of the patients varies. Many of the patients are victims of severe abuse (violent, sexual, emotional) and they become depressed, suicidal, and drug-addicted to cope. Some of the stories you hear are really heart-breaking. Some of the psychotic or detoxing patients can act really bizarre. For the worst of them, it's not unusual to strip naked in the hall, smear shit on the walls and bathroom, fling shit, scream gibberish, run laps around the unit, scream at us about how we're poisioning them or killing their babies (that's a delusion that the psychotic women come up with surprisingly often). I remember one dude dancing around with a sign that said, "will lick the feet of white women for fried chicken." That's more of a highlights reel of my work experience, and usually the staff do an excellent job of keeping a lid on that stuff.
All patients are checked up on every 15 minutes. If a patient is actively trying to kill or harm themselves, we put them on a level, or a 1 to 1 (different facilities have different terminology.) That means an aide is sitting, watching them and within reach of them, every second, all the time. If they persist in trying to harm themselves, they are medicated with antipsychotics (Haldol or Geodon) or sedatives (Ativan), either by pill or needle. If they are persistent and continuing danger to themselves or others, and every other intervention has been ineffective, they go into 4 point leather restraints (cuffs to ankles and wrists, strapped to the bed.) When restrained, they can't move at all. They are made an automatic 1 to 1, assessed by the nurse every 15 minutes, and released as soon as they are no longer a danger to themselves or others.
Hope that answers some of your questions.
The complete opposite of Zoe’s and Otter Snacks thoughtful responses is what I alway envision.
Shirley Ujest I’m on dial up. What’s the video of?
Back To The OP
Last time I was institutionalized was in the ninth grade. We had a certain amount of freedom to move about the grounds. But staff always had to know where you were. Fights did break out. But the staff stopped them almost instantly. There was a lot of sexual activity there, despite the official ‘no further than holding hands’ policy. There were trips to local malls and such for those patients who had earned higher levels of privileges. Apparently, some of the patients arranged to make drug buys while at the malls.
The experience can be almost pleasant. But, you aren’t allowed to leave and a group of people have control over you that can be used at whim.
Another anecdote; my experience has been a mix of traumatic, mundane, and light-hearted:
When they first told me I was going to be institutionalized (age 15), I bolted out the door and they chased me across my school and then again, later, out of a hospital and through the grounds. The cops got involved and when I was finally brought in, I saw two layers of thick steel doors slide shut behind me like something out of a sci-fi horror movie. I freaked out and was wrestled to the ground, tranquilized, straitjacketed, strapped to a gurney and wheeled alone into a cushioned, florescent-green room with a blinding light above me and puddles of piss on the ground.
I could not understand what was going on; mere hours earlier I had been dumped and I was devastated, sure, but I still thought I was just a regular kid… now, suddenly, I was insane? My entire world view was shaken to the core and I could not stop crying.
The next day I was shown to my more permanent quarters. Pink bedsheets, chained windows, tiny garden just out of reach… that was the moment I truly learned to appreciate freedom. Looking back in, there were old people walking around crying at nothing in particular, others drooling into space, and one woman was walking around with an IV drip and no throat – she’d swallowed some chemical and dissolved most of her pipes, and that feeding tube was what’s left of her eating ability.
Anyway, as the weeks progressed and the crying spells subsided, the normality of daily life set in. It’s much as the others described.
Wake up, join a group session or two, maybe talk to the counselor or the shrink, take meds (or hide them between teeth), go back to bed, wake up again, eat some yummy hospital food, blah blah. It was a dreary routine, but I suspect it was intentionally made that way to keep us predictable and stable. At certain times through the day, a little snack cart would come rolling through, allowing us to purchase junk food or toiletries. We were expected to have real money (provided by family members), which I always thought was odd.
The patients there were universally nice (if they were sound enough to interact with you at all) and I never felt I was in any sort of danger. Socialization was difficult, however, between whatever mental illness they had and the drugs they were on. I was the sanest one there… not that that’s saying much.
There were also some fun times. Some student interns started visiting us, for one thing, and in between flirtations we’d talk about the nature of madness, life on the outside, our music tastes, etc. Eventually I was allowed to have a CD player and even a laptop, and I became the semi-official DJ of our ward. People would gather, drool, chuckle, and dance all at once. The nurses would trade CDs with me and occasionally even stand by and enjoy the festivities.
Then one day, for no particular reason, I wrapped the laptop in a blanket and Marioed it to death. Good times.
Life became routine again after that, so I started to entertain myself by acting like some of the more seriously ill patients (yes, I was very mature back then). That was fun until the nurses started simply rolling their eyes and going, “Reply, you’re not that crazy… yet.” Then I snuck into people’s wheelchairs when they were in the bathroom and raced around the ward. I also experimented with different suicide methods, more to “beat the system” than out of any genuine desire; I learned you could unscrew light fixtures with coins and crack 'em in blankets for sharp shards and no noise, rig up pulley systems with (haphazardly-prohibited) shoelaces and bathroom doors, suffocate yourself with bedsheets, etc. When that got boring, I plotted my Great Escape; grab a syringe here, take an orderly hostage there Sarah Connor-style, draw just enough blood… usually, at that point, I’d lose interest and go back to bed.
All in all, it was like 6 months of – more than anything – routine. It wasn’t bad or good, just… mundane. Still, not an experience I’d want to repeat. Luckily, the second time it happened (a decade later), I knew just how to act and what to say and got out in two or three days.
I’d recommend reading Girl, Interrupted and Voluntary Madness; the former’s about a young girl institutionalized against her will, the latter about a journalist who semi-faked depression to enter (and compare) four different classes of institutions. The Girl, Interrupted movie is also good if you’re short on time, but the book’s much better.
Was I the only one who got that?
The patients spend the first half of the day editing the Wikipedia and then the other patients spend the remainder of the day reverting the edits 
No. But I don’t matter, I’ll probably just get hit by a bus anyway…