When Is Hospitalization Needed for Schizophrenia?

Schizophrenia can cause delusions and behaviors that disrupt daily life. But once these symptoms are stabilized with treatment, most people with schizophrenia do well managing the condition.^1,2

Those who are at risk of harming themselves or others may need a hospital stay, however. A stay in the hospital can ensure a person's safety, stabilize their mood, and improve their diet and sleep. They may need a change to their medicines, a new treatment plan, or simply relief from life stressors.^1-3

Reasons for hospitalization

Reasons for hospitalization for people with schizophrenia include:¹

• A psychotic episode, which includes delusions or hallucinations
• Signs of extreme paranoia
• Thoughts of suicide or self-harm
• Threats of harming others
• Severe medicine side effects

Other reasons someone with schizophrenia may need to go to the hospital include:¹

• Special tests or medical procedures
• Going off or changing a medicine
• Substance use disorder treatment
• Inability to cope with life stressors

How hospitalization can help

People usually have better treatment outcomes if they work with their healthcare team and take medicines as prescribed. If your treatment is not working, it is best for you to seek help voluntarily. A stay in the hospital can help you:^1,2

• Focus on getting better
• Monitor and improve nutrition and sleep
• Take better care of yourself
• Get back into a routine
• Connect with a therapist
• Plan for your discharge and future

The type of hospital facility and length of stay varies from person to person based on their needs. Typically, hospital treatment combines:^1-3

• Physical exam to determine your overall health
• Assessment of your mental state or threats of self-harm
• Medicine review or new medicine
• Talk, group, or family therapy
• Self-care tips to manage stress
• Education on how to cope with symptoms
• General support and care plan following discharge

You can create a psychiatric advance directive before you need hospital care. This written legal document explains your wishes about medical care and the services you want or do not want.²

This directive gives instructions to your care team. It protects you if you cannot communicate or make decisions when you need to be hospitalized. You can grant legal authority to another person to act on your behalf when you cannot make decisions for yourself.²

Finding a hospital for schizophrenia

You have options for where to seek inpatient care. This decision will depend on your symptoms and the level of care you need.²

Types of facilities include:²

• Emergency room – Best for an acute mental health crisis, suicide attempt, or in response to a 911 call. The ER takes walk-ins, and the staff can assess your mental and physical health. You may be admitted for tests or overnight observation. Or you may be discharged with follow-up care.
• Psychiatric units – Offer inpatient, 24-hour care usually at a general hospital, private psychiatric hospital, or drug treatment facility. The care team includes psychiatrists, psychiatric nurses, and group therapists.

Public psychiatric hospitals – Provide acute and long-term care regardless of one’s ability to pay. These hospitals are often the preferred choice for veterans and forensic or court-ordered evaluation.
Residential care centers serve children and adolescents with psychiatric conditions and people in treatment for alcohol or drug addiction.

• Partial or temporary hospitalization – This can include out-patient services during the day but not 24-hour care. This might be used as a bridge to discharge from the hospital.<²

Involuntary hospitalization for schizophrenia

If you pose a risk to yourself or others, involuntary hospitalization for schizophrenia may be necessary. If your loved ones are concerned for your well-being or others’ safety, they may try to have you hospitalized. The police and courts could become involved if you were arrested or lost your housing.^1-5

Laws around involuntary admission for mental health conditions vary from state to state. These laws protect people with mental health conditions who do not want to go to the hospital. You do have rights to refuse admission or treatment.^1-5

What to do if you are concerned for a loved one with schizophrenia

If you have a loved one with schizophrenia, research the laws in your state. You also can ask mental health providers or local police to explain your state’s requirements for getting inpatient care for a family member.^1-5

Depending on the situation, the courts can order evaluation or treatment for a person with a mental health condition or co-occurring substance use disorder. This usually applies to people with a diagnosed mental health condition who have not followed their treatment or face criminal charges in court.⁵

You also may be able to file a petition in civil court to admit a person into a hospital. This process can take longer, and certain criteria must be met for involuntary admission.⁵

Get help for schizophrenia

If you feel unstable or out of control, you may wonder whether you should seek help at the hospital. Do not be afraid to:^1-3

• Reach out for help
• Tell family or friends
• Contact your psychiatrist
• Check yourself into the hospital

Your healing and well-being should be the priority. Do not be afraid to talk to a trusted friend or therapist, and seek inpatient care when you need it.