Those who are seriously ill with depression are at high risk for suicide. Hospitalization alone does not prevent that possibility. It takes time for medication and therapy to take effect and for recovery to begin. The involvement and advocacy of family and friends is an important and appropriate part of the treatment plan. The following suggestions provide a guideline for working with a treatment facility when a loved one is undergoing treatment for depression.

At Admission

What is the policy on involving family members with the patient's care and availability of staff to answer questions?

Printed sheets that promise classes, sessions, etc. without a definite date or appointment specified to meet with a supervisor, nurse or doctor are of little or no use. Set up an appointment, and obtain a name and phone number of someone who will be available to answer your questions throughout the duration of treatment. After a patient is safely admitted, don't leave the area until you are satisfied that all of your questions and concerns are answered and you have established a contact person who will be able to answer any additional questions that arise. Ask the doctor or your contact what the treatment plan is, what has to change in the patient's attitude, behavior, and physical characteristics before he or she is discharged, and any additional questions you have regarding the patient's care and treatment plan.

During Treatment

What, if any, is your role and how can you assist the patient in this process?

If you have questions or disagree with any decisions at any time, it's very important you discuss them with the doctor. You know the patient better than the doctor and staff, and may be able to shed light on important issues. Patients may not recognize behavior changes because they're ill; the doctor and staff may not recognize differences, especially if they're not familiar with the patient. You are the best person to observe and state anything you are concerned about. Don't be afraid to ask specific questions about how the patient's treatment is progressing, i.e. is the patient participating in group or individual therapy, or both; is he with students, interns, registered nurses, practical nurses, doctors, etc. Find out the actual amount of time the doctor is spending with the patient. This may determine the quality and value of care the patient is receiving.

Keep in mind the facility may not be capable of meeting all the patient's needs. As a person close to the patient, you can advocate for appropriate services. The ultimate hope is that she'll be provided the best chance of becoming healthy, thereby regaining the ability to make decisions in her own best interest.

Upon Discharge

Some treatment facilities have a release or discharge meeting with the staff, patient and significant others. Some do not.

You can insist on a discharge meeting to determine if the patient is ready to leave and if he is healthy enough to manage his own care, or is able to obtain care from some other source. A continuing treatment plan is a necessity. In addition, if there is a difference between the planned and actual discharge, ask the doctor to review any changes in the patient during that time. (Even a few hours can present situations that would preclude discharge). Ask the doctor how the decision to discharge is made, and voice your concerns if you disagree with the decision. Check with the patient to see if written goals have been established. You can help the patient arrive at some constructive short-term goals for solving specific problems. Your interest will show the person you care. The patient should have specific goals in writing before leaving the treatment facility. Help locate and evaluate outside resources such as ministers, relatives and friends who can help in the recovery process. Continuing observation and support are vital, and follow-up is crucial to ensure a successful recovery.