Tuesday, May 5, 2026

72 Hours in the System: A Personal Look at Psychiatric Holds and the Path Back to Myself – Part 2

 

72 Hours in the System: A Personal Look at Psychiatric Holds and the Path Back to Myself - Part 2 of 4

In the past 17 years, I have experienced 13 hospitalizations, each beginning with a 72-hour psychiatric hold for assessment. In total, that is 936 hours spent in observation and isolation during the most acute phase of my mental health crises. This number does not include the more dehumanizing experiences that often follow, such as being transferred as an involuntary patient to the Psychiatric Intensive Care Unit (PICU), which I explore in Part 4 of this series.

The path to a 72-hour hold is rarely calm or controlled. For me, it often begins with a wellness check initiated by police. These calls may come from loved ones who recognize a mental health crisis, or from strangers concerned for safety. While necessary, the sudden presence of police can intensify fear, confusion, and emotional instability. In those moments, you shift from being seen as a person to being assessed as a risk.

Once the decision is made, you are apprehended and placed in the back of a police cruiser. The loss of autonomy is immediate. I can pinpoint the exact moment everything changes. It is when my hands are pulled behind my back and the cold metal of handcuffs tightens around my wrists. Even when I ask for relief, the response is predictable. “We are almost there.” But when you are in manic psychosis, physical pain feels amplified. The handcuffs become more than restraint. They signal the end of freedom and the beginning of confinement.

By the time I enter the Emergency Room, I already know what lies ahead. The 72-hour hold is only the beginning. My history with bipolar disorder and psychosis often means I will become an involuntary patient. From that point forward, I must prove to the psychiatric team that I am more than a risk. I am still a person capable of recovery.

A Bipolar Woman’s Lived Experience: What Is a 72-Hour Hold?

A 72-hour hold feels like a storm inside the mind. Sometimes violent, sometimes quiet, but always present. Understanding the system helped me reclaim some sense of control, even when my emotional reality told me I had none.

Under Ontario’s Mental Health Act, several forms govern psychiatric assessment and hospitalization:

Form 42: Application for Psychiatric Assessment

This initiates the process. When police bring me to the hospital, a psychiatrist signs this form based on observed behaviour.

Form 1: Involuntary Admission (72 Hours)

This allows detention for up to 72 hours if I am considered a risk to myself or others. It is the foundation of the psychiatric hold.

Form 3: Extended Involuntary Admission (14 Days)

If I am not stable after assessment, I am held for further treatment.

Form 4: Certificate of Renewal

This extends hospitalization in increasing increments, one month, two months, then three, depending on clinical need.

Before I understood these processes, I believed I would never leave the hospital. The uncertainty intensified my anxiety and disrupted any sense of emotional stability. Over time, learning the system gave me back a sense of power. Knowledge became part of my healing. It allowed me to advocate for myself, ask informed questions, and begin imagining life after discharge.

Understanding structure, even within confinement, helped restore hope.

The First Hours: Fear, Confusion, and Loss of Control

In the first hours of a 72-hour hold, I do not always feel fear. I see it. I see it in the eyes of nurses and security staff responsible for my care.

Though I have never been physically violent, I have been verbally aggressive. In psychosis, confusion becomes something I try to solve. My mind creates problems rooted in delusion, codes on walls, imagined escape routes, distorted realities. When staff challenge these beliefs, fear replaces confusion, and I react defensively.

Even when I believed I was in control, I was not. My behaviour reflected the severity of my illness, throwing food, refusing care, stripping away dignity in desperate attempts to regain control. I was both deeply unwell and, in moments, painfully aware of it.

When the 72-hour hold ends, I am often still in psychosis. This leads to transfer into the PICU, where isolation and restraint become more frequent. Days blur into nights. Time stretches and collapses at once. The goal becomes survival. Enduring the hold, the assessment, and the long path back to myself.

Inside the 72 Hours: Structure, Observation, and Stillness

Some hospitals use a Mental Health Triage Unit, where patients are placed in private rooms and monitored continuously. Depending on behaviour, doors may remain unlocked or locked without warning.

With manic energy, stillness feels impossible. My behaviour often extended the time before psychiatric assessment, reinforcing the system’s perception that I required acute care.

The goal of the 72-hour hold is to reduce stimulation, observe behaviour, and assess mental capacity. It is a structured environment designed to evaluate risk and determine next steps.

Time behaves strangely in these spaces. Without access to phones, personal belongings, or external connection, your world narrows to observation and evaluation. The outside world disappears. You are suspended in a moment where everything depends on how your mind presents itself under pressure.

This vulnerability can shape outcomes, for better or worse.

Emotional Reality: What No One Sees

There are aspects of the 72-hour hold that remain unseen, even by me.

In crisis, I am often moved quickly into isolated observation rooms. Disoriented, I rarely process my surroundings. Only later, in moments of clarity, do I recognize the spaces where I was confined.

These rooms are small, with windows meant for observation rather than connection. They are designed for safety, but they can feel like confinement without dignity. In these moments, basic needs become dependent on staff response. When those needs are not met in time, shame can take hold.

I try not to carry that shame. What people do not see is the depth of illness during these moments. Psychosis distorts behaviour, perception, and control. The actions that follow are not always choices. They are symptoms.

Isolation intensifies everything. Claustrophobia builds. The need for freedom becomes overwhelming. Resistance often leads to further restraint, creating a cycle that feels impossible to escape.

These are the realities rarely discussed, experiences known mostly to patients and staff behind closed doors.

After the Hold: Returning to Life Changed

For me, the 72-hour hold is never the end. It is the beginning of a longer hospitalization journey. After the hold comes continued treatment, often in the PICU, followed by months of stabilization focused on medication, sleep, and emotional recovery.

Even after psychosis lifts, the process continues. Healing requires time, structure, and support. Emotional stability is rebuilt slowly.

I have learned that recovery is not about returning to who I was. It is about understanding who I am becoming. Each hospitalization changes me. Each experience reshapes my relationship with mental health, healing, and identity.

I carry accountability for my actions during crisis, even when they are symptoms of illness. I also recognize the humanity of the staff who care for me, individuals who absorb the emotional weight of these moments.

To rebuild after hospitalization, I rely on self-compassion, forgiveness, and grace. These are essential tools for healing, especially for women navigating complex mental health conditions like bipolar disorder.

Leaving the hospital is not the end. It is the beginning of reintegration, of learning again how to exist in the world with emotional awareness and resilience.

I have been changed by every 72-hour hold. While I may never agree with all aspects of the system, particularly the use of restraint and isolation, I understand that my journey through it continues to shape my path toward healing and emotional stability.

To my readers:

How do you make sense of moments when your life changes without your consent, and how do you begin to rebuild your story afterward?

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Sunday, May 3, 2026

Behind Locked Doors: A Lived Experience of Psychiatric Hospitalization - Part 1


Behind Locked Doors: A Lived Experience of Psychiatric Hospitalization - Part 1 of 4

I Didn’t Know If I Was Being Saved or Discarded

It was the summer of 2006 when my mother received a call from my then-partner. He described my strange behaviour, my loss of control, and the chaos he could no longer manage. He told her something was terribly wrong with Onika.

My mother was minutes away from leaving for a 12-hour nursing shift, four hours away from her child, yet she knew she had no choice. She made the trip to Quebec with my father and aunt to assess the situation herself.

When she arrived, she didn’t recognize me. I was deep in mania, consumed by psychosis, experiencing visual and auditory hallucinations, delusions of grandeur, violent outbursts, disorganized thinking, and a complete break from reality. I was unreachable. So my parents made the painful decision to take me to a Toronto hospital for psychiatric evaluation and treatment.

I remember arriving at the Emergency Room, completely naked, confused, and terrified. My mother tried to put shoes on my feet as she cried. Everything happened quickly after that. A nurse and security guards restrained me and wheeled me inside. The last thing I saw was my mother screaming my name in the driveway.

In a brief moment of clarity, I realized something was terribly wrong. I fought against the restraints, feeling trapped in my own body. I don’t remember consenting to any of it. I was no longer in control.

I don’t know if I passed out from exhaustion or from the injection administered to me. When I came to, I was alone in a brightly lit isolation room. My family was gone. I felt discarded, powerless, and afraid.

Later, I would learn this was the beginning of a psychiatric 72-hour hold. But in that moment, I only knew fear, confusion, and anxiety. I didn’t understand how I had gone from being myself to being inside a system that now controlled every part of me.

Hospitalization, while necessary for mental health stabilization, can feel both like rescue and removal, saving you while stripping you of autonomy.

When Crisis Becomes Clinical (The Shift Into the System)

That first crisis felt endless. My parents stayed with me for two days, completing admission forms and trying to understand what had happened.

By day three, I hadn’t slept in 56 hours. Doctors made the decision to sedate me heavily to prevent permanent psychosis. I was placed into a medically induced state so my mind could recover. I slept for four days.

When I woke, I was disoriented. The first thing I noticed was the scratches on the wall, marks left behind by previous patients. I tried to open the door, but it was locked. That was the moment I realized my autonomy was gone.

In this mental health system, nothing was yours, not your schedule, your movements, or even your basic needs. Everything required permission.

I called for help to use the washroom, but no one came in time. I wet myself and lay there, overwhelmed with shame, exhaustion, and emotional defeat. Sleep became my escape.

In those moments, I didn’t think about healing or recovery. I simply wanted to disappear from the reality of my situation.

Inside the Ward: Routine, Rules, and Emotional Reality

After isolation, I was moved to a room with a bathroom. I could wear my own clothes again. My mother began visiting daily, bringing food and comfort. We spent evenings quietly together, sometimes talking, often just holding each other as I cried.

The psychiatric ward operated on strict structure and routine. Days began at 7:30 AM and ended at 10:30 PM. That structure, though restrictive, became a foundation for emotional stability.

Each morning, nurses asked the same questions:
How did you sleep? How is your mood? Did you complete basic hygiene?

The focus was always on routine, behaviour, and medication.

Daily group sessions included mental health education, creativity, mindfulness, and interpersonal skills. Some were mandatory, reinforcing structure and engagement.

Over time, I learned that following the system helped you move forward. Structure, routine, and compliance often led to discharge. Disruption could send you back into isolation.

The ward felt like a controlled environment where stability was slowly rebuilt. While it could feel dehumanizing at times, it also provided a framework for healing and recovery.

Repetition, though monotonous, became grounding. For someone living with Bipolar disorder and psychosis, structure is not just helpful, it is essential.

The Shame, the Silence, and the Stigma

In the early stages of my mental health journey, I didn’t understand my anxiety or emotional responses. When friends called to check on me, I felt fear instead of comfort.

What if they saw me differently?
What if I never recovered?

The stigma surrounding mental illness weighed heavily on me. I internalized it, turning my diagnosis into my identity.

I withdrew from people, isolating myself emotionally. I carried the shame silently, believing I had failed in life despite doing everything “right.”

Instead of learning how to manage my mental health, I avoided it. I rejected the idea that hospitalization could be a place of healing. Instead, I saw it as proof of failure.

Looking back, I realize that stigma, both external and internal was one of the most damaging aspects of my experience.

What Hospitalization Taught Me About Myself

Over 20+ years and 13 hospitalizations, I have learned that while the system is imperfect, it plays a critical role in managing severe mental illness.

Hospitalization acts as a forced pause, a reset when emotional stability is lost. It provides structure, routine, and support during moments of crisis.

It teaches boundaries, stress management, and the importance of consistency. These are essential tools for long-term mental health and women’s wellness.

I have also learned the value of a strong support system. My personal and professional networks understand my journey and help me navigate both crisis and recovery.

Most importantly, I have learned to advocate for myself. My experiences both positive and traumatic have given me a deeper understanding of the mental health system and my place within it.

Hospitalization is not something I welcome, but I respect its role in my healing journey.

Final Thoughts

Hospitalization: A Chapter, Not an Ending

Hospitalization is not the end of my story, it is a chapter in my ongoing journey toward healing and emotional stability.

It is often the hardest part, but also the most necessary when psychosis returns. It provides the tools and structure needed to rebuild and reintegrate into everyday life.

That said, the system must evolve. Practices like restraints and prolonged isolation need to be re-examined, as they can hinder recovery rather than support it.

When my dignity remains intact through these experiences, that is progress worth celebrating.

Hospitalization is part of my recovery process not the definition of it. It is a turning point, not a conclusion.

Question to my Readers:

How do we make meaning of experiences that feel both protective and painful and how do we carry them forward without losing ourselves?


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Thursday, April 30, 2026

Why Lived Experience Matters in Social Work Education

 

Why Lived Experience Matters in Social Work Education

As I waited for the University of Toronto Master’s of Social Work (MSW) students to settle into the classroom, I could feel my nervousness rising. These young people are the future of social work, and I was a woman who had lived through psychosis, invited to offer something no textbook could provide. My role was simple in theory: share my lived experience of mental illness, offer insight into one of its most complex realities, and leave a lasting impact as they prepared to support clients experiencing psychosis firsthand. Simple, right?

Yet as I listened to the professor’s lecture on psychosis, stigma reduction, medication side effects, and intervention strategies, the full weight of my experience returned. How could I capture what it truly means to live through psychosis in such a short time? How could I help them understand that people navigating this form of mental illness are still whole, still human, and deserving of dignity, patience, and compassionate care?

Through my work with the University of Toronto’s Factor-Inwentash Faculty of Social Work, alongside social workers and lived experience advisors, I contributed to a Psychosis Simulation Project. Our goal was to bring lived experience into social work education. The initial result was an educational video that bridges clinical knowledge with human reality, highlighting both practitioner perspectives and the voices of those who have experienced psychosis and returned to wellness.

This blog explores why lived experience must be part of social work education. Psychosis cannot be understood solely through clinical language or diagnostic criteria. It must be understood through the lives of real people who live, work, love, and heal beyond their diagnosis.

Humanizing Psychosis Beyond the Label

One of the most important messages I share is this: I am not psychosis. I am not my illness. I live a full and meaningful life.

For many MSW students, their early exposure to mental health is rooted in clinical settings. Clients appear as case files, diagnoses, or mental status exams. In those environments, people can become reduced to symptoms. Their humanity is often overshadowed by hallucinations, delusions and disorganized speech. 

What is often missing is the fuller picture. The person behind the diagnosis may be a mother, a sister, a student, an employee, or a friend. They have identities, relationships, and aspirations that exist far beyond their mental illness.

Sharing my lived experience challenges this narrow lens. It reminds future social workers to see the person first and the diagnosis second. Hearing directly from someone who has experienced psychosis and built emotional stability, structure, and routine in recovery helps reduce stigma and deepen empathy. It brings forward dignity, identity, and the complexity that defines each individual life.

Stages of Psychosis: What to Expect Before, During, and After

Individuals experiencing psychosis often move through distinct stages, each with its own challenges and needs. Understanding these phases is essential for effective mental health support and long-term healing.

Before Psychosis

In the early stage, symptoms such as paranoia, delusions, and hallucinations may begin to surface. Many individuals are still living in the community, often without a strong support system or awareness of what is happening.

In these situations, crisis intervention may occur, sometimes involving police wellness checks. While intended for safety, these interventions can feel deeply distressing and, in some cases, harmful.

For social workers, this stage highlights the importance of early, compassionate intervention. Consistent check-ins, emotional support, and trust-building can make a meaningful difference. Care should not begin only after the crisis peaks. It must start as early as possible.

During Psychosis

During psychosis, individuals are not grounded in shared reality. Their thoughts, emotions, and behaviours may become intense, disorganized, or unrecognizable. Emotional responses can feel overwhelming, often described as a form of emotional hijacking, where the brain’s fear response overrides rational thinking.

It is important to understand that behaviours during this phase are symptoms of mental illness, not reflections of character.

Social workers must respond with steadiness, empathy, and a willingness to look beyond the moment. Supporting both the individual and their support system helps create a foundation of safety and understanding. This foundation becomes critical when the person begins to return to baseline.

After Psychosis

The period after psychosis is just as important as the crisis itself. Recovery does not end when symptoms fade. In many ways, this is where the deeper work of healing begins.

Supporting individuals in rebuilding structure, routine, and stability is essential. This may include sleep regulation, medication management, and reconnecting with daily life.

Social workers play a key role in this phase. They become a steady point of reference as individuals reintegrate into their lives. Care must remain continuous, grounded in patience, empathy, and non-judgment. True recovery is not a single moment but an ongoing process of rebuilding and growth.

Medication Management: Nuance and Non-Compliance

Discussing medication in mental health care is rarely straightforward. My own experience reflects this complexity. There have been times when I resisted medication and times when I recognized its value in supporting my stability and recovery.

For many individuals, hesitation around medication is rooted in real concerns. Side effects from antipsychotics and mood stabilizers can include emotional numbness, fatigue, and significant weight gain. These changes can impact identity, self-esteem, and overall well-being, especially for women navigating mental health and body image.

There is also the reality of forced treatment during acute episodes, when individuals may not have the capacity to advocate for themselves. This can create lasting distrust toward medical systems.

For social workers, advocacy is essential. This means asking thoughtful questions, listening without judgment, and helping bridge communication between clients and psychiatric teams. Medication management should be approached with empathy, collaboration, and respect for the client’s lived experience.

Lived Experience Reflection: The Social Worker Who Helped Me Trust

In 2016, during a severe episode of psychosis, I was hospitalized at St. Michael’s Hospital in Toronto following a traumatic wellness call. What followed was a period marked by isolation, restraints, medication challenges, and a deep mistrust of the system. At the same time, I was experiencing homelessness.

It was during this time that I met Tarak, the social worker who would change the course of my recovery.

Our early interactions were difficult. I was fearful, reactive, and guarded. I pushed him away with anger and mistrust. Yet he remained consistent. He showed up daily, calm and present, even when I tried to drive him away.

What I did not realize at the time was that he was listening, not just to my words but to the pain beneath them. He recognized my trauma, my fear, and my desire to heal, even when I could not express it clearly.

At one point, he made me a simple offer. Give him a month. If I was not satisfied, he would step aside. That consistency, paired with empathy, allowed me to take a chance on trust.

Tarak supported me in finding housing, rebuilding structure, and reconnecting with life. He sat with me through small moments that became significant turning points. Over time, he became more than a social worker. He became a steady presence in my healing journey.

He saw beyond my Bipolar disorder and psychosis. He saw possibility. He helped me reconnect with my sense of self, my creativity, and my potential. That belief changed everything.

Final Thoughts

Speaking with MSW students was deeply meaningful. It felt like an opportunity to shift how future social workers understand mental health, not just as a clinical field but as a human experience.

Lived experience brings depth that textbooks cannot offer. It adds context, emotion, and reality to the study of mental illness. It reminds us that behind every diagnosis is a person with a full life, not defined by their most difficult moments.

Psychosis is part of the story, but it is never the whole story. Healing, growth, and emotional stability are possible. And when social workers are trained to see the whole person, not just the symptoms, they become far more effective in supporting lasting recovery.
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Thursday, April 9, 2026

From Patient to Panelist: A Reflection After the 2026 SPA Convention (The Society for Personality Assessment)

From Patient to Panelist: A Reflection After the 2026 SPA Convention
(The Society for Personality Assessment)

 From Patient to Panelist: Entering the Room

As I walked through the doors of the Sheraton Centre Toronto Hotel for the 2026 SPA Convention, I felt a quiet anticipation for what the morning would bring. I had been invited to join the LEAF Deep Dive Panel only days before, yet even as a late addition I knew I was meant to be there.

The panel focused on psychiatric assessments. It explored what it means to seek assessment, move through the process, and live with the outcome of a diagnosis.

After more than twenty years as a patient within the mental health system, I had experienced assessment, reassessment, diagnosis, and misdiagnosis. My voice had echoed through psychiatric units across Ontario. Now, as I entered the Huron Room, I stepped into a space that patients rarely access.

I carried both apprehension and purpose. I was determined to share my lived experience with clinicians, researchers, educators, and thought leaders responsible for shaping the very systems that had shaped my life. I wanted to know whether lived experience truly belonged in professional spaces.

This blog reflects on that experience. It explores what it means to move from patient to panelist, and the impact of being invited into rooms where mental health systems are discussed, evaluated, and reimagined.

Surrounded by Leaders Shaping the Mental Health System

The energy in the Huron Room was thoughtful and uncertain. There was a quiet divide between healthcare professionals and lived experience panelists. We were all there for the same reason, yet there was a sense of curiosity about what would be said and whether it would lead to meaningful change.

As each panelist shared their story, a common message emerged. The mental health system must do better when it comes to psychiatric assessments. For many of us, including myself, the assessment process shaped the course of our lives. Diagnoses determined treatment plans, medication, and long-term mental health management.

We emphasized that assessments are the first line of defence in mental health care. When done incorrectly, patients carry the consequences through misdiagnosis, ineffective treatment, and prolonged suffering.

Looking out at the audience, I could see the shift. What once may have felt routine or procedural began to take on weight. Assessments were no longer checklists. They became human experiences with lasting impact.

From Subject of Assessment to Contributor to the Conversation

After years of psychiatric assessments that often led to hospitalization, I felt a deep sense of pride standing in front of that room. For the first time, my experience was not being documented. It was being heard.

My lived experience was no longer data for observation. It became insight for change.

Moving from subject to contributor was a powerful shift. I felt seen not as a diagnosis or case history, but as a person with knowledge, perspective, and something meaningful to offer. My journey, with all its complexity, had purpose beyond survival.

Entering the Rooms: A Panelist’s Reflection on a Rare Experience

Being invited into a professional conference space like this is rare for someone with lived experience. These are rooms typically reserved for clinicians, researchers, and decision makers.

I never imagined that my mental health journey would lead me from being assessed to participating in conversations about how assessments should be done.

That access felt like a gift. What was once a system I struggled to navigate became something I could begin to understand. The walls that once felt impossible to cross were no longer barriers.

After more than fourteen psychiatric assessments, multiple hospitalizations, and experiences of restraint and isolation, standing in that room felt transformative. My voice, once confined to clinical settings, was now part of a broader conversation.

Sharing my story allowed it to become something larger than myself. It became part of a collective understanding that could shape future care.

Unrestrained: The Emotional Impact of Being Seen

During the panel, I was asked to speak about my personal experience with psychiatric assessments.

My response was honest and deeply emotional.

I shared how most of my assessments occurred under duress. They often began with a wellness check by police, followed by apprehension, transport to hospital, and placement under observation. I described the isolation, the restraints, and the lack of autonomy that defined those experiences.

For the first time, I spoke openly about what that process felt like. Not as a clinical case, but as a human experience.

As I spoke, I felt something shift. I felt unrestrained. I was no longer being observed. I was being heard.

The tears that followed were not just about pain. They were about release. They were about finally being seen.

The Impact of Psychiatric Assessments: A Message to SPA Professionals

After years of assessments and over two decades of living with mental illness, I was still misdiagnosed for much of that time. That reality points to a larger issue within the system.

It was not until my residency at Ontario Shores Centre for Mental Health Sciences that I received what I believe to be a more accurate diagnosis. Even then, communication remained a challenge. I discovered my diagnosis through medical records rather than direct conversation.

This highlights a critical gap in mental health care. There is often a disconnect between clinicians and patients. Clinicians focus on diagnostic criteria, while patients seek understanding, clarity, and tools for living.

Resources like the DSM 5 provide diagnostic frameworks but offer little guidance on how to live with a diagnosis. Patients are left to build their own systems of care through trial, error, and personal resilience.

For me, that system includes self-advocacy, therapy, medication management, sleep hygiene, nutrition, exercise, and self-care practices such as journaling and reflection.

When patients leave the hospital, they are often given minimal guidance. Yet they are expected to navigate a complex mental health system on their own.

Diagnosis is only the beginning. It is not the end of the journey.

Final Thoughts

How Understanding Can Lead to Change: A New Sense of Possibility

After the panel ended, clinicians and attendees approached me with gratitude, curiosity, and a desire to stay connected. Some did not know what to say beyond thank you. Others expressed how impactful it was to hear lived experience directly.

One psychiatry student shared that my voice brought awareness into spaces where it is often missing.

That moment stayed with me.

Being in that room was not just about visibility. It was about contribution, connection, and reclaiming a voice in spaces that shape real lives.

My hope is that experiences like this create more opportunities for lived experience voices to be included in mental health conversations. These voices have the power to move us beyond stigma and toward meaningful change.

Being in the room did not erase my past. But it changed what felt possible for my future.

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