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Care Pack #029

The First Week Out

For the days right after a hospital stay. This is the hardest week, and almost nobody is told that.

Before you begin, where are you right now?

One tap. It gives you something to measure against at the end.

1, settled10, at its worst

You came home and everybody treated it as the good part. The door closed and the structure was gone: no observations, no meals arriving, nobody looking in. Just a house, and whatever you brought back into it.

Here is what the evidence says about this week, plainly, because nobody says it out loud. The period straight after a psychiatric discharge carries the highest suicide risk in the whole of psychiatry, and it is also the period when around two out of three people are contacted by nobody at all. Those two facts sit on top of each other and produce this week.

If tonight is bad, call or text 988, or go back to the emergency department. That is not an overreaction this week. That is what this week is.

  1. 1.If you are thinking about ending your life, call or text 988 now, or go back to the emergency department. This is exactly what that week is like for a lot of people and it is exactly what those lines are for
  2. 2.Do not be alone in a room with the means to hurt yourself. If something is in the house that worries you, ask someone to hold it for a week
  3. 3.Tell one person the truth about tonight, in plain words. "I got out on Tuesday and tonight is bad" is enough
  4. 4.Eat something and drink water. Discharge days routinely end with neither
  5. 5.This week is known to be the hardest one. That is not a warning about you, it is a fact about the week

What actually protects this week

One booked thing

A date in the diary for being seen does more than any resolve. If your discharge paperwork has no follow-up appointment on it, making that one call is the most protective thing available to you today.

The single strongest predictor is whether anything is scheduled.

One person who knows which week it is

Not the whole story. Just that you came out, and that this is the stretch that is hard. People cannot check on a thing they have not been told about.

Being known about is the other half of being reachable.

Nothing dangerous within reach

If something in the house worries you, ask someone to hold it for a week. This is a normal, temporary and extremely effective request, and it is asked far more often than you think.

Distance is protection. It costs nothing and it is reversible.

If nobody has contacted you

That is common and it is not a message about your worth. Median seven-day follow-up in the United States is around 32%, which means most people are in exactly your position, and the ones who get seen are usually the ones who chased it.

Ring the number on the discharge letter and say: I was discharged this week and I have not been contacted. Ask for a date. Ask to be added to the cancellation list. If you cannot face making that call, that is a reason to ask somebody else to make it with you, not a reason to leave it.

This week is known to be the hardest one. That is a fact about the week, not a verdict about you.

You reached the end. Where are you now?

One tap, however it landed.

1, settled10, at its worst

Take this one with you

You will not remember which page this was on at three in the morning. Put your email in and this pack comes to you, then one steady letter a month. Never a gate, and it stops the moment you say so.

There is more on the shelf

10 other packs sit alongside this one, written for the stretch you are in. All of them free, all of them yours.

See the other packs

This digital shelf is free for everyone, and it stays that way because people hold it open. You can be one of them, from $12 a month. Nobody is ever charged to read a pack.