When my son has went in, it’s always been on a TDO that allows them to keep him for up to 30 days.
But, he is always much, much better by the 2 week mark. Not well, but stable enough to no longer be a danger to himself.
This was our experience:
1st time - we all thought he just stopped taking his meds & getting them back on them would fix him up. He had been stable on Zyprexa for around 7 years. He was better in the hospital, but came home & refused to take the meds after about 2 days. However, I used alternative methods to get him to take the meds, and the truth was the Zyprexa had just stopped working for him.
2nd time - he finally got to the point he wasn’t sleeping again, and after about 5 days of no sleep at all, he asked to go see someone, anyone - so he ended up in our local crisis office & they decided he needed to be hospitalized about 5 minutes after he got there. This time, due to compliance issues, they started him on the Invega injection. About a week after they started this new med, he was like a totally different person. Very close to symptom free - so they let him come home.
3rd time - after your initiation doses, they try you on 117 mg/month as a maintenance dose. It wasn’t enough for him, so once again he stopped sleeping, and on the day he was supposed to get his third shot, he was asking to go to the hospital again - so off we went. They bumped him up to 156 mg & once again, he was good in about 2 weeks.
4th time - The 156 mg was still not enough to hold him near the end. This time, he got his shot & still ended up in the hospital about 4 days later. He had only slept 16 hours in 8 days - yes, I know exactly because I am hyper-vigalent about his sleeping. This time, they couldn’t up his dosage on the Invega shot until the next month, but they added Risperdal & a mood stabilizer that seemed to work miracles. This time, they only kept him 8 days, but he was doing well & ready to come home. This time, he came home willing to take the oral meds - that’s something he hasn’t been willing to do for almost a year.
Since them, they’ve changed his shot to 234 mg, took him off the Risperdal & tripled his mood stabilizer. Only time will tell if this is the right combo. He’s not sleeping as much as I would like, but he is sleeping some each day. He’s still delusional, but not very paranoid. I don’t think he’s hearing voices or seeing anything. We have good conversations that make sense - even if some revolve around his less bizarre delusions.
I flip out every time he slides backwards, even a tiny bit, but overall he’s much better than the first time he went into the hospital.
So, to borrow his phrasing, his recovery is a process and I have to expect that there will be bumps in the road. Maybe he’ll be back in there again. If he has to go, he has to go. I don’t want him to, but it won’t be the end of the world.
Also, I think you have to have a few short stays that don’t work before you can convince someone to keep them for an extended stay. I don’t think that’s a law or a hard & fast rule, but it seems to be how it works.
I also have some theories about why he gets better in the hospital, then doesn’t do as well at home. He always makes friends in the hospital - at home, he isolates. In the hospital, he can’t watch things on the TV or computer that fuel his delusions or give him racing thoughts like he can at home. They also have multiple group therapy sessions per day, the nurses and case managers are always trying to engage them in conversation, and he sees the doctor daily.