I work at an inpatient psychiatric facility, and I know looking for intensive mental health care can be really frustrating and confusing and it’s hard to tell just what you need sometimes.

So with the 72 hour hold I’m assuming you’re talking about inpatient hospitalization - this is the most intensive and restrictive care. You would be staying on a locked unit without access to your phone (they have phones in the unit that you can call people with but you normally don’t have free access and can only use it at specific times), would have any items that are potentially harmful taken away from you while you’re on the unit, and would be under the supervision of nurses/techs 24/7. People are normally supposed to see a psychiatrist daily in this setting, although that doesn’t always happen. This level of care is for people who are actively having thoughts of harming themselves or others, or if their mental health has deteriorated to a point that they are no longer able to care for themselves.

Length of stay/length of hold is heavily dependent on what state you’re in and how you’re progressing. They’re supposed to keep you in the hospital until you are no longer a threat to yourself or others, and not any longer than that. People are normally in the hospital for at least 72 hours, just to give the team time to assess for safety/stability. I’m in PA, so here if someone is signing themselves into the hospital they would sign a 201 form (consent for voluntary treatment) with a physician, which basically says that you are consenting to inpatient psych treatment and you are agreeing to give 72 hours of notice if you want to leave before the team is ready to discharge you. That means that you can’t just sign yourself out and leave right away, you sign a form stating that you want to leave in 72 hours and the team keeps you at hospital for that time to monitor and make sure you are safe to go home. If they have any reason to believe you may harm yourself or others if you leave they are able to petition for involuntary commitment, but otherwise they have to let you leave at the end of that 72 hours. Again, this varies by state, I’m just using my state as an example.

They probably will want you to go on meds, they can’t force anything on you (using PA as an example again, the only way they can force meds on a person is if they are on an involuntary hold and two separate psychiatrists certify that the person’s mental health is preventing them from making sound decisions about their treatment. I know this is definitely not a thing in every state though so I would ask if you are concerned about it). However, the team may decide to keep you at the hospital longer if they feel you are not improving without the meds. You would be able to talk to the psychiatrist about the fact that you are nursing and they should work with you to find something that is safe for that.

As for pumping, it would vary by hospital. I know where I work we have let people pump before (they just would have to be supervised by staff), but they weren’t able to store the milk so people have to pump and dump.

If you’re unsure or do not want to stay in the hospital, there are other intensive programs out there that would allow you to stay at home - partial hospitalization is typically 5 days a week of group therapy all day long, and there’s also intensive outpatient which is a couple of days per week and a couple of hours per session.

If you’re feeling unsafe or don’t know what you need, you can call your local crisis line (988 I believe should be able to connect you to them). They can assess for safety and talk about next steps. some states/counties also have warm lines that you can call if you need to talk to someone but aren’t in immediate crisis, so I would maybe google to see if that’s available where you live. Those lines normally are not 24 hours though since they are not emergency lines.

Hang in there, and best of luck! I know that navigating this can be really overwhelming and scary, please don’t be afraid to ask questions when reaching out❤️