Onika L. Dainty

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?