Fetterman's hospital stay for depression was atypical

Abraham Gutman
The Philadelphia Inquirer

PHILADELPHIA — John Fetterman returns to the U.S. Senate this week after spending 44 days hospitalized to treat an episode of severe depression.

That’s about four times longer than the typical stay for a Pennsylvanian admitted for the first time to treat a disorder that Fetterman said made him stop eating and feeling indifferent about life. He was unable to get out of bed even when his son tried to celebrate his still-fresh victory in one of the most-watched elections in the nation.

To put Fetterman’s experience in perspective, The Inquirer analyzed state data on all 42,000 hospital stays for depression in 2021, the most recent year available.

About a third were in the Philadelphia area, the records maintained by the Pennsylvania Health Care Cost Containment Council showed.

The length of Fetterman’s stay was unusual — about 97% of patients hospitalized for depression were discharged within 30 days.

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But he fit the profile of many Pennsylvanians treated in hospitals for this condition: a white man who was discharged home after his stay.

That’s not to say that Fetterman, a freshman U.S. senator, is a typical patient. The 53-year-old from Braddock, Allegheny County, sought care at Walter Reed National Military Medical Center in Bethesda, Maryland, a premier hospital serving national leaders. By contrast, many in Pennsylvania have to wait months just to see a therapist.

Fetterman’s health has been scrutinized since he suffered a stroke ahead of last spring’s primary election and began sharing information about his long struggle with depression after his hospitalization in February. His office has shared information about his mental health struggles through news releases, which included physician statements noting that his depression is managed with medication and therapy.

“He had great health care and was able to really take the time he needed to do what was right and address his mental health,” said a senior aide to Fetterman, who shared with CBS Sunday Morning that his depression is in remission for the “first time ever.”

Here is what The Inquirer’s analysis showed about how hospital stays for depression usually play out in Pennsylvania.

Who gets admitted for depression?

In 2021, hospitals throughout the state recorded more than 42,000 admissions in which the primary diagnosis was depression. In about 6,000 of those cases, the person was first admitted for another reason, such as having suicidal thoughts, a psychotic episode, or anxiety.

Young adults ages 18 to 39 are the most likely to be admitted for depression — accounting for 40% of hospital admissions statewide. Adult men and women were equally likely to get treated. The exception: Girls under the age of 18 accounted for three out of four of hospitalized youth.

People of color accounted for one in five of these cases.

This roughly matches the demographics of the state.

Men in their 50s, like Fetterman, represented about 6% of admissions.

In announcing his hospitalization, his office shared that Fetterman has struggled with depression throughout his life. This was his first hospitalization. Slightly more than half of admissions in Pennsylvania in 2021 were for reoccurring episodes.

The majority of those hospitalized are having a hard time performing daily living activities, said Brittni Jones, the medical director of the inpatient psychiatric units at Main Line Health’s Bryn Mawr Hospital.

“I’m so depressed or I’m so anxious that I can’t function,” she said patients tell her. “I’m not getting out of the bed to shower. I’m not taking my meds.”

Fetterman’s physician at Walter Reed described his symptoms as “severe.” The senator said that he arrived at the hospital after a period in which he had stopped eating and drinking, which affected his blood pressure.

And although Fetterman said that he didn’t care whether he lived or died, he also told CBS that he did not have thoughts of suicide or self-harm.

How long are people hospitalized for depression?

Length of stay is where Fetterman’s experience differs greatly from that of most Pennsylvania patients.

In 2021, about 3% of hospitalizations for depression lasted for more than 30 days. Fetterman’s stay totaled 44 days.

On average, a hospital admission for depression in Pennsylvania spans 10 days, the state data showed.

Patients who had previous episodes of depression stayed slightly longer. Stays were longer for children under 18 and adults 60 and older — both groups on average were in the hospital for roughly 13 days.

There are many factors that could contribute to length of stay: severity of symptoms, other medical issues that could complicate treatment, or insurance.

Fetterman is also a celebrity patient, a status that often leads to special care and privileges, which could have also contributed to the prolonged stay.

“It shouldn’t be something that only a senator may get,” the senior aide said about Fetterman’s care. “It shouldn’t be something that is a luxury, it should become the norm and that’s something he’s going to fight for.”

What do people do while in the hospital?

Fetterman spent his time at Walter Reed having therapy and learning about depression, while clinicians adjusted the dosage of his medication, a senior aide said. For much of the time, Fetterman met almost daily for an hour with staffers to continue his Senate work.

Working while seeking hospital care for a mental health condition is not routine.

Robert Fine, 61, spent two weeks in the psychiatric unit of Bryn Mawr Hospital in late 2019 for depression and anxiety. He said he felt as if his “brain stopped working.”

To the lawyer from Ardmore, the stay at times felt like camp. Fine spent his days with about 20 other patients. They did group therapy, puzzles, shared meals. He also met with his assigned social worker and psychiatrist.

Overall, Fine was miserable. As visitation hour ended, the doors would lock behind his departing family members.

“If you said to me, ‘Bob, you know, you can go rest for two weeks. You want to rest at a mental health unit?’ I’m like, ‘No, I don’t want to go back there,’” Fine said. “But it definitely served an important purpose in getting me better.”

Where did patients go afterward?

On March 31, Fetterman left Walter Reed and returned to his home in Braddock. That is how roughly 90% of hospital admissions in Pennsylvania ended in 2021.

The end of a hospital stay is often followed by therapy or medication.

Fine, the lawyer, was prescribed medication that made him feel like himself again during his hospital stay. Even though he was ready to leave earlier, he stayed for two weeks, at the encouragement of his wife.

After discharge, he graduated to daily outpatient therapy that lasted multiple hours, five days a week, for two weeks.

Three years later, he is feeling good. He still visits his psychiatrist and takes medications. Fine said that he isn’t embarrassed about the experience.

“As long as you are under the care of a doctor, as long as you’re taking the appropriate medication,” he said, “my disorder can be treated as well as any other disorder.”