Tuesday, 16 July 2013

Life in a Mental Hospital

Loony bin, nut house, mental hospital, call it what you will, it’s no pleasure cruise but nor is it as bad as you might think. Most people will probably think of old Victorian buildings, surrounded by high walls in a remote location. Inside; bare, whitewashed stone walls, bars on the windows and drooling patients shuffling around talking to themselves and the odd, manic, scream echoing around the long, featureless corridors. Well, some of that’s true but it’s not the whole story.

You can be admitted to mental hospital in a number of ways.  A full description of the types of admissions and your rights can be found at the MIND website or you can download a PDF Guide but in essence there are two types of admission: Informal or sectioned. Informal means that you have the right to leave the hospital if you wish but you can still be detained if they feel that you may harm yourself or others and sectioned means that you are being detained under the Mental Health Act. Being detained or sectioned does not mean that you have committed a crime, although it could be, the majority of detentions are under a civil section whereby you are detained for assessment and treatment for your own health and safety or for the protection of other people.

So what’s it really like?
On my first ever admission to mental hospital I would be lying if I said that I wasn’t afraid. For me, admission was all a bit of blur. I had been drinking heavily and had only been out of A&E for about a week after an attempted overdose so I was still under the care of the Crises Team. I knew that I was getting into that state again so I called my brother who was at work, some distance away, but still he dropped everything and came to see me. He called the Crises team in and so I found myself surrounded by people telling me that hospital; might be the best thing for me.

Eventually I agreed and was driven the nearest mental hospital. No police this time. When I went in I didn’t even notice the security and it was some time before I realised that I was in a secure hospital. The first difference that you notice between a mental hospital and a general hospital is the security. Any other hospital you are free to come and go as you please but in a mental hospital, even if you are an informal patient (Not under section) you have to ask to go out and you will be quizzed as to where you are going and how long you will be. On your return, you will also be searched for drugs, alcohol or weapons.

 For the first few days I basically hid; partly because of my own mental state and partly because I was convinced that the place was like a prison filled with nutters, which of course it’s not.

On this occasion, I had my own room to hide in, though this is not the case in all hospitals, some still have shared wards or dorms.

The Daily Routine
The routine in all of the hospitals I have been in is pretty much the same: You get woken up around 6.30am – 7.00am then you queue up at the dispensary at 8.00am for your morning medication. Breakfast at 9.00am – Toast and Cereals, Midday medication then lunch – Salad or sandwiches, Dinner at 5.00pm – reasonable hot food, snack at around 9.00pm – more sandwiches, medication again at 10.00pm, and lights out at midnight.

In between those exciting interludes in your day you have the TV lounge or reading to occupy yourself. All of the hospitals I have been in have also had OT (Occupational Therapy) sessions which are basically things to occupy your time like walking, cooking, table tennis and the like. If you smoke then you have the added entertainment of regular smoke breaks. The frequency of these has varied from hospital to hospital but generally once an hour and, if you are informal, you are allowed off the premises to smoke anyway.

The routine is only broken up by a once a week ‘Ward Round’ where a doctor will have a brief discussion with you to assess how you are getting on and ad-hoc ‘one-to-one’ sessions with your designated health care worker if they have the time and, of course other patients ‘kicking off’.

Fellow Patients
To allay anyone’s fears, 99.999% of all patients I have met have been perfectly reasonable and non-violent people. In my various stays in mental hospital I have only ever witnessed one actual act of patient-on-patient violence and frankly the recipient of said violence asked for it.

Of course, everyone there has their own ‘issues’ or they wouldn’t be there in the first place but, if you treat them with respect, they will reciprocate. In fact, I received better counselling from my follow patients than I did from the medical staff. As one patient wrote on the notice board ‘Don’t judge my journey until you’ve walked my path’ or in other words, no one understands a mental patient like a mental patient.

Unfortunately though, some of the stereotypes are true. Some patients do pace the corridor, some do drool because of their medication and you do, from time to time, hear the manic psychotic laugh as portrayed in films. However, catch any of them in the ‘right place’ and you will generally find normal human beings that you can talk to, albeit sometimes the conversation might be a bit ‘off the wall’.

Do be aware though that, even though you may think that you are having a rational conversation, some patients are delusional. I once had a number of conversations with a fellow patient who made so much sense that I started to wonder why an earth she was in hospital. It took a few days for it to dawn on me that she couldn’t possibly be an author, a police forensic expert, a member of the armed forces and own her own pub as well!

Kicking-Off Time
If you lock up a group of people, all of whom are unwell, together and in many cases against their will you will inevitably get tensions boiling over.

When a patient loses control and becomes aggressive, an alarm sounds throughout the hospital and all available health care workers drop what they are doing and rush to scene to calm or restrain the patient involved.

This does happen quite frequently and can be extremely unnerving when you first see it but the aggression is normally just bluster; a lot of shouting, slamming of doors and banging on walls.

The catalyst for these outbursts can be minor such as missing the smoke break or something another patient has inadvertently said. Other times it can be more serious like a patient being told that their section has been extended.

In any event, I found that the best policy was just to sit tight and wait for the staff to deal with it. Normally the patient is just escorted to a quiet place to calm down and minutes later you might be talking to them again quite normally.

Occasionally, if a patient was too agitated or aggressive, they would be locked in a segregation room. No padded cells and straitjackets these days though just a quick jab in arse to calm them down!

I only ever saw one patient that the hospital staff could not control. After a whole night in the seclusion room, screaming abuse, making threats towards staff and smearing excrement on the door window. In the morning, the police were called to remove him to a nearby high security facility.

The Miracle of Modern Medicine
I could be critical of the care that you receive in mental hospital. You are basically detained and fed medication. If you are expecting counselling and psychotherapy, well I never saw it.

But what I did see in many cases was the quite remarkable turnaround in some of the people admitted.

Initially some are very aggressive others are simply on another planet but, as medication starts to take effect, you slowly see a different person emerging. I was the same apparently. As a friend of mine so kindly explains to people about me; “he was a complete mess hwne he first came in”. But, as I got over the alcohol withdrawal and my anti-depressants started to take effect again I began to resemble something like normality again.

In other words, yes, it can be a bit daunting to start with but, as patients tend to say to each other, ‘at least you’re in the right place now’. 

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