Imagine you are in a situation for months, or even years where you have to ask to take a bath or use a hair dryer, shave your legs or underarms, watched when you take a shower or have a pee or eat.. or ordered to be weighed in your underwear, ask permission to go to the shop or outside..it's days since you've been outside and due to low staffing levels there's a very slim chance you'll get to go out today..
A world where all your basic rights as a person are taken from you, leaving you infantilised and making it very difficult to break free.
Welcome to the psychiatric ward.
Often I had stays in hospital that lasted well over a year and after 20+ admissions I came to see it as my home.. It's quite sad when I think about it now..that girl, dismissed as a diagnosis who was not allowed to make any decisions for herself or have any opinions or say into how or why she was treated.. That girl who saw things in hospital that never should have happened but was powerless to do anything about it, because any complaints were brushed off as delusions or disruptiveness...then dosed up accordingly by yet more medication to make her more compliant..
As time went on, the outside world became a distant place as you became used to the rhythms and routines of the hospital until eventually, the prospect of life outside was unimaginable and terrifying.
You would think I was describing an institution from decades ago, but sadly no..
If you're new to the system, it can be very frightening to see someone attempt to do a runner off the ward, triggering alarm bells and then carted back in a brutal fashion if they are caught, or if they are not caught, brought back to the ward in handcuffs escorted courtesy of Police Scotland. Sometimes though, they never come back and you hear much later on that they are no more..
Sadly these scenes become normal quite quickly..but seeing someone go berserk..being restrained by 4 or 5 members of staff and injected on the spot is traumatising however often it happens and very hard to forget.. Rarely you are given a debrief about what you have just witnessed.
I attempted many a runner in my time and I think even the healthiest and sanest of people would do so if they were cooped up for days on end with no fresh air or exercise, doped up on medication that you knew had a bad effect on you..
What the staff didn't seem to understand was that they got to go home after their shift and chill out with their friends and families or in the great outdoors. We never got to do that. We never got that break we so desperately needed.
Once it all got too much and I was restrained after I turned violent towards a member of staff. I deeply regret it now, but at the time I was like a caged wild animal in Fight or Flight mode...
I was pinned face-down on the floor by 3 or 4 nurses who'd been summoned by alarm bells. Despite the struggle I put up, I couldn't move and it was difficult to breathe.. It was pretty traumatic for everyone involved.
THE LASTING EFFECTS OF INSTITUTIONALISATION.
I am not institutionalised now, but some of the negative effects still echo in me.
- I developed claustrophobia after being restrained all those years ago. If I'm stuck in a crowd I bolt and if I can't, I can end up having a panic attack. Shopping in the city-centre is usually done as soon as the shops are open before it gets busy (or on-line).
- Sometimes I still catch myself saying "Is it okay if I _____?" and getting very odd looks in the process!
- I'm submissive and have a fear of authority. The power doctors have is frightening. They can medicate you, shock you and section you against your will. You have no voice and you get used to all your decisions being made by others.
It's getting a bit better, but I often feel unable to speak out and voice my own opinion or confront someone when I know they are being unfair. Sometimes I have plucked up the courage and it's been okay, but on other occasions my point of view was dismissed immediately because they saw me as "unstable, with mental health issues". (It didn't matter that everyone else in the room felt the same way). It discourages me from speaking out more.
I always make a point of being open about my mental health..I want to open doors, banish stigma and get people educated that I'm not some axe-murderer waiting to strike..that I'm just like everyone else, with thoughts, ideas, opinions and feelings.. Sometimes it's to my cost and is manipulated by people.
It shouldn't be this way, but a person with mental health issues still tends to be treated like a second class citizen...that's my experience anyway..
CLOSURE.
For many years after my last discharge, I couldn't go near the hospital without retching.
Closure came for me when a friend asked me to get involved in collective advocacy at the hospital. The aim was to give patients a voice, heard by people who knew what they were going through, and also to extinguish the "Them and Us" that exists between staff and patients.
It really helped. I was going to the hospital several days a week that had nothing to do with appointments or treatment. I was there working and helping others through my own experiences and I came to see the hospital in a different light..a workplace rather than the home I once had.
I also participated in meetings with doctors and nurses (some of whom had treated me) which was extremely uncomfortable to begin with, but we were all treated as equals and called each other by first names. We were there to do a job and for the first time, my ideas and opinions were taken seriously and my perspective was seen as extremely valuable. It was very liberating!
Eventually I came to see psychiatrists in a different light too. They are just normal human beings who have a very frustrating job with very limited resources. Of course, there are exceptions I've come across who possess what a friend so beautifully calls, a "God Complex" who are not interested in building bridges or really listening to the patient.
During my time on the ward, advocacy was still in its infancy and the ward staff were very suspicious of it. Fast forward a few years and things are so much better. Patients have more of a voice now and it's very reassuring knowing that someone is on your side helping you with things you may not have had the strength or courage to do alone.
The vision for the future is care in the community. These days it's much harder to get admitted to hospital and stays are shorter. There are pros and cons to this which are probably a whole blog post in themselves which I won't go in to right now!
The hope is to eradicate institutionalisation and lengthy hospital stays and keep people functioning in the community and in their own homes.
In principle it's a good idea, but there's a long way to go and many many issues to iron out before I see it working efficiently.
