Content warning: descriptions of restrictive interventions

 

I have lived with mental illness for the past thirteen years and have been admitted onto acute mental health wards five times in total. I have also been a resident at a rehabilitation unit for almost two years.

Many people have an idea of psychiatric units as being chaotic places full of unpredictable people with Hollywood portrayals of mental health illness reinforcing these stereotypes. Movies such as 'One Flew Over The Cuckoo’s Nest' bolster this idea that patients are always forced to take medication and are rendered powerless, foaming at the mouth and restrained by strait jackets. Fortunately, strait jackets are not used in the UK but they are still used in America.

"Doctors shouldn’t have god-like power over people who are unwell".

The truth is that mental health wards can actually be quite bright and cheerful. Granted, medication like anti-psychotics can have side effects including lethargy or tiredness, but there are many amazing and inspirational staff and patients on mental health wards. I have met an ex- professor and someone who used to earn £28,000 a week before becoming homeless.

First time being sectioned

It is true that there are elements of truth in these misconceptions. As someone who has been sectioned [detained in hospital] a number of times including being forced to stay in hospital for up to a year at a time, I have experienced powerlessness and a lack of control over my life.

The first time I was placed on a section was easily the most stressful time in my whole life. I actually became more ill due to being sectioned and forced to live a restricted life.

After being sectioned I kept trying to abscond from the ward. I clearly remember running down the hospital corridor at full speed with five or six members of staff chasing me.

I can look back at these difficult times now and appreciate the duty of care that staff abide by. My first experience of being on an acute mental health ward was anxiety inducing as the doors were locked, so as a first time patient I felt imprisoned and claustrophobic.

That is the worst part, having to come to terms with your freedom being taken away. When I heard doors being slammed shut it caused me psychological distress and increased my delusions.

Restraint

It was in this state of psychosis that I was forcibly injected for the first time.

I was paranoid and hostile and tried to grab a male nurse. The alarm was pressed and about eight members of staff came running from every direction and restrained me.  I was injected and fell asleep within minutes. I was told by another patient that I slept for about sixteen hours.

Being restrained and injected was a humiliating experience but I understand why staff did it. They did this without hurting me but it was a difficult and shocking experience. They had to consider my safety and the safety of other patients and staff. 

"It was apparent that the PICU wasn’t designed for comfort"

If the acute ward was difficult then the Psychiatric Intensive Care Unit (PICU) was worse.

It was apparent that the PICU wasn’t designed for comfort - the first thing I noticed was how cold it was. The walls were plain and there wasn’t much colour. There were ten rooms with en-suit showers and toilets. There were no duvets, patients just had a blanket.

On my first admission, smoking was still allowed on mental health wards. I started smoking due to severe stress and anxiety, something I regret as I am still struggling to quit thirteen years later.

I saw a staff member being spat at and threatened. The staff on the unit were amazing and patient. After facing stress and abuse every day they would come back into work the next day with a smile and a cheerful attitude. Although patients are very ill and can be difficult, they are treated firmly but with respect.

I met Big M, who was about 6’6" tall and was always joking around. He used to work on the night shift and study during the day, eventually qualifying as a nurse. I also befriended D, a nineteen year old ex car thief; he walked around boisterously and acted as if he was the manager of the ward.

A dull environment

My time on the unit was difficult as leave wasn’t granted at all. I spent a number of months without going out which was very hard. Everything was locked and TVs were in cabinets so they couldn’t be smashed. Things have changed at PICUs over the past decade and now there is access to the garden and leave is granted once a patient is deemed ready.

My time at the PICU was dull and boring as there were no activities whatsoever. I was told that the unit was a low stimulus environment so there wasn’t much going on. We would mainly sit on the sofas for hours or watch television. I would wake up early and go to sleep as soon as I had my medication at night.

Taking medication everyday was new to me and was hard to adjust to. I understand the important of medication as I have relapsed due to stopping it and ended up back in hospital.

What needs to change

From my experience I believe that there should be more activities on mental health units as inactivity leads to rumination and negative thoughts. Vocational and educational courses should be offered. I found playing chess to be very therapeutic and reading too, when I managed to concentrate.

Patients should be strongly encouraged to exercise even if it is doing ten press-ups a day. As a result of gaining weight after taking anti- psychotic medication and not exercising I developed diabetes.

Doctors shouldn’t have god-like power over people who are unwell; patients should have more of a say in how they are treated. I have found work with a psychology team to be very effective in helping to manage voices and I have learnt useful management techniques such as mindfulness and other tools within compassion focused therapy.

Whilst my first admission was quite traumatic and is seared in my memory, later admissions weren’t as stressful as I was familiar with the process. I have met many amazing people on my thirteen year journey and now want to work in the mental health system one day supporting people through difficult times.