
I wake up, my hazy brain unable to comprehend how I have ended up here. The nurse doggedly insists that I get out of bed, as the sunlight searing through the barred windows taunts me. I ram my thumb in between my shoulder blades, in a futile attempt to iron out the creases my muscles cling on to. The mattress is cold and hard, the room uniformly clinical, as the âGet Well Soonâ card perches patronizingly on the windowsill. I wander in a drunken daze of dissociation through the corridors, painted a stark white that hurts my eyes. The nurse escorts me, swooping around me, like a hawk stalking its prey.
Anti-psychotics, PRN, Anti-depressants, mood stabilizers, sleeping pills, pumping into me, all dispensed from a hatch, which I nicknamed âthe barâ, whilst taking great pleasure in pretending my meds cup was a shot of tequila (much to the nurses annoyance). You would be made to stick your tongue out, to ensure you had actually ingested the medication they so desperately wanted to numb you with.
Sadly, medication is a cheap, handy solution to the staff shortages in inpatient wards. I would drag my semi-lifeless body around the ward, those devious little cylinders of chemicals morphing me into a pale-faced, compliant zombie. These handfuls of drugged-up patients gave the staff some respite. When someone is so sedated, they havenât the energy, physical or mental to act out. It was far easier for the staff to manage the ward, chemically restraining patients, knowing that dispensing more meds equated to less incidents.
The country faces what amounts to an epidemic of behavioural mental health malpractice that has destroyed the lives of countless over drugged patients; children, seniors, veterans, yet no powerful advocacy body is seriously addressing it.
If I refused my medication, I would be reprimanded through having my visitation rights changed, my home leave taken away, and my section renewed. However, if I complied and took my medication, I would be met with a feeling of sheer emptiness, devoid of all human emotion- my vacant, ghostlike gaze signifying the oblivion I found myself in. As cliché as it sounds, I would rather feel something, than nothing.
This place was no healing sanctuary, no oasis of refuge for the soul. I recall noticing the bittersweet irony, that the environment created to help the most mentally vulnerable was one of terror, alienation and despair.
As this particular hospital admission was at a medium secure unit, the ward was locked. We were not allowed to go outside, except brief, supervised visits to the courtyard, barbed wire lazily hanging over the tops of the walls, singlehandedly crushing my plans of escape. No phones, no computers, one ward phone where you had to have phone numbers pre-approved by a social worker. I recall a situation where I couldnât call my boyfriend as his number had not been approved, so I called my sister on her home phone, she called my boyfriend on her mobile, and sat for twenty minutes pressing her mobile to the home phone so I could talk to him.
At one point early on in my admission, my mental health deteriorated quite rapidly (which isnât surprising considering the chaotic surroundings). Two staff picked me up and essentially dragged me to a seclusion room, equipped with only a thin, hard mattress on the floor, and a hatch to be passed food and water through. After what felt like the longest hour of my life, I was taken back to my room, and put on 1 to 1, constant supervision. A nurse watches you sleep, she watches you get dressed, she watches you shower, she watches you go to the toilet. A necessity to keep you safe? Perhaps. A degrading experience, stripping you of your last shreds of dignity? Absolutely.
Worryingly, after liaising with other patients later that month, I discovered that my brief time in seclusion was uneventful in comparison.
A girl with learning difficulties described to me how she was hauled through the corridors to the seclusion room, her arm tightly wrapped around her back, pinned to the ground and forcibly medicated via injection. She was stripped of all clothes (the reason being, apparently, she could form a ligature with her trousers) and left in a locked room for hours, as staff watched on through a small, wire-glass window.
Contact with the outside world was sparse, particularly in the first few weeks of this admission. Visits took place in a separate room off the ward, with supervision from at least one member of staff. I cannot begin to coherently articulate how awkward it is to express emotions at this time in public view. I felt like a caged animal in a zoo, merely a spectator attraction. Hugs felt manufactured and uncomfortable, and the compassion I so ravenously craved became twisted into a voyeuristic display, the staffs piercing eyes darting back and forth as they furiously scribbled notes on how I appeared to act with my family.
The difficulty in hospital was not only staff shortages & lack of resources, but a wide range of cases & complex needs. During my admission, 40% of the patients were on remand from prison, meaning they had committed a crime, but were mentally ill so would serve their sentence in hospital instead. In order to prevent the ward from crumbling into disarray, the staff relied highly on a military style regime, which although at the time I was thankful for, with the benefit of hindsight, I can see how it contributes to individuals becoming institutionalized.
Wake up, shower, get dressed, take meds, breakfast, wait (whilst the plastic cutlery is counted back in), education, lunch, group therapy, snack, keyworker meetings, room time (enforced time spent in your room), dinner, take meds, lights out, sleep. Repeat the next day.
In many ways, the regimented structure the hospital gave me was a silver lining, however, upon being discharged I found myself wandering this plane of existence with very little idea as to how to live. Although the hospital served its purpose in many ways, I could see how so many people end up in wards for years on end. You become institutionalized, strangely comfortable with the discomfort of being confined to one building. I tasted curiosity, yearning to reconnect with the world outside of hospital, but poorly equipped, with none of the tools to cope in a world full of uncertainty.
There is no dictionary definition of a locked rehabilitation/psychiatric ward, but it generally means a unit where patients are unable to leave, treating people who are considered high risk to others and themselves.
There are very few conversations Iâve had that I genuinely consider to be life changing, however, there is one that has prevailed. Around a month into this admission, I had a meeting with my primary nurse. She told me, that on average, patients stayed at this hospital for 2 years, and usually werenât discharged straight back into the community. She (off the record) spoke to me about the way long term hospital treatment makes you, how it drains you of energy, and steals your zest for life. She urged me not to be another statistic, and that if I complied in being pumped full of alleviants and jumped through the psychiatrists impossibly high hoops, I could be out in 6 months. And sure enough, 5 months passed, and I boldly stood up in front of a tribunal to appeal my section and was deemed sane enough to return home (by a psychiatrist I still think is more nuts than most).
Hospital is not the only answer. Many return home after hospitalizations demoralized and despondent. Being in a secure unit, at times, I was made to feel like a criminal being punished, a danger to society, who should be locked up and shackled to the end of a bed. By no means am I implying this is the same with every hospital, or that this hospital did not help me at all, however, to anyone thinking inpatient treatment is the better option, it may well not be. As a society we need to focus on turning psychiatric hospitalization into a constructive experience towards recovery; and shaping hospitals into places that give you care and support, as opposed to seclusion and sedation. I am forever grateful to my primary nurse for planting the seed, that my fellow patients and I, struggling though we were, could get better, and go on to live a full and fruitful existence.
And so I fast forward to 2018, and I sense you, uninvited, slipping through the decrepit side door of my consciousness. I find myself once more sitting on a hospital bed, when in fact I should be sitting at my desk, writing essays and preparing for my end of year exams; feeling foolish for cradling the fickle belief that I wouldnât end up here again. In these moments, itâs easy to feel like a failure due to the unrelenting nature of mental illness. I ask a nurse for a pen and begin to write- words spilling carelessly onto the page, the paper acting as a safe haven for the deepest, visceral feelings. Soul to pen to paper.