Here’s a great blog about adult mental health wards from one of our London young people…
It must be hard for those who have not experienced it, to imagine what it is like to be forcibly detained against your will. To be confused, alone and absolutely petrified with only a stranger there to talk to, comfort you, and prevent you escaping.
At 19 I was taken, against my will, to an adult mental health unit. I remember vividly walking through the doors, wearing somebody else’s clothes that didn’t quite fit, being ‘lead’ on both side by nurses, and freezing with terror. At that moment, I couldn’t move or speak or think just cry wholeheartedly for everything that I had been through and everything I knew was about to come. I was dragged onto the ward which would be my new home for the foreseeable future.
I didn’t cease crying. I was put in a room with the door propped open by a nurse sitting on a chair, watching – or ‘obs’ as they call it. The other side of the nurse stood a 6’ something, well-built man, clearly suffering from psychosis, staring at me with what appeared to me to be a look of anger. I could feel his eyes on me, watching me crying, hysterical, cowering in the farthest corner of the room. In my head I saw him throwing the nurse out the way with ease and attacking me. I made attempts at getting out of the way of the door, but rule were rules and I had to be within site of the nurse, and of them both.
After a day or two the man no longer stood at the door. I eventually stopped crying. The trauma of the last week kept replaying in my mind on a constant loop. Blood, cries, dreams, re-sus, being naked, a room full of strangers, pain, questions, more dreams. I could hear shouting day and night, prayers to God from a very ill woman on the ward. Eventually I left the room and saw the people I shared a living space with. Everything I saw made me feel unsafe: a smashed T.V, an alarm which periodically went off and caused all the male staff on the ward to go running to some unknown danger, and the other patients all much older 30,40,50-somethings.
One day in the lunch queue a fight broke out between the man who had stared through the door and a new man on the ward. They were on the floor, punching and kicking, people screamed, the alarm went off, ten or so staff turned up and removed both the men. I no longer felt safe enough to eat and went back to my window ledge for another day.
I very quickly found out there was a healthy drugs trade going on between patients in the hospital. ‘Smoking time’ in the courtyard was not just for smoking cigarettes and some of the more compos mentis patients got high in this time – and happily offered it to me as well. Others would go out on their ‘day release’ and come back drunk, stoned and with more illicit supplies.
Often on my cigarette break I was harrangled by men – sexual comments, questions, comments on my appearance – all which made me feel very uncomfortable and unsafe. Men from other wards were allowed by staff to come onto my ward to visit me – without my expressed permission – and offered me drugs, food, and in one case flowers. I felt very disconcerted by this apparent free-for-all.
One day I requested some PRN – the drugs prescribed for ‘as and when’ you need them to take the edge off. My request was denied, for as far as I could tell no real reason – or at least not one that was ever explained to me. Later I walked out of my room to the drugs room, where the door was open wide and the drugs cabinet was also sitting there, open wide. But no one was around. Not in the room, not even anyone visible on the whole ward –despite the fact I was on obs. Another patient walked over and peered in with me. We both moved away from the door, for fear of getting in trouble. But then we returned. Minutes passed, still no one was around. Suddenly, impulsively, I went in and riffled through the drugs – looking only for the drugs I knew would make me feel better – lorazipam, diazepam, zopiclone. I took some blister packets and returned to my room. Still no one appeared.
Later I took all the drugs I had stolen, seeking to numb myself, to sleep, to just not have to think. In my intoxicated state I texted a friend to tell her about my misadventure. Again, I must have passed out and the next thing I remember I was awoken by 2 nurses in my room. I was still completely inebriated, but remember having my pockets searched and questions asked and then being left alone. I woke up the next day and it was as though nothing had happened – except for my amazing night’s sleep.
Some days later, and the next time I had an anxiety attack, a strange doctor from another ward arrives asking me to take a tablet to ‘calm me down’ and I willingly obliged. I remember nothing else but woke up in my bed with a sense that something was seriously not right. The only way to describe the feeling was like someone had literally squeezed every single ounce of energy from my body, like I was dead, like someone had taken my soul, my life source. My muscles felt rigid, stiff like dead weights, my tongue felt swollen and it felt difficult to breathe and swallow. I must have fallen back asleep as I was woken again the next day by the same doctor asking how I was. I asked what I had taken – haloperidol (an old-generation anti-psychotic drug) was the answer.
Over the next few days when my anxiety rose or when I was crying too much for the nurse’s liking I was given haloperidol. The side effect of which were dyskinesia – The muscles in my neck spasmed so that my head was constantly tilted, very uncomfortably, up and to the left, swollen tongue and loss of control of swallowing muscles, and the unrelenting sense that someone had taken the energy out of every cell of my body. After a few days I mentioned to a nurse the fact that my head was actually ‘stuck’ looking up and left and she said it was a side-effect of the medication and promptly gave me another drug to ‘counteract’ the effect.
Then I was moved to a different ward. Here, the other patients were very ill indeed and, having managed to make a couple of friends on the other ward, I was very upset to find that none of the other patients on this ward were able to hold a coherent conversation. I was alone again. The progress I had made in the last month unravelled and I felt utterly defeated.
One day I was asked to speak with two medical students on placement at the hospital. It was the only real conversation I had had in days. They expressed surprise at seeing me on that ward, with people who were as seriously ill and unable to interact. We chatted for hours about everything: my life, my reasons for being there, my feelings, my story. And they came back another day and we spoke for hours again but this time about normal stuff – countries, food, university etc. I finally actually felt someone had seen me as a person, not a patient, listened to me, and had at least tried to understand my fears and pain. Talking to them made me remember what it was like to have normal conversations, with normal people, and it made me yearn for life and normality again on the outside. Soon after I was allowed to leave hospital and flung myself back into everyday life.
Only a long time since leaving hospital have I begun to let myself re-live some of the events of this time and begun to question some of my experiences. Some things now don’t seem quite right – the man allowed to stand at my door, the haloperidol, the cannabis use, the unmanned drugs cabinet, the fact I was never checked-over by a doctor after overdosing, being sent to a different ward which appeared to be inappropriate for me.
Some of these things I conclude are the result of understaffing, mismanagement and even pure negligence. But the main thing I feel is that many of these things would not have occurred had I been on an adolescent ward; there would be no intimidation and sexual harassment from older men, there would have been much closer monitoring of the use of older-generation anti-psychotics, there would be mutual support from other patients and there would almost certainly not be a culture of illicit drug use.
Many who enter the adult mental health ward have done so many times before on a roundabout of admissions and releases, but not me – and probably not any other teenager. Having suffered long term from periods of illness and periods of wellness, I can tell you that when I am ill I do not think, or feel, or behave like and adult, but like a frightened, impulsive, selfish, child. I am no danger to anyone but myself. All I need is for someone to trust in, to listen, to hold me, to tell me I’m going to be ok. For these reasons I think an adult ward is an inappropriate environment for a young person and the option of being somewhere with other young people should be made an option – if one wants it.
Perhaps 12-21 wards are not suitable. Perhaps having 16-21 wards is just not viable given the space and funds available. But there must be some way to protect other vulnerable young people from suffering similar experiences to myself on an adult ward. Rightly so or not, this experience has made me very mistrusting of doctors, nurses and the mental health system. Since then I have had no contact with any of them apart from my GP and I honestly believe that no matter how unwell I am, I’m probably better off that way.