This is a story about therapy...
Everybody's an expert on my mental health, it seems. I need to be exercising more, eating a balanced diet, abstaining from alcohol and mind-altering substances BUT not the ones the doctors want to give to me. But which doctors? Every doctor has a different idea of how I should be treated - which doctor should I listen to? Perhaps somebody else knows, because people have some very strong opinions on what I should be doing, considering that only a handful of individuals with whom I am still in contact, have known me for any length of time and have followed along. Only I know what I've tried before and what I haven't - what works and what doesn't.
Here, there's a student nurse whose dissertation investigated the benefits of exercise, in terms of potentiating - that is to say improving - the efficacy of medications. Not considered for a single second, was the control study which would have investigated the efficacy of exercise alone. This student nurse, who I find passionate and intelligent, was eager to suggest that I tried sodium valproate or lithium - both life-shortening medications prescribed to people who have regular episodes of mania where they believe they're Jesus reincarnated etc. Everybody thinks they've got a cure to a problem I might not even have - it was under a very dark cloud that I entered hospital, one must remember.
Externally, the perception of a psychiatric ward is that it must be a place of therapeutic activities and meetings with doctors to fine-tune my medications and cure me of my madness, making me safe to release back into the community again. Internally, my fellow patients perceive staff members as persecutors, jailers and masters of everything from food & drink, to bedtimes and bathtimes - a cross between a policeman, a teacher and a parent. Certainly, to have a blackboard on the wall is an incredibly dated nod to the classroom days of our youth. Note that the list of activities for the ward is completely blank, which I find quite accurate... not that I'm complaining.
The UK's stringent fire regulations for institutional buildings - hospitals, schools etc - mean that they look very similar. A company that manufactures and supplies the fixtures and fittings for a school will probably also supply those same items to a hospital. Everything needs to be built to last in this incredibly abrasive environment, where the footfall in the corridor would destroy even the most hard-wearing of floors, laid by a contractor who normally worked in regular houses. The finish is not just high standard, but the selection of the materials used has been honed over the years to create an interior that is easily mopped and wiped down, and very hard to damage.
As a patient, I find myself recalling my schooldays, as a dinner lady ladles goo onto plastic plates and I sip juice from containers that are identical to those that I had in my boyhood. Just like school, nothing much really happens except for crowd control. There is a little sifting and sorting, so the naughtiest boys end up in the shittest parts of the hospital, and the golden child will find themselves in the top class. However, it must be remembered that staffing a hospital is a job to quite a lot of people, and over the many years that they will work their job, any ill-founded notions of making a difference, will be thrashed out of them by the system. Nothing changes very much or very fast in massive organisations - you can't fight the system, or else you will drive yourself insane... that goes for both patients and staff.
It's very hard to not be driven mad by being hospitalised. It's a chicken and egg situation. For sure, nobody gets hospitalised without putting some effort into it. It's very hard to get a psych bed in the UK, unless somebody's gonna pay £5k/week for you to go into a private place. Of course, the patients here are here for a reason, but I have also experienced the terrifying moment where I realised that my liberty has been restricted. I just heard the jangling of a massive bunch of keys, carried by one of the staff members, as she passed my bedroom door. If I was to draw back my curtains, I would see bars on my window, to stop anybody climbing in or out. There are constant reminders that I'm here under lock & key, and to escape would require a little more social engineering (or climbing) than another secure ward that I was on in 2015, where I could have just walked out behind somebody who was leaving the ward, and then run away. To run away now, I would need to request an escort off hospital premises, and then I would simply get an Uber or perhaps I might have arranged a local cab company to have my getaway car waiting. I came into hospital with £1,150 in crisp £50 notes, so I have the financial means to grease whatever palms I need to.
Why would I want to escape though? Yes, you're right - to discharge myself prematurely would be a mistake. This isn't a very therapeutic environment, because staff spend so long spying - quite literally - on patients, which is absolutely dreadful for mental health: creating an us & them culture and exacerbating even the slightest hint of paranoia. If you value your dignity, privacy and liberty, psych hospital is not for you. There aren't any therapeutic activities. However, it is a safe place where my rent and bills are paid, I get 3 free hot meals a day, I get my own bedroom/office type thing which is quite generously proportioned and has an ensuite bathroom, and I don't need to cook, clean or otherwise worry about the responsibilities that burden nearly every other creature that was unfortunate enough to have been born.
Sounds nice, doesn't it? Perhaps you too would like a stay - mandated for up to 28 days on a section 2 - in the hotel "psych ward". Perhaps you imagine that it's a calm and restful place, where I get to sleep lots and read books. I think perhaps you're getting confused with that holiday you took to Tuscany last year. On a psych ward, you get woken up in the middle of the night by alarms going off, staff running in the corridors, yelling and screaming. On a psych ward, music blasts at top volume from patients' bedrooms, because headphones are not allowed lest we strangle ourselves with the cables. On a psych ward, one must evaluate the level that one's fellow patients are intoxicated by their cocktail of medications, and whether one has the energy to engage in their psychoses that are extremely repetitive - I've been here a week and I've learned a little of everybody's "thing"... their particular identity on the ward, which is characterised by an apparent madness, which is why we must remain here. I wonder what mine is? The staff tell me that I'm lazy - always just sitting with my laptop. Yes, that must be me right? Probably just watching mindless Netflix rubbish on it, right?
Ward rounds - when important decisions about "leave" are made - happen on Fridays and nothing else happens apart from waiting and hoping. Most patients here are hoping to get some leave. Some have not left the ward for nearly 6 months - considered too much at risk of running away, if they were allowed out of this super secure part of the hospital, accompanied by a staff member.
Gossip is rife, and everybody on the ward knows that I arrived with a wad of cash and was granted leave from the hospital almost immediately. I try to downplay these things, and now people have forgotten. When takeaways or shop orders are being placed, I feign not having any money, in the hope that I can alter my perception in the eyes of my fellow patients and the staff. I remember being called into the office, simply because some of the senior staff members wanted to have a look in my envelope, containing all those fifty pound notes. It's totally vulgar, and an accident of the illness that was stimulated into existence by the ridiculous sleep deprivation, stress and disruption to my medications and routine, over Tuesday / Wednesday / Thursday of last week, which followed my near-fatal suicide attempt... it should be expected that my behaviour would have gone a bit haywire, under the crushing pressures I faced.
Perhaps I will be "stepped down" to a less restrictive ward today. I had to pack my bags last night, because I thought I was being moved. I should have remembered that nothing happens very quickly in the National Health Service, but sometimes if you're quick, you can nip in before the system decides that actually you're getting ahead far too fast. I'm not really in a rush to go anywhere though - this ward is perfectly decent and I know the two spots where I can get 3G signal.
I'm here to recover, but I'm not here to feel completely isolated. Who do I know in the local area who can come visit me? Two months ago I'd never set foot in this city, and the company I've been working for has cut all contact and has been skulking around in a most unusual manner. I have nobody - it's a real ball-ache for any of my friends to travel, just for a 2 hour visiting slot. Even my fellow patients, who are locals, do not have visitors - the hospital environment is not exactly somewhere people would like to spend their free time.
Should I immerse myself in the daily rhythms and routines of the hospital? Should I hang around by the door to the kitchen, looking for food scraps to be tossed out? Should I hang around by the door to the yard, hoping to be let outside? I'm not a fucking dog. I find it immensely useful to maintain contact with those who are still in full possession of their marbles, while I'm in an environment where staff humour the patients - "is it Tuesday today?" one asks, and is told that yes it is, even though it isn't... is that useful, helpful, therapeutic?
I was very sick when I was brought in, without a doubt. Some incredibly stressful things still hang over me, like Damocles' sword. I have little power to influence the speed of my recovery, nor the speed with which those who have wronged me are forced to offer recompense. At least I'm in a safe place to pursue what is rightfully mine: to get money that is owed to me and recover my possessions. I'm in a safe place to make arrangements for housing and income, so that I don't fall flat on my face, as soon as I leave.
I'm glad I'm here, at the moment.
