Psychiatric Hospitals-The Unwritten Story
Zonenblick, Simon, Contemporary Review
IN the spring of 2003, I began a stint as a Health Support Worker on a psychiatric ward in a large northern city, having spent the best part of the previous three years employed in mental health work around the country. From my first job in mental health, I recall many patients to whom I owe considerable thanks. I worked hard; together we achieved a great deal. I went into the new post having been out of work. Still, knowing the pitfalls of recreating the past, I planned on progressing within weeks or months. In reality, this took a year. And an eventful year it was.
The longest staying patient was a young man called Paul. Friendly and peaceable with me, I never observed him to be particularly unwell, and his doctors agreed. He certainly had been ill, schizophrenia some years back prompting several admissions. Since then he had turned his back on training as a chef, and started using cannabis, making normal life impossible. He had been found wandering his neighbourhood with a crossbow, and his psychiatrist, fearing legal action should he fail to have him sectioned, ensured that, for eleven months, he was kept under section. Transferred to supported housing, he refused to turn down the music in his room, and was sent back to the ward. Loud music would belt out of his stereo even when he left the unit, until we ventured in to turn it off. This loud music, often racially offensive, was obviously discomforting for others. When a man in his sixties, having been admitted just that day for the first time in his life, confronted Paul, he was punched several times, necessitating stitches and a night on a general ward. The next morning he, not his attacker, was transferred to a different ward, not covered by his own team of doctors. Efforts were made to 're-integrate' Paul into 'the community'. He was unwilling to look for alternative accommodation when expected to contribute to the rent. Four properties were found. The first, a bedsit, he refused without giving a reason. The second was too small, the third too big. The last he never bothered going to see. As far as I know, he is still, nearly two years on, in hospital.
One morning, a patient was making his presence known in the smoking room. He was a depressive, and there is no denying he was ill. His negative attitude, however, persisted whether unwell or not. On this occasion he was singling out Pakistanis as his most hated people. I tried to stop this and was sworn at. Minutes later, he thumped me on the eye, stating, 'Speak to me like that again and I'll knock you out, you little bastard'. My request for his transfer was dismissed.
An art student was admitted in the autumn. He was armed with an arsenal of intellectual arguments to justify any behaviour. This included assaulting patients whose tastes in music he disliked, sexually harassing women, and racially abusing various people. On admission the previous Christmas, appealing for discharge, he had ripped a door from its hinges, thrown it across the room at staff and had to be arrested. Yet each time he becomes unwell, or his temper too unbridled to control, he must be admitted to an open ward until an incident of appropriate severity justifies removal to a locked unit.
Innumerable similar incidents occurred. One lad, baseball-capped, puffa-jacketed, dressed in the most expensive clothes, reported the theft of his mobile. I assisted him in completing a claim form, with which he stood to recoup its value. It was then proven he had sold it to another patient. He took to the kitchen, smashing bowls and plates, turning over trolleys and pushing over tables. Next he kicked open the smoking room doors. Chairs were thrown. The tea and coffee jugs were smashed. The walls were punched and kicked. Later that day he stole a cigarette from a woman's mouth, threatening her when she protested. That night the same woman complained about the volume of his music. He lit his lighter in her face and threw a coffee jar at her head. …