During my first depressive episode, I engaged with the NHS only reluctantly. I’d gone to my GP, telling her about the suicidal thoughts I was having. The same day, she got me an appointment with the local mental health team, a few towns away. I arrived, was taken upstairs and practically interrogated by this member of staff, who was trying to determine whether he could let me out of the room or not, whether I was safe enough to be let back into the world. I was unable to convey how I felt and said very little. He let me go. Meanwhile I was begging counsellors to put me in a hospital.
I went again, and waited, trying and failing to read a book for six hours. I was soon whisked upstairs again and I was able to lie and say I was fine. I couldn’t, or wouldn’t, explain myself or my situation. Eventually, I saw a psychiatrist on my eighteenth birthday, who was nice, jovial and funny to boot. He recommended we try some anti-depressants, so that we’d know if they worked before I went to university.
I’d already made up my mind though. I saw these people as an intrusive force, as invasive. I begrudgingly accepted them into my life and now I wanted them out. I didn’t care about the consequences, I was going to act as though I was fine and get a ticket out. I said I was unsure about anti-depressants (this was true) and we made another appointment. I never showed. I’d slipped out of the net and was free, as I saw it then.
Fast forward a year or so and I’m in the same situation again, only now it has increased tenfold. There are no acts to play this time. It just isn’t possible. Eventually I became engaged with local mental health services. My assessor was blunt, down to earth, astute and very cunning. She recommended I stay out of hospital if I could. She warned me though, that if I didn’t show for an appointment she’d call the police. I nodded and left.
Fast forward a week or so and I’m too depressed and drunk to care about missing an appointment. Soon enough, there’s a knock on my door. It’s campus security, my assessor and an assistant. We weigh up our options. They suggest the crisis team, who would visit me every day. I wanted to avoid it, having flashbacks of the ominous, invasive force I had engaged with before. And I knew how prone to miscommunication the crisis team were. Reluctantly, I agreed.
Of the things that my depressed brain was able to predict accurately it was the miscommunication. Ideally, someone would come in who was already aware of your situation, you’d debrief them on how you felt that day and they would act accordingly. Of course, this wasn’t the case. Asking a depressed person who can’t shower or get out of bed or think even remotely clearly to explain themselves and the situation they are in is an absurd demand. It’s the equivalent of asking someone who had just broken their arm to do a handstand.
For me, being presented with a force that saw me every day, who had faults of their own, caused my faith in them to die a gruesome death. I had no faith in them and they knew it. Toward the end I just said what they wanted to get rid of them.
We need to go now, I said to my flatmate, slightly drunkenly. I was sure I was going to kill myself, and took what in my mind was the last resort. A&E. We took an expensive, extortionate taxi. I walked in to the waiting room and said that I was a danger to myself. Take a seat, the receptionist said. After waiting for an hour or so (a good time for an A&E) I was taken through to the hospital. I had two options, the assessor explained. No psychiatrists worked on the weekends, so I could either stay overnight and see someone in the morning, or come back of my own accord tomorrow morning. Knowing that in all likelihood I’d kill myself, I chose to stay the night.
I was given a small room and I was tired and try to sleep, pulling the thin sheet over me. Every now and again a nurse would ask me how I was feeling. I just said that I was fine but tired. The next morning I was assessed, and promptly sent packing with some leaflets on depression. I was back out in the world, and I hated it. I thought I’d made a good choice, that I would get the help I needed if I went to A&E. Evidently this wasn’t the case and I felt worse.
If someone needs a new heart, then they are put on a waiting list. The same is true of suffering from mental illness. However someone who is suicidally depressed cannot wait days. It may sound like nothing but it is everything. Days mean years. When you’re told that you’ll be seen in a few days, you may as well be told that you’ll be seen when you’re dead.
Eventually I saw the crisis team’s psychiatrist. This guy, to say the least, was a fucking asshole. I’d waited weeks to see this guy. For once I spoke as best I could about my situation and what was happening to me. Everything I said to him simply went in one ear and out of the other. He just didn’t listen to me at all. He ended the meeting abruptly, as though my very existence had annoyed him. He said that I didn’t need to see the crisis team every day, that there was absolutely nothing they could do to help me, and that I was fine. To say I was seething would be an understatement. Disheartened by this I got drunk and more hopeless. The only system that could have saved me had failed me spectacularly. Amidst all this and my worsening mental state I attempted suicide multiple times.
With each failed attempt, my despair grew like a tumour. Fast forward some weeks and I caused a scene at a university bar. Campus security show up and escort me off the premises. I start to panic and scream, that I was fine and needed no help. I have no memory of what happens next, but doctor’s notes don’t tend to lie. I expressed an intent to harm myself and the police were called.
Once I saw them I well and truly entered panic mode. I had to find a way out, a way of clearing up the misunderstanding we were all unwittingly embroiled in. After withstanding my drunken ravings I was detained under Section 136 of the Mental Health Act. I was being taken somewhere where I would receive treatment, they said. For once, I believed them. As I was put in the back of their car I felt a mix of shame at being treated like a common criminal, as though I’d done something wrong, and relief, now I didn’t have to drive and my fate was out of my hands. We arrived at Suite 136, and I was detained, pending an assessment.
I was lead to a room with four white walls, a bathroom, a chair, a bed and a camera that followed my every movement. Once the police officers had left, it was made clear that I couldn’t leave the suite until I had been assessed. Nobody had mentioned this to me and I felt betrayed. I was livid.
The nurses spoke to me, if at all, only reluctantly. It felt as though I was talking to my jailors. My belongings were taken away, swiftly and without question. When I asked for my phone, the staff said that I couldn’t have it due to it having a lens. I asked them to justify the reason. I got no response. When I was talking to the morning staff they told me that I should’ve had my phone, that there was no reason for me not to have it. Great, I thought, I’m in the charge of these people. There was nothing to do, and there was no timeline for when I would be assessed, as only two psychiatrists were operating in the county on the weekend. Great.
In the meantime, I was given a drugs test. I would test positive for alcohol and that would be all, this I knew as an absolute certainty. The results had come back. “He’s testing positive for cocaine, cannabis…” I overheard a doctor saying. The list went on. How could this be? Was I so drunk that I’d done these drugs? The thought was too unpleasing and worrisome to brood on. “Wait no, I think this stripe means positive and that one negative?” I hear the nurses say. Great, I think, I’m in the charge of these people and they can’t even read a drugs test. Fan-fucking-tastic. As I expected, I tested positive for alcohol but negative on all other counts.
When the day for assessment came, after a few days of virtually complete isolation, (always a good thing for a depressive, obviously), the time for my assessment came. And who should walk in but the very same guy who told me he couldn’t help me. Steam was coming out of my ears, I didn’t want him assessing me, I want him out I screamed. After much deliberation he was ejected. Shortly thereafter I was told that I should go into hospital. But the decision was ultimately up to me, I wasn’t being sectioned. I said yes.
It couldn’t be said where I’d end up, as there was a bed shortage and no beds were available in my area. I could end up anywhere in England, and I was scared. After hours of searching for a bed, one had been found, in Brighton, a few hours away. The staff told me the name of the hospital and I googled it. It looked good, but I was suspicious. Yet I felt relief. I’d no longer be under detainment.
Full disclosure: the establishment I was in was a private hospital, with an NHS run program. I was extraordinarily lucky to get this, and I know that. This isn’t to say, however, that it was perfect.
I arrived after midnight. I was given a tour, got a tea and went to bed. I detoxed from alcohol, and remember nothing of my first week there. Our timetable consisted of CBT Sessions, Tai Chi, and occasionally yoga. We were under no obligation to attend and if we did attend or not depended on how we felt on the day. I saw my consultant once or twice a week, usually in the morning. However it could never be said when he would appear, or how long the appointment would be. We switched medications innumerable times, and I still felt depressed and actively suicidal. After weeks of different medication cocktails, apathy, and on and off suicidality my outlook got more positive, but only fleetingly and very, very slowly.
The people I was with became my family, and that would be underselling it. To give you an idea, I came in with no clothes to speak of, just the clothes on my back. I couldn’t go out to buy new clothes as I didn’t have any leave yet. Needless to say, I reeked. Knowing my situation, everyone banded together and gave me any spare clothes they had. I was practically with family.
I only snapped once when I was in Brighton. I’d been there for a few weeks, and was still deeply depressed and anxious. I felt like the CBT wasn’t helping. My last stand was a failure and I would die, this I knew. The days were sticking to me like mud.
I was presented with a theory called Maslov’s theory of the self. I ripped it apart, arguing how nonsensical it was with the therapist. A fellow patient began to argue with me. The failing treatment and the doctors asking me to take a blind leap of faith in order to get well made me implode. I shouted fuck this and walked out. I hear the therapist shout my name and that I don’t have to leave as I walk out of the door.
Minutes later, one of the therapists is in my room. I’m so angry I can’t move. I was angry at myself for being so critical of CBT, not being receptive, and angry at everyone else for letting me flounder and die before their eyes. If I do move, the movement is shaky, a jerk that I’m unable to stop. She’s telling me that I must adopt what works for me, it doesn’t matter about theories. But I don’t care.
Suddenly my key nurse is in the room, handing me a brown pill which I’d only been on for a few days. I swallow it, as any state is better than the rage that is consuming my every cell. I hold slurred conversation with the nurse, talking about Van Gogh, telling her that he painted Starry Night from his asylum window. I always found comfort in that story. She eventually left and I slept for hours on end. When I awaken I’m not sure what time it is, and I’m unsure of if I can face the hospital staff again.
Days later, this episode is brought up again. I had scared staff, they said. I had to be sedated. What they left out was that I chose to be sedated, it wasn’t forced. Yet the damage was done, apparently. My key nurse is talking to me as I sip my decaf coffee. She says that if I continue to be a problem they could always call the NHS and recall me. They have that power. She used scare tactics to terrify a mentally ill young person. Draconian images of psychiatric hospitals of the past flash by my brain, and I wonder if we’ve really come as far as we like to think we have. Evidently if you’re a psychiatric patient you aren’t allowed to show human emotions such as anger, as they can be written off as symptoms to the right eyes. Symptoms are in the eye of the beholder.
The nurse seeing me also mentioned something that irked me. That I would never receive care like this again, care that was this good. I felt guilty for not being receptive to it and blame turned inward. I still felt awful, and I felt worse that I couldn’t ‘appreciate’ the care being given to me on a silver platter. I was lucky, everyone kept saying, and I knew it. Most NHS patients were only there for a few days or a few weeks at best. I ended up being there for just over a month.
After a month, I’d let the anxiety that ruled over me in regard to being recalled drift to the back of my mind. I simply tried not to think about it too much. One evening though, the time had come. With the treatment unfinished and the medication still being tampered with and altered, I was being recalled. The NHS transport would be there within an hour. I had an hour to say goodbye to the people who had become more than family to me, and an hour to pack my stuff. It was at times like this that it became readily apparent that what my treatment came down to was a business transaction. Crying and hysterical, I reluctantly left.
I was now Patient B14A.
Again, I arrived after midnight to a hospital in my area. If no beds had been available in the month I was away, if I had to wait for this bed to be available I would be dead. Of this I had no doubt. As soon as I arrived I knew the game had changed dramatically. In the previous hospital, we were all basically of the same temperament, and thus there was little to no commotion. Here, however, the depressives were merely lumped with the violent and volatile patients. I knew the waters had changed, and not for the better. As I was being admitted one of the more violent patients approached me and my admitting nurse, started conversation. He was promptly told to fuck off by my admitting nurse.
If I hadn’t have done a majority of the work in the previous hospital, I never would have recovered in this environment. You had to be on your guard all the time, due to the violent and volatile nature of the ward. You can’t get well if you can’t even relax. This was a concern voiced to me by many patients who were under section. How am I supposed to get well with all this going on? I understood what they meant.
Therapy was due to happen every day. In the entire time I was there it happened once, and even then it was only art therapy. Days were spent idly, with many staring at the encased television. I couldn’t wait to leave.
When I imagined life from the sectioned patient’s point of view, I felt for them. It seemed as though they were trapped in an Orwellian nightmare. A nightmare of bureaucracy and tribunals, where they had little to no power. A world where if they could be given leave or not had to be decided by a consultant that rarely appeared and if they did, they did so unannounced and abruptly. Their lives were made of these sorts of two steps forward one step back suppositions.
I was being given weekend leave, then I would be discharged. I enjoyed the leave, and I was happy to be back in the ‘real’ world again. It was a world I enjoyed yet wasn’t at ease with. Not yet. I walked back reluctantly to the hospital, ready for discharge. I arrived, waited all day, and was finally discharged. Something that should’ve taken half an hour took a day. This was the hospitals way. Full of minute frustration which is as absurd as it is valid.
When I was discharged, I ran home. I was free and my life wasn’t going to be governed by observation levels, visiting hours and consultants anymore. I was free. However, many were not so lucky and I couldn’t forget it.
I hated One Flew Over The Cuckoo’s Nest. I saw it as a damaging piece of work, one that forever altered the perception of psychiatric hospitals, created fear and thus stopped people getting treatment. However, given my experiences, I’m now not so sure, and that’s deeply unsettling.
Ultimately, I think the principal part of the Hippocratic oath that all doctors swear was broken in my time in hospital – do no harm. I think, more often than not, that more harm was done than good. It seemed as though for every good experience or nice member of staff you got three bad ones. It doesn’t take a genius to see that CAMHS is overstretched, and doing what little it can. However, this simply isn’t good enough.
The system is failing young people and spitting them out as though they are canon fodder. People are being told to wait three months or more for therapy yet cannot last through the day. More must be done. What would I rather happen, I hear you ask. The answer is I’m not sure. But more must be done. More must be done, of this I have no doubt. More must be done. The picture looks bleak, money is being pledged to mental health services with little observable improvement, Natasha Devon’s axing. I could go on. Young people who are scared are being failed by the system. More must be done.