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Anne Marie Brian
Mental Health-The Reality


It was a student doctor, not much older than twenty, who told me I had schizophrenia. She liked to prowl around the ward jangling her keys and looking important yet casual in a dress and a jean jacket. I looked from her to my consultant psychiatrist, Dr Bottomley. I wanted him to say she was wrong, but he nodded gravely in agreement.

"You have heard voices, haven't you?" She had been asking me this question almost daily, every time she saw me on the ward, every time she was in the "ward round" with Dr Bottomley. I was desperate to please these people, who had the power to tell me I could go home. So in the end, even though in my whole life I have never heard voices in my head, I said that I had.

I was also asked if I had been "high" when I was at University, in the run up to being admitted to hospital. I thought she meant high on drugs, so I said "absolutely not". She meant "high" as in an upward mood swing as part of a manic depressive illness, but this was not explained to me. I was a complete lay person where mental health diagnoses were concerned. All I knew was that I had had a "psychotic episode". I knew what one of those was. It was the new (to me) name for being mad. I had been mad as a hatter for about a month and before that, at College, I was actually high as a kite. At the end of the Christmas term, I wrote four essays at once, scribbling ideas down on post-it notes which were stuck all over one wall of my room in student digs. I like to think they were brilliant essays, but I shall never know, because they were never marked.

I did not know that my answers to these two questions, whether I had ever heard voices, and whether I had been "high", were so crucial to finding my diagnosis and would determine the rest of my treatment. I was doing OK on stellazine, I had realised what had happened to me and I was co-operating. But my consultant decided to put me on weekly injections of Modecate. This is a very heavy medication and quite the wrong thing to have given me. It is given in depot injections which are administered in the buttock. I had my first injection of modecate on my 30th birthday. The student nurse who gave me the injection also gave me a birthday card. No doubt she thought that she was doing the right thing, but I rapidly went downhill on this medication. I started to get a terrible restless feeling inside me, and the only thing which would get rid of it was more tranquilisers, which I used to follow the nurses around begging them to let me have. I was a walking zombie, a shell of my former self, and I grieved deeply for the lively, intelligent, fun-loving person I used to be. The modecate made me stiffen up, even though I had side-effect medication, and one of my hands became contorted, and my eyes were wide and starey. I hated to look in the mirror.

What the staff did not seem to grasp was that it was their hospital which made me display schizophrenic-type symptoms. It is stressful being locked in a ward with thirty other people with mental illness. They say mad things to you and you say mad things to them, and everyone’s madness feeds everyone else's. And if a psychiatric nurse feels like it he or she can totally crush a person with a cruel word. A young male nurse I knew, used to delight in thinking up ways to torment me. He told me he had something to show me, and he took me into a room where there was a painting on the wall where a staircase went around and around without actually getting anywhere because it just took your eye back to the beginning again. He looked at me wryly and said "This painting is rather like your predicament, wouldn't you say, Anne?"

I was also pursued by manic men who would ask "Are you on a lot of chlorpromazine?" in the hopes of a quick shag in the men's loos. I do not think that wards should be mixed, but they do it because the presence of women on the ward tends to make the men easier to handle. It never happened to me, but I know of two occasions where a vulnerable female patient on medication had sex on the ward when they were not in a fit state to consent or otherwise. One of these incidents happened when the young girl had just arrived that day, was completely insane, and, incredibly, was supposed to be on "ten minute observations", ie being checked on every ten minutes because she was so ill.

I had resisted medication and tried to escape, so my voluntary status was taken away soon after my admission to hospital. I was then held under section 7 of the Mental Health Act. This meant that I could be put into an arm lock on either side by two nurses, marched down to my bed, held down with my face in the pillow while my jeans were ripped off, and I was injected in the buttock with medication which knocked me out for hours. To this day I do not know what it is they inject you with in a forced injection, I have never been told, it is not discussed. The doctors think that this forced injection helps people to get well, but what it actually did for me was to make me realise exactly what I was up against. From that moment I became entirely co-operative because I did not want to go through that experience more than once..

The first time I met my consultant psychiatrist, Dr Bottomley, he came to my parent's house where I was staying, because I had taken most of my clothes off and ran five miles or so across country and ended up at a pub where the landlord called the police so I was locked in a police cell for hours because I was too scared to tell them my name. My parents had reported me missing and eventually my description came through on the fax machine of the police station and the duty sergeant phoned my Dad, who came to collect me. A close friend of mine came to the house and he said "the next person who comes to the house, you can trust". He wrote this down on a piece of paper and I lay on my bed for a long time looking at the piece of paper and waiting for the person to come. That person was Dr Bottomley. I agreed to go into hospital, and this made me a voluntary patient. The ambulance collected me later in the evening. I chatted happily with the ambulance men all the way to the hospital, because I was going in and out of madness, it was not a constant thing. My sister has actually talked me out of a psychosis before, just by saying the right things and by being someone I know I can trust. When I was booked in at the hospital, the nurse seemed OK and I spoke to her calmly and lucidly and told her all of my details. But she disappeared without telling me she was going, as it was the end of her shift. This made me panic, and I was too scared to take the medication I was offered, because it was offered to me by a nurse who looked really weird, she had a cast in one eye and her face was very ugly, not her fault of course but she really scared me. I said to her "please don't kill me", and rather than attempting to reassure me that she had no intention of killing me whatsoever and that the tablet was just something to help me sleep, she turned to her colleague and said "It's time for me fag break" and left the room. I swallowed the tablet she had left me holding in my hand, with a mouthful of water in a tiny plastic cup, but then I thought better of it incase it was poisonous and I went down to the loos to try to sick it up by putting my fingers down my throat. A kind word from a ,nurse would have made such a difference to the way I felt. There was no sign of Dr Bottomley, the man I thought I could trust, only these two nurses, one who looked like a criminal capable of murder and the other who was Dutch and liked to knit, and would put her knitting down with a sigh if she had to actually get up and look after someone. Night nurses on psychiatric wards like to sleep if they possibly can. They get quite angry if they are disturbed in the beds they make out of armchairs with their nurses capes for blankets. So if a patient is unable to sleep, they are offered double or quadruple the prescribed amount of sleeping medication. I sometimes used to lie awake all night in bed rather than disturb them, because I knew they would insist on more medication being taken. They were not even happy for you to sit quietly somewhere, you had to be in bed.

I had been in hospital for a few days when they told me that Dr Bottomley wanted to see me in another part of the hospital. I was still holding on to the fact that this was a person I could trust, so I went along, escorted by a nurse. When I entered the room, I saw to my dismay that it was a lecture theatre full of students, and Dr Bottomley was addressing the crowd. He asked me some questions, to which I gave suitably psychotic answers. Some of the students laughed and I felt totally humiliated. I think the intention was to present me as a mad person and then present me again in a few weeks when I had been cured with medication. But the next time I was summoned, I refused to go.

I saw so many occasions when patients were humiliated, but the one which will stay in my memory for ever is overhearing a nurse tell Henry that he was "disgusting", just because he staggered, drugged-up, to the medication queue in his pyjamas and the bottoms fell down. The only person who cared about Henry was his mother, and she had recently died. The next day, Henry took his own life. There was an inquest and I am sure that nurse was never held to account. I saw the same nurse baracade an elderly lady into a room because she was playing up a bit and refusing to go to bed. The lady wanted to leave the room to go to the toilet and in the end, inevitably, she wet herself. I jumped over the baracade and I held her in my arms and she wept, and I wept too, because she said she wanted to go home and I did too.

There was one male night nurse who was dedicated and kind. I remember him sitting by me for most of the night once, when I said to him that I felt as though my blood was on fire. That is what it feels like when your nervous system breaks down, because your nerves are in every part of your body, and they actually hurt in a physical way. Even this night nurse seemed different when I met him years later, on the same ward. He seemed to have lost his enthusiasm and interest in the patients, as if he was tired of it all and just looking forward to his retirement.

The medication given routinely on the ward causes a person's mouth and lips to be numb, so they cannot tell if food or drink is too hot. And yet, scalding hot puddings with custard are served up, and patients are encouraged to drink scalding hot chocolate if they can't sleep. Medication also causes a dry mouth, and yet I have known the kitchen to be off limits from six in the evening until seven the next morning. It was only when some visitors complained that the situation was rectified.

When you are an in-patient, if you are co-operating and you have somewhere to go, you can go on "home leave" at the weekends, and the length of time at home is gradually made longer, until you are discharged completely. The effect of this on me was to make "home" seem like a fantastic place. I would take with me my TTOs (to take outs) of medication, just enough for the time away, and my parents and all my family were so nice to me, and things like being able to use a clean ashtray, and an ordinary bath instead of the huge Victorian baths at the hospital, seemed fantastic. It became a goal to get home again. I thought that when I was discharged, it would be like home leave but a hundred times better because it would go on forever. The reality was nothing like this. I left hospital heavily sedated on modecate, and I had to have injections of this at home once a fortnight, administered by a male CPN. He did not tell me that it was not necessary for me to completely strip off the bottom half of my clothing and lie face down on the bed to have these injections. I did this because it had been the way the nurses did it in the hospital. It was only later on, when I had the injections at an out-patient clinic, that I realised I could have simply remained standing and exposed a small area of my upper buttock, for the depot injection to be given. There is something very demeaning about having medication in this way. My consultant said that you could have lower doses than with medication in a tablet, so it was better, and because I wanted to appear co-operative, I agreed to have medication this way.

At home I was also extremely lonely. There is nothing quite like a mental illness for making all of your friends scatter. My best friend in particular would never leave me alone with her young son, and she said that my starey eyes and contorted hand was scaring him. I was so hurt, I had to stop seeing her, and she said later that when I lost touch with her it was "a relief". When I was in hospital, I let go of someone I loved, James, the special friend who had told me I could trust Dr Bottomley. I knew that James would be happier without me, because of me having an illness, so I told him to stop visiting me in hospital. I must have been crazy to do this! Yes, I was, and I have been crazy lots of times since, but one thing I have never been is dangerous to children or to anyone else. I wish that people would realise that about mental illness, people who suffer are far more likely to hurt themselves than another person. In hospital I had a sort of a boyfriend and he continued to see me for a few weeks after we were both discharged, but then he phoned me to say he had met someone else, someone at work, and I never saw him again. I lost touch with all the friends I had made in hospital. I did meet some fantastic people, brilliant artists, writers, poets and musicians, but I found it quite hard to be friends with them outside, because I would be doing things like going to the hospital for them with clothes and money and I once had to rescue someone who almost died because her GP put her on anti-psychotics without the essential side-effect medication.

I was not able to drive, I could not think about working, there was no way I could have gone back to University. There was nothing for me to do but go to the day centre for people with mental ilness. There I was supposed to make paper flowers and smoke cigarettes all day. I sat there and wept, and nobody noticed.

The best decision I ever made was to stop having the modecate injections. Perhaps it is helpful for some people, but for me it just made me feel so indescribably unwell, tired and restless at the same time, and so muddle-headed I could not even read, the words would not sink in. Without the injections I rapidly got better and then my consultant wrote me a letter in which he said that I did not have schizophrenia, that manic depressive better described me in view of the fact that I had made a full recovery. I do take medication now, but always in tablet form, and always the most modern drugs available.

I was so low after three months in hospital, where they had told me that if I stopped my medication I would rapidly become unwell and have another breakdown. The outlook seemed so bleak, that I tried to walk under a bus. The bus driver managed to stop and I was unhurt.

Perhaps I was spared so that I could tell you my story.





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