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ashesirise
October 5, 2014 | by  | in Features Homepage |
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Out of the ashes I rise

It was never meant to be me. My life was mapped out. Go straight from high school to university, graduate with top marks, have a high-powered career. I was the smart one, the successful one. Not the crazy one. Success for me was meant to be winning prizes, not merely getting out of bed in the morning. Hospitals were for the screw-ups that nobody wanted, the nut-jobs. They weren’t for people like me. And yet, on a Monday at the start of December 2012, a few days after my final NCEA exam, I found myself being shown to my new room in the loony bin. The nurses took all of the drawstrings out of my clothing. “What, you aren’t going to take my shoelaces?” I joked. “We’d better take those too,” a nurse replied. It would seem joking about shoelaces in a psychiatric ward is similar to joking about bombs in an airport.

My introduction to mental-health services, in the form of being admitted to a general adult psychiatric ward, was certainly a shock (which is also an amusing pun about the ECT I later had). There were a lot of difficult experiences in hospital. Something I found especially hard was that the things I was experiencing weren’t supposed to happen to people like me. Here I was, my high school’s resident overachiever, the one voted “most likely to be Prime Minister”, being pinned down and injected in the butt with drugs.

Of all the things I saw and experienced while a compulsory psychiatric inpatient, it was my time at a private hospital in Dunedin that was the hardest. In a lot of ways, it was nice not to be locked up anymore – I had just spent a few months in a locked ward before arriving. However, the clinic was not secure, and wasn’t equipped to deal with people who were acutely unwell. This meant that when it was unsafe to keep a person there, they were transferred temporarily to the local locked hospital, until it was safe for them to return. This happened to me on several occasions throughout my stay. The third time was the worst.

I had stopped taking my medication a few days earlier. I hadn’t slept since I stopped taking it and I knew I didn’t need to: I felt fantastic. Everything just seemed to make sense. I was joking around with a couple of people I was friendly with when another person overheard something I said. She told me it was inappropriate. We started to argue and I wouldn’t let it go, not even when she stopped engaging with me. I went to the computer room, printed off a quote by Stephen Fry about people who take offence and pinned it to the notice board. Then I stormed off, down the road. I was bulletproof and nothing could hurt me; I could jump off a car-park building and be fine, which was exactly where I was headed. It was a strange feeling, something I’d never really felt before. Sleep deprivation does weird things to your mind.

I became aware I was being followed by staff that had seen me leave, so I veered into an area of bush and climbed a small tree. I had a stick to fend them off. The police must have been called because a police dog found me and barked to let the officers know where I was. They came and yanked my stick off me. One of them climbed the tree and lifted me down. I was dragged back to the police car. The dog wouldn’t stop barking. I didn’t go quietly: I kicked them and tried to bite them. The police were restraining me, holding each arm in a wristlock, which is a “pain-compliance hold” – your wrists are twisted in such a way that if you resist, it hurts, and they can twist them even further so it hurts more. It felt like they were going to break.

Once in the police car, the ride to the locked hospital was short. I was to be put in seclusion, which is like the psychiatric version of solitary confinement. The seclusion rooms in the general ward were full, so I was put in one on the forensic ward, which houses criminals. The room was small and smelt of urine, clearly not properly hosed out between “clients”. I have always hated how they call us “clients” or “consumers”, as though we have a choice in the matter. There were a lot of people in the room with me – nurses, police officers, and a psychiatrist. They asked a lot of questions but I couldn’t find the words to speak. My head and legs were being held so I couldn’t bite or kick anyone. I was pinned down, and my clothing was forcibly removed: all of it, even my underwear. I closed my eyes while they did it. Then I was thrown to the floor so I was lying face down, and my arms were pinned behind my back. Everyone who had been in the room with me hurried out and locked the door.

I was naked and alone. The room had nothing in it other than a blanket and a cardboard bowl to use as a toilet. There was no bed or mattress or pillow. The door had a small window on it so staff could come and peer in at me from time to time, like I was a zoo animal. I needed to pee, but fuck them: I wouldn’t piss in their stupid cardboard bowl. I pissed on the floor. No wonder the seclusion rooms always smelt of urine.

It was cold. The blanket they had given me was small, stiff and heavy, designed so it would be virtually impossible to tear or roll it and strangle yourself. This also meant it wasn’t an ideal candidate for wrapping around me like a makeshift sleeping bag. All of the surfaces in the room were linoleum. Lying on the linoleum with the blanket over me was uncomfortable because it was cold and hard against my back. On the other hand, lying on top of the blanket meant the person doing checks would see me naked, and it also didn’t provide any warmth. I tried to use the cardboard bowl as a pillow, but it only made things more uncomfortable.

I had no way of keeping time, and it seemed to pass incredibly slowly. The lights were always on, all night; there was no way to turn them off. I tried covering my face with the blanket to block them out. A person checking on me through the window called out that if I didn’t uncover my face, the blanket would be taken off me. I wouldn’t have slept even if I was in a more comfortable place and the lights were off. Going through withdrawal from sleeping pills has always left me unable to sleep for a few days. There are not many things more frustrating than being so tired but unable to fall asleep. I had broadly calmed down after an hour or two. I did not feel invincible anymore. The way I was treated made me feel small, powerless, and like an animal.

I was in seclusion for close to 24 hours. The next day, my psychiatrist and the head nurse from the private hospital came to talk to me. They said I could get out of seclusion and go back to the clinic with them if I agreed to start taking my medication again. Honestly, at that point I would have agreed to anything to get out of there. Anyone would.

Seclusion is meant to be a last resort. A psychiatrist must approve it and it has to be reported. I was secluded in Dunedin. Dunedin is part of the Southern District Health Board, which has a rate of seclusion more than three times that of the rest of the country. And the rate reported is probably not even close to the actual rate. Loopholes enable them to get around reporting it. Their favourite trick is to put you in the seclusion room but not lock the door. You are told that if you try to leave the room, they will put you back in it and lock the door. Effectively you are secluded, but they don’t have to officially report it.

Being secluded is incredibly dehumanising and happens far too often. During the experience I described, I was a risk to myself, but I was not dangerous to other people. Sure, I fought back when I was being restrained, but anyone would: it is terrifying. The risk I posed to myself could have been managed in the general area of the locked ward, with a watch. A ‘watch’ is where a staff member watches you and remains within an arm’s length of you at all times. This in itself is unpleasant, but not nearly as unpleasant as being in seclusion.

So why put people through something so distressing when there are better alternatives? The answer is very simple: it’s cheaper. And that isn’t just a conspiracy theory. In a 2013 Otago Daily Times article, the mental-health director of the Southern District Health Board is quoted as saying, in relation to why the DHB secluded so many people, “Unfortunately, interventions that will reduce seclusion rates are likely to be expensive.” There is a price on human dignity, and it’s a price that DHBs and the Government are unwilling to pay. Mental health isn’t an issue with an abundance of political capital, and it doesn’t get the money it needs.

What happened to me in that particular incident was not the proper procedure to be followed. You are meant to be given a hospital gown to wear (made of the same stiff material as the blanket), and a mattress and pillow, which is the procedure that was followed on the other occasions I was there. But hospital staff can usually get away with doing what they want to mental-health patients. Because who’s going to believe us over them? We’re the crazy ones; they’re the ‘professionals’.

Although so many people experience mental-health problems at some point in their lives, we don’t talk about it much. And a lot of the discussion about it focusses on the more socially acceptable, even ‘desirable’, aspects of, for example, depression – dark, tortured, nihilistic souls. You don’t often hear about things like not showering or brushing your teeth for over a week because you can’t bring yourself to get out of bed. And we never seem to talk about how we treat people with mental illnesses who aren’t capable of making their own decisions. I’m not angry with people for this. I too had no idea about the things that actually happen to psychiatric patients until they happened to me.

I think maybe the reason people don’t talk about it is because mental illness doesn’t just happen to the stereotypical drug-addicted homeless guy you see begging on the street everyday. And if it can happen to people like me, it could happen to them too. They could be the ones who find themselves locked in a bare room, naked, pissing on the floor.

But it is so important that we do talk about it. That we challenge the system. That we don’t accept “it’s cheaper” as a reason for taking away a person’s dignity. It’s especially important too because people who are acutely unwell often aren’t able to advocate for themselves. And even in a totally selfish way it’s important, as at some point in your life it could be you, your friend, your sibling. Because it was never meant to be me. Until it was me.

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