I woke in the middle of the night. Whatever liquid was in the needle certainly did the trick, great for a post music festival coach trip home. I had been out and missed the evening meal, dodged a bullet. Shivering on a blue plastic mat, I looked up. A psychiatric nurse was sat at her post, eyes glazed (she might have had one as well?) watching another slow night pass through the looking glass. My movement rescued her from the boredom. It was the most peace and quiet I had experienced for a long time, same for her I bet. Groggy, my mind turned over slowly, cognitive function lowered, I was still a long way from normal. I was kept in the panic room after waking for a few more hours, until the sun showed his face through the larger windows up high on the cleaner, whiter walls.
When I exited the holding bay, I walked into what most would expect a psychiatric unit to look like. There was space. It was friendlier, calmer and the windows seemed designed to allow more natural light to cascade across the shiny, laminate floors. More importantly the nurse-to-patient ratio was nearly one nurse for every two patients. I relaxed; it wasn’t going to be as stressful in here. I knew it.
In the Psychiatric Intensive Care unit, Skelbrooke Ward, I met other patients; some acute, some in it for the long haul. This was now the knockout stage of the Champions League. I’m as competitive as the next person, but I was slowly realising this wasn’t a competition I wanted to see through. Fuck knows what you would win; a lifetime supply of Prozac, Zopiclone and a signed Straight Jacket by the patients and staff. After my performance the day before I had made it through to the Semis after demolishing the opposition.
The self-harming young girl who had swallowed the batteries earlier in the week was present and correct, as was another lad called David, and an older, very rude patient. He remained nameless, a mute from what I could gather. I am not writing about myself in the third person, with my reference to psychosis previously. David was in the hospital after an incident in prison where he was serving another sentence for a violent burglary. He was tall, wiry, and refreshingly friendly and articulate. I instantly warmed to him. He wanted to know more about what happened in the Cusworth Ward. I happily provided cigarettes and we spent a lot of time in the smoking area chatting. You’ve got to love fresh air. In the first few days I missed listening to music, but my family provided an old iPod, and this helped. When I find myself not able to enjoy music, I am seriously in the shit. I shared earphones with David and spent hours introducing him to what I had been listening to recently.
There was a gym, granted nothing to write home about, but it was something to keep my mind occupied. The rowing machine helped; I was keen to use it when one of the nurses was free to accompany me. They sat on a few occasions and watched me row 2500m over 250m intervals, 20 seconds rest, another notch of resistance up / down. 10 to 1, 1 to 10. I used to do this religiously after each gym session with an old pal when we lived in Manchester, a great time of my life. I had slowly dismantled the friendship since then which still upsets me, but I have done everything in my armoury to atone for my mistakes. Exercising helps improve my mental health massively especially when I push myself. Something extremely cathartic in it. Maybe the pause from pain nullifies the thinking, still haven’t put my finger quite on it but it still helps immensely.
I wrote a lot to my responsible clinician, most days in fact. I would request a pen and some blank paper and list the reasons why I shouldn’t be held in captivity. Often losing my train of thought, I would grab a blank sheet and propose new ways the hospital could save money, improve the health care, and reduce the risks to patients. Like the black rhino knows too well, all this fell on deaf ears but helped me pass the time. You’re staying in the zoo pal.
There were a lot of seriously ill people on the ward as you would expect, I hadn’t yet noticed myself staring back in the reflection of the porthole windows. Some patients I didn’t get to know. Some were unable to leave their rooms. I used to walk the ward and wander past a young lad, he was catatonic, held in an unresponsive stupor. I had never seen this before. It was extremely hard and frightening to witness. He would lie still, eyes fixed on the wall like a statue, beyond help, the nursing staff would try and feed him and give him fluids. Again, made me realise what a powerful bit of kit the mind is. Lost in his own mind. As I write this I am learning about Kanye West and his current plight, reluctant like I was to listen to the professionals, that can help manage bipolar disorder. Another person dismantling his life, piece by piece, impulsive act by impulsive act. I empathise and hope he has people he loves fighting with him. He’ll need them when the parasites have had their fill and there is no more money to be made. Jesus walks indeed.
Visiting time was always welcome, breaking up the monotony of the day. The first visit in the new ward was from my mum and my older brother. I was still heartbroken that my mum had done the right thing, the only thing she could do; giving her permission for me to be detained in the psychiatric unit. In the visiting room I waited, and they walked in. They had brought me some fresh orange juice, worried I wasn’t getting my vitamin C, always caring, and always thinking of me. I was pleased to see them, but I was also angry. I lost my temper. I erupted. Again. Screaming at my mum and our Phil,
“HOW COULD YOU DO THIS!!! A fucking psychiatric hospital!!! I’m fucked now!!!”
One of the nurses quickly came to the room to make sure everything was okay. Crying and sobbing, I was inconsolable. So were my family. I had strained so hard screaming; my nose had started bleeding from the pressure exerted, blood and tears dripped slowly onto the floor. I felt betrayed. They persisted to appease me. After a while, I calmed down and the nurse left us to talk to one another. This was the first time, realising from the look of concern and worry facing me. I had to start listening to the people who loved me and the medical professionals around me.
From this point, I realised I wasn’t getting out of here in my current state of mind. That evening when my family left, I enjoyed a cigarette and mentioned to David that I would start taking my medication. He explained how lucky I was that I had people that cared who would come and visit me in hospital. His mum had never visited him since he had been sectioned at her discretion. He had a brother who was also doing porridge, so he never saw him either.
He went on to tell me about helping a friend of his when he was in prison. How he had been in and out of prison since he was a teenager. I remember him saying sometimes doing the right thing isn’t always the easiest option. When he was in prison his friend was late down to lunch, he panicked and raised the alarm with the prison guards. It turned out his friend had overdosed and was lifeless in his cell. Fortunately, on this occasion he was saved thanks to David noticing his empty chair in the lunch hall. Later in the day one of his other friends would stick a blunt object through David’s neck. David had received all the plaudits for saving his life and this lad did not like that one bit.
David showed me the scar at base of his skull, just inside in his hairline. I in turn showed David the scar on my arm where I had placed with force, a heated knife and branded myself whilst travelling in Thailand in 2008 to commemorate the trip. Hypermania and alcohol, a toxic mix.
I had battled mania and depression for years and only now was it being correctly treated. I thanked him for sharing his story with me and thought about my family, all raising the alarm and doing the hardest thing so I could get the help that I so sorely needed. I slept that night; it was the first time I had slept through in a very long time aside from the post Glasto cocktail. The fasten seatbelts sign was flashing, we were coming into land. It wouldn’t be exactly one from the flight manual.
Over the following days I took my medication from the little paper cup and noticed a change. I was calmer. My short temper and my obsession with escaping waned. I managed to hold my focus a lot more. I kept up my exercise routine, body weight circuits and the punishing session on the rower. I worked on my relationship with the caring psychiatric nurses who I would spend my days with as well as the other patients. I didn’t call them by their first name, instead I learned their favourite musician and called them by the him or her they loved. I insisted that they referred to me as Alex. It amused them a little and I thought helped me recover some of the ground lost when I was selfishly serving my own interests in the other ward. I can’t remember too many nurses by name, but there were a couple who made a lasting impression. Years later I bumped into Tom and Jarvis, as they sat outside The Salutation Pub in Doncaster. It was great to see them, and they were together which was a great result. A romantic relationship created in the Forge of St Cath’s; I suspected this one would last. I thanked them with a beer for treating me like a person, treating my illness and helping me to help myself.
Following my behaviour, the responsible clinician, Dr Alikhan pushed for keeping me in the hospital under Section 3 of the Mental Health Act, for a period of “treatment”. If you think Section 2 sounds harrowing, I can assure you Section 3 is a lot worse. It would have had ramifications for work, travel and could have seen me being kept in hospital for a period of up to 6 months. Everyone pulled together to avoid this, the nurses, the social worker, and my family. My Uncle Séa, one of my mum’s younger brothers was unbelievable through this period. He had direct contact with the social worker fighting my corner. He would travel across from Leeds after work each day and with the social worker would push buttons and pull levers. The night before my Mental Health Tribunal, the team stayed up through the night, preparing and ensuring the evidence was compelling to fight the psychiatrist’s recommendation. The odds were against us, but again with love and support we got the result my family, friends and I wanted. I was kept in for further assessment under Section 2 of the Mental Health Act. I remember my Uncle Pad and my Uncle Tom coming to visit me when my mum and brother couldn’t. I also spared a thought for my younger brother as he was away travelling in Australia. Having the lead up to this play out regrettably on social media, I now know that I was the main reason he cut his trip short to support me and my family. Some boy. Both of my brothers are incredible people.
What is astonishing looking back is the cost of treatment. If you factor in the cost of a bed in a psychiatric unit for the best part of four weeks, nurses, psychiatrists, the support of a social worker, a solicitor, support staff, the help of the police, paramedics, doctors on numerous occasions. This has me thinking of the cost of the number of prisoners not correctly diagnosed for an illness, they are often in the wrong place. The cost of their crimes. The emphasis of early detection of mental health symptoms and how important correct treatment is. I would like to say in the past decade since my correct diagnosis we have come a long way.
Truth is, whilst society is now discussing mental health, it has become more normalised, less stigmatised and I have noticed more people at both work and in my personal life talking about their mental health. In this same period since I was in hospital more funding has been allocated to mental health spending by our NHS. Whilst this is admirable of the government and welcome, waiting times for children and young people in need of assessment and treatment has increased. Young people with life threatening conditions can wait more than 100 days before receiving any form of treatment. I know there isn’t a magic money tree and 14.9% of all funding allocated to Clinical Commissioning Groups for health services is for mental health, learning disability and dementia. Again great but when you think of the billions wasted, for instance on bogus PPE contracts by the Tories. Money that would have gone a long way in helping prevent more young people going through the mill. Getting the help they need before they are desperate. In some cases it is too late compounding the situation more for grieving families.
My parachute didn’t open first time and I relied on my reserve chute for the next ten days in hospital. I slowly descended to earth once it had successfully deployed. There were a couple of hairy moments. I remember the old bloke who didn’t say anything, never engaged or acknowledged anyone, the nurses or patients who tried to help him. I couldn’t stand this. He only ever ate Weetabix with warm milk for breakfast and dinner. I had been told by David to steer clear and memorably that he hated spitting.
One morning whilst smoking outside watching the sun come up over the grey hospital buildings, the old boy was patrolling. I coughed, cleared my throat, and spat the phlegm to the floor at his feet. He snapped, HE’S ALIVE!!! Charging at me, disgusted and ready to knock my head clean off my shoulders, he grabbed me by the throat, shouting incoherent bollocks. I held him at arm’s length despite him having had his Weetabix. I dropped my cigarette, banging my fist on the window of the nurses office, where they were sat enjoying an early morning coffee. Tom responded quickly and ran outside diffusing the situation, restraining old man river. A few hours on the blue mat for you young man. I blew him a kiss as he was escorted back inside.
I learned later prior to his visit to St Cath’s he had consumed two bottles of Domestos’ finest vintage to take his own life and it wasn’t on his hair. This hadn’t worked out well and had sadly left him with serious complications, consequently the only food he was able to digest had to be soft, which explained the Weetabix. I never got to the bottom of the spitting, I didn’t press that button again. Manners cost nothing.
The medication I was prescribed were not the magic pill we all hope for, my mood was still elevated. I wasn’t the easiest patient to treat looking back writing this, I demanded a lot of time from the nurses. I spoke to the psychiatrist only three times in my whole stay and one was when the bastard was trying to keep me for another six months; this was only for approximately 45 minutes at each meeting. That’s less than an hour a week with a psychiatrist. Hardly intensive care. I know this is the manifestation of a lack of skilled staff, resources, and time. We can and must do better.
The hospital manager relied heavily on the overworked psychiatric nurses and support staff who always cared for the patients as best they could. They reported back from what I could gather to the responsible clinicians. She also relied heavily on their goodwill, asking them to stay late, start early, cancelling their plans to work that extra bank shift. I didn’t doubt they would sit vacant at their dinner table, exhausted when with their family and friends. Lying awake, thinking of what had happened or what was going to happen next time they were on shift.
Don’t forget though Tom and Jarvis, we clapped for you on our doorsteps during Covid, what more do you want?
Better pay and conditions please. This might prevent the brain drain to private healthcare.
You ungrateful bastards! No chance. If you don’t like it go do something else. Amazon Warehouse is hiring down the road. Honestly the people these days, want it on a plate.
One evening I set my room up and set a prank on one of the nurses. I had got to know Tom well, not well enough. I positioned my jeans and shoes coming from the shower with the curtain drawn and stuffed my jeans with toilet tissue so that it appeared that my legs were in them. I then left a pillow in view of the porthole window, with a note on it. I can’t remember exactly what I wrote in blood on the pillow (no pens allowed), but it can’t have been pleasant for him to read when he did his rounds and peered through to see if I was safely asleep in my bed. I had crawled from my room and hidden behind one of the sofas in the main living area, waiting for the nurse’s office door to click.
Tom was remarkably calm when he returned to the living space having walked into my exhibition of poor taste. I laughed and he begrudgingly did too, ‘Very funny, I’m glad I found that and not one of the other nurses, come on get to bed’.
The next day I learned that one of the patients had taken their life in their room two weeks prior to my arrival. Very poor form from me. This looking back explains how my mood was levelling, but it was far from what one would call normal, and my behaviour was still erratic and impulsive. I was being given 15mg of Olanzapine, an antipsychotic and whilst this helped me sleep it didn’t relieve me of my mania completely and I still needed to be under observation.
For the rest of the time, I played the X Box, listened to music, completed jigsaws with David and chatted to the nurses. Deploying the waiting tactic meant finally, after three and a half weeks skydiving, I was discharged.
I promised David I would come back to visit when I got the chance. In the week after leaving, I kept my word and returned buying David a tall caramel latte and a retro Leeds United shirt. This is / was his team. His face told me it made his day.
Sadly, the next time I returned; it wouldn’t be to treat mania. I had hit the ground hard, and I didn’t stop there.
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