Often when I mention my role working in a mental health hospital, people tend to change the subject! It’s a real conversation killer, because people have conflicting views on what mental health actually looks like!
Allow me to shed some light on this subject and share the true nature behind the stigma and shame associated with mental illness!
A day on a medium secure, complex care mental health ward.
The patients are really vulnerable, working therapeutically can be extremely self defeating, because it can take a long time to make a tiny inch forward with recovery progress. All professionals working in mental health know only too well, how difficult it can be to engage someone let alone ignite motivation. But when you do finally have a breakthrough in therapy, it can be highly charged with emotion and jubilation. The patients are raw, frightened and low. Or defensive, angry and hostile! Some patients can be extremely challenging, almost possessed, others are more frightened, and just need understanding and non judgement. It can be very challenging on some days, the role is instinctive, keeping you on your toes.
Working in a locked unit, the patients can become highly volatile, vulnerable and unpredictable. The patients have been here for a long time, some are institutionalised, others have nowhere to go due to shortages of community placements, some community providers assess and refuse, due to the nature of the patients temperament and level of violence. The patients on this ward have been institutionalised over several years. Not one patient had seen Christmas outside the unit for quite at least three years. It saddened me to know that there was nowhere else in the community for these patients to go. This made my role on the ward more meaningful to me, I knew I had to make a difference to their lives inside this concrete building, regardless of how small that difference would be. However, this doesn’t come without its dangers!
One of the patients took a shine to me, she called me hazel, or azel. (I gave up correcting her and accepted my new name, it helped to build trust between us) We would have long talks, some bizarre and others enlightening, I was fascinated by her eccentricity. I remember the day she dragged her nails along my arms, it was a bit like a ritual, if you passed, you earnt her trust! I guess I passed! The relationship was encouraged by the psychologists and psychiatrists, the ward sister was also a rock and a source of support when I was on the ward.
On this one particular day, I was entering the building, I made my way past the security doors, I instinctively knew, something was off, as I made my way to the ward door, I could hear one of the patients was becoming volatile. I opened the door, the patient who was experiencing a psychotic delusion, came straight at me aggressively, she was shouting in a Latin tongue that was incoherent to understand. I was taken aback, I tried to calm the patient down but it was futile. So I quickened my pace to the nursing station, alongside the patient.
As she shouted and yelled at me, I walked around her then she started walking beside me, throwing her arm back and forth as if she was anointing me, she yelled nihilistically, continuing to anoint me. I speeded up my pace to get to the office, I never thought about pulling my PIT (alarm), until now! As typical of me. It was in my bag?
She spoke two coherent words, my name and the word ‘evil’ as we quick stepped down the ward to the nurses station. I kept my eyes locked into hers at all times, although I don’t believe she heard anything I was saying, I acknowledged her and nodding as her face came square up to mine. Now I was panicking, she was about to fly off into a rage, but my PIT was in my bag! I kept her eye contact as my fingers fumbled over the buttons on the locked door to the nursing station, I was starting to feel anxious and said a silent prayer -‘oh god please help me,’ I whispered in my mind, my fingers eventually managed to punch in the right keys and the door opened, I flew into the staff room, my heart banging like a drum. Only this time I whispered in my thoughts, ‘thank god,’ and leant my back against the door as I gasped in a deep breathe. Phew, that was close. Ironically, I felt lucky. The patient was still yelling at me through the door, so I refused to turn to face her or make any eye contact, I took another deep breathe, regaining myself.
I barely had time to take off my coat and put my bag down when the ward alarms went off. I knew it was the same patient, there was more shouting and chaos, instinctively, I ran back out, into the lions den.
I was shocked….
I walked over to the doors where all the commotion and violence was happening, I was also joined by most of the staff on the ward, who had ran down to de-escalate the drama. I mentioned briefly to the ward sister that I may be antagonising things, explaining that the patient was screaming at me. We both agreed I should get out of sight, so I did.
My friendship with the patient who called me ‘azel,’ who I had befriended, was in her room, a short distance from the nursing station and wouldn’t of seen anything? She must of heard it all? I had my back to the ward as I was punching in the keys on the door in panic.
She heard the commotion and charged out from her room, with her three wheeled walker, she marched very quickly at the woman shouting in Latin tongues and knocked her flying off her feet by pushing her wheeled walker into her. The patient was lying on the floor, shaking her fist at the other patient and then pointing at me when she saw me. I kept myself on the mens ward for the rest of the day, avoiding antagonising the situation further! I was quite taken aback at how defensive my patient was towards me.
I never stopped to think through the situation until I was driving home. I thought about the patient who was extremely sick, her behaviour was like watching a demonic possession, it was unnerving. Then there was my ‘azel’ who came flying round the corner and knocked the possessed patient flying, to stop her screams? To protect me? It made me remember an old phrase my gran said – ‘God moves in mysterious ways!’
She wasn’t wrong today, god bless her soul.
The moral of the story…. Love and friendship is found in the darkest of corners, the deepest of abyss and beyond the boundaries of stigma and shame!