francis in the mental hospital

Francis king

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Dear all, I am currently working in an acute inpatient psychiatric facility and would like to make available a space for my thoughts...

I will be returning at 10pm tonight (as I'm on a late shift today)... I will write about 15 pages and update this page...

hope u are all well...

oh , fk I saw the headline and i was worried......... Glad you are working there, not a patient. Good luck with it and i look forward to reading your thoughts..........
And now I am here I wonder what to say...

Two years ago I was working in the exact same facility, as an mental health advocate- a person who helps those who feel unable to speak up against or to the system do so, and now I am a nurse... or rather... a trainee nurse...

I knew the system, then, but moved onto other things- bright lights beckoned me... I kept up to date, ish, with my knowledge of madness and the psychiatric arts, and hoped that over time things would have moved on a bit... I had also hoped this particular facility had changed, and inside, the building has- they have split wards up, spruced up the paintwork, and replaced the furnishings, yet...

the exact same staff are there, and, begorrah, some of the same patients too... there's at least 10 well paid professionals regularly employed to take care of them, and yet... here they are again... with the same problems they had before, and even worse off than the last time, after another six months of missed opportunities...

the majority of patients, sick as they are, are still human beings- tolerant of each other, as compassionate as they can be, and few of the staff are... they refer to patients as mad, off his/her head, bonkers (these are not medical diagnoses, or specific symptoms), there is no real treatment available to patients except medication, and nurses fill in forms all day and have minimal interaction time with patients. When they do interact with patients it never really progresses beyond the realms of polite chit chat (as if this alone is effective in managing serious mental illnesses), and all the issues I found before- such as threatening to section informal patients who seek discharge, over-prescribing medication, staff negative attitudes to patients and each other, low staffing levels ...all still exist...

although now at least there are pretty pictures on the walls of the ward and hand sanitising gel available..!!!

... on my ward, there are two paedophiles and a rapist... one paedo raped a three year old kid... another man has assaulted a female member of staff and is now on the sex offender's register... they should be in jail, but instead they are on the ward... there are two homeless guys, a guy trying to claim asylum and hoping being mad will swing it for him, and two young bucks escaping court charges by pretending to be mad... again, none of them should be there either... there's a few vulnerable guys- some get bullied, they hang around the office, stay near staff, and there's some people who could be helped, but aren't...

I am just a novice, supposedly, and am supposedly being trained by my superiors, yet most of them seem lacking in any real skills based practical medicine- they fill in forms, turn keys, hand out pills, maybe do some chit chat, but beyond that...?

Hi Francis,

A few years ago I was renting a flat from a psychiatric nurse who's boyfriend was a doctor at the same hospital. They were both very bizarre and disturbed people. He was an insanely paranoid and jealous man and she was a very pretty blonde of the "bimbo" variety. He had every reason to be jealous, that, without going into details, I can vouch for. Two others, another nurse and doctor, that I know were in a lesbian relationship at the same hospital. You know the kind of really unhealthy paranoid relationship that two butch lesbians can get into, always aggressive, bitching and sniping at each other.

On top of that I have known a number of patients at the same hospital. Most of them were not truly ill but chose mental illness as a career. Some of them were so blatantly obvious, like one guy who looked like a young DeNiro, and based his illness wholesale on DeNiro's performance in Taxi Driver. Still others were in it for the drugs, to escape custody and all the reasons you stated. So I know exactly what you are talking about.

Mental Health Care is in crisis in this country. The really sick tend to be foisted into care in the community and those that are playing the system do so with impunity. And the so called professionals are as nutty as anyone in their charge. It is a very brave choice you have made to go into that field of medicine and I hope you can find a way to make a difference to those that need and deserve your attention. The whole system will be against you but I hope you persevere and do your best to bring some sanity to the asylum. I will look forward to your posts here.

I used to say "only those ****** up in the head work in asylums...." I still stand by that today ;) Just I'd kinda try and put it more softly... lol

Sometimes it is necessary to be at somebodys level to try and understand them better :)
lol! But if you are at their level, and you believe they need to be drugged up 24/7 and kept locked away from society and have no rights and basically see them as jibbering idiots that couldn't even grasp the concept of responsability.... Like minded people... should they be running such a place?

(for the record! That isn't how I see mentally ill people... I see them equal.)
Have any of you read The Politics of Experience by R D Laing? It's pretty good.
Quite an interesting discussion.

One of our wards here at the hospital I work at is for psych patients. I'm not fully certain why, but it is the one ward I am exxtremely uncomfortable working on. If I can perform my admin functions from elsewhere I will do so without reservation.

It takes a special kind of person to deal with the psych patients. One of my favorite profs was/is a psych Dr., and he is a bit quirky, but in a fun way. Another is a psych professional (although what her title is I am not sure). She has been a tremendous help to me over the last several years serving as a massage therapist (the *legitimate* sort!). She has served as a sounding board and fence post from time to time.

Yet, I have also known of some psych professionals that were, ummm..., not what I would personally consider altogether cool, calm and collected themselves.

The aforementioned quirky prof has a practice that includes hypnosis for smoking cessation. Yet he smokes like a chimney (no exaggeration). I asked about this seeming contradiction and it led to a conversation about how so many psych professionals are themselves dealing with psychiatric issues.

In the strictest sense, we all have psychiatric issues. Most of us are "adjusted" well enough to function in greater society. Some of us deceive ourselves, use denial, or go through a list of interior head games with ourselves in order to maintain some semblence of sanity. Sanity seems to me sometimes just a game we play for the benefit of others.

Is a grown man playing with toy soldiers on the floor a nutter? Maybe, unless he is entertaining his 6 year old son. The presence of a child seems to make nutty behavior OK, sometimes.

I think what disturbs me is the mental health professionals who teach what I would consider unhealthy attitudes and head games to cover and excuse improper behaviors. "Do what you feel, it's alright as long as it feels good." OK, what if (hypothetically) I feel good about shooting other people...see where this kind of nonsense breaks down? I'm not making this up either, this is what a psychologist told a friend. I told him what I thought about this nut's advice, and my friend assured me "oh no, it's not like that, this guy's good..." Until the next visit, and the psych told him the same line of BS. Thankfully my friend is not dumb, and caught on pretty quick. But how many people are strung along with this kind of BS, paying hard earned money for psychobabble, with the psych having no intent to aid or cure whatever is ailing the patient?

I'm sorry but...of all of the health professions, I think psych is the one field that is wide open to abuse *by the practitioners.*

Kinda gives new meaning to "the lunatics running the asylum."

OK, sorry to have gotten carried away...

Best of wishes to you, Francis. Good luck.
While the English mental health system sounds a tad different than the American, all I can say working in an outpatient center is that the only folk we send off to a hospital are those in acute and flagrant psychiatric crisis-those that may directly or indirectly be at risk of harming self or others-the floridly psychotic or suicidal as the only means of ensuring their safety is if they are placed in a "secured" environment. As to whether the mental health staff are any saner than the clientelle, well we may all be bozos on the bus but relatively speaking most of us are not too far off of plumb in my experience.:D Adequate funding/staffing of a facility is a key factor though both in the quality of care and in maintaining the sanity of staff and $ seems in short supply everywhere. Given the difficulty in effecting adequate "cures" for persisting severe psychological disorders can over time lead to a disspiriting effect among professionals but the profession's knowledge base to effect such change is far more limited with mental health issues than in physical health. Juan the vast majority of professionals would not take the naive position of that 1 fellow you noted. Earl
Because of the aura of uglyness?

I really don't think so. With me I think it is the loss of security, I just don't feel "safe" around a bunch of militarily trained killers with PTSD and substance abuse issues. I think it boils down to self-preservation.

the vast majority of professionals would not take the naive position of that 1 fellow you noted. Earl

I would really hope that person was not exemplary of the profession.

I find psych as an intellectual exercise is great, I love exploring what makes "normal" people tick. I have nothing against legitimate counsellors who have their clients best interests at heart, of course one needn't be a credentialled psych professional to perform the role of counsellor and advisor. I have nothing but respect for those sincere individuals reaching out to assist those who really need them.

It's the zookeepers and charletans I can live comfortably without.
Hi juan, hang onto your seat.....
In the strictest sense, we all have psychiatric issues. Most of us are "adjusted" well enough to function in greater society. Some of us deceive ourselves, use denial, or go through a list of interior head games with ourselves in order to maintain some semblence of sanity. Sanity seems to me sometimes just a game we play for the benefit of others.

.......yes I have to agree with you once more!! 100% in this case. Even my most 'well adjusted' associates and friends have chinks in their armour. It's a funny old world... a big funny farm....if you will.

I agree with you Earl- the folk we send to hospital in the UK are also in acute and flagrant crisis and directly or indirectly at risk of harming themselves and others...

at least, they are on paper...

The problem here, in the UK, seems to be related to perception... I have a guy here on the sex offenders register... he assaulted a female member of staff. There are no details on the offence in his file, just his sex offenders papers.

The guy has learning difficulties, and a low IQ. I have watched him on the unit- he's shy, nervous, scared of being bullied and assaulted, and he doesn't look capable of attacking anybody. Last week a patient bought him a pair of trainers... the patient actually stole the trainers, from outside the store, and stole two right feet- the left being boxed, inside the store... our sex offender here has tried to get the patient to take the shoes back, but the patient is refusing. The supposed offender doesn't have the skills to force the issue, and is now down 50 pounds. He has now been ID'ed as a soft target, and the rate at which he gets played will escalate. Nobody will interfere, as the patient who ripped him of has anti-social personality disorder, and they are concerned that a situation will arise...


Last week a man was admitted. He's currently homeless, and has been an injecting drug user for 15 years. Visibly, he does not appear psychotic or suicidal- a member of the team suggests he's swinging the lead, he seems depressed due to his drug use, and the treatment he currently receives, which makes him sleepy.

A few days later the man attempted to kill himself by swallowing razorblades... Unfortunately he wasn't under close observation, as the staff team have already pegged him as a druggie looking for money or a bed, and low risk, and nobody has bothered to really talk to him, as they have already judged him to just be a junkie, and they're overstretched, and have other things to deal with...

when you read his file you discover that actually, he's trying really hard to come off drugs, and has been clean on his last few drug tests... he's been regularly admitted to the psych ward every two years for the past fifteen, and he has a history of suicide attempts...

yet, because he's a junkie, and an informal patient, he was written off as a patient nobody needed to care about...

In both situations, our negative perceptions have coloured the care we supposedly give people in crisis...

These cases are not rareties- this kind of thing happens all the time. We admit people who don't really need admitting, and the people who do then often have to suffer the effects of overcrowded wards, etc..

the observer newspaper had a piece today on mental health care- the link is here...

Psychiatric patients 'feel lost and unsafe' | Society | The Observer

A veteran of the mental health system describes the trauma of being an in-patient | Society | The Observer

Marjorie Wallace: People need a feeling of safety in their place of refuge | Society | The Observer