I have never been in a place more indifferent to suffering than a psychiatric ward. People walking around in great distress must be so much part of the furniture that mental health nurses can walk past them with barely a glance.
A few nights into my stay a nurse found me crying in my room. “It’s good to cry” she said matter-of-factly, “But sometimes it can go on too long”. She got up and left, promising to return later when I’d calmed down. I wondered what point there would be for her to return when I was no longer in distress, but ultimately it didn’t matter, because she never came back. I had a similar experience a few days later. While I was crying in my room, two health care assistants entered and began to carry out a room search. They didn’t ask if I was OK or acknowledge in any way that I was sobbing. After they finished they smiled and said “Thanks!” brightly, before leaving the room as quickly as possible.
In both these encounters I believe my historical diagnosis of borderline personality disorder (BPD) was at play. My crying was attention seeking, manipulative and proof that I was unable to regulate my emotions. Had they spent time to get to know me, they would understand that I rarely cry, let alone sob in front of people. As someone who OVER regulates their emotions it was upsetting to have my vulnerability responded to in such a callous way.
These experiences reminded me how dangerous the ‘All Nurses Are Heroes’ narrative is. There were some amazing, stand-out individuals working there, whose kindness were the true bright spots of my admission. But there was a culture of indifference which allowed behaviour that was everything from incompetent to genuinely cruel. I saw staff roll their eyes or laugh behind the backs of perceived ‘difficult’ patients. The psychiatrist referred to me in the third person during ward round in a way that should only be reserved for “Does she take sugar?” disability satire. Safety did not seem to be a priority, despite the fact there have been multiple deaths at this hospital. When a patient collapsed in the corridor after taking her nighttime medication, it was other patients who helped carry her to bed. The nurse who’d dispensed it simply shouted after her, “It just means they’re working”.
Two days into the admission I got given somebody else’s medication. I had been given my own meds about an hour before so questioned the nurse whether I really needed them, but she insisted. It turns out they were a different type of benzodiazepine to the one I had just taken and were intended for a woman with a similar name. The last thing I remember clearly from that night is them frantically trying to get a doctor onto the ward when the door to the ward wouldn’t open, but after that is black-out.
The same thing almost happened again two weeks later, but this time I was well enough to refuse and ask them to double check (once again, it was for the woman with the similar name). I was also given the wrong version of my medication on three occasions – an instant release type that left me more sedated and with more side effects. As someone who struggles to take medication, these mistakes left me mistrustful and scared to continue accepting the meds.
It didn’t help that the basic environment was not taken care of. The bathroom was filthy and not cleaned for two weeks, with a blocked drain that meant it flooded every time I took a shower. When I reported these things, the message never seemed to get to the right people. They were unable to find curtains for my room for the first week, and the floodlight outside the window meant I was unable to sleep properly.
To add insult to injury, the hospital I was in has a strong social media presence, where they use buzz words like “quality improvement”, “compassionate care” and talk about being HASHTAG “humbled”. It’s a self-serving denial of reality that’s almost cult-like in nature. It allows them to construct an image of life on the ward that is pure fantasy, all the while keeping genuine conversations about patient’s experiences at bay.
Perhaps most distressing, I was treated as a detained patient throughout the admission, despite being there ‘voluntarily’. This included being prevented from leaving multiple times. On one occasion, I tried to push past a member of staff entering the ward, and a nurse shouted at me, “Hey! You’ll be getting a Mental Health Act Assessment if you’re not careful!”. Her tone was that of a parent threatening a naughty child, not a nurse informing a patient of their rights. Weaponising mental health legislation in this way leaves patients with the experience of being detained without any of the legal safeguards. I was not allowed any ‘leave’ until near the end of my admission and even then, it was hit and miss as to whether the decision to let me out had been handed over. If it hadn’t, I would be left waiting until a member of staff who HAD been informed was on shift, sometimes days.
Despite being ‘de facto detained’ I was told by multiple members of staff that they didn’t think being there would help me. Once again, I’m sure this was related to my historical BPD diagnosis. To tell a patient simultaneously that they aren’t allowed to leave, but that they won’t be helped by staying, is both confusing and cruel. I had lost all hope for myself and saw this hopelessness reflected back at me by the people who were meant to be in a position to help. All of this is contrary to the National Institute for Health and Care Excellence (NICE) guidelines for hospital admission which recommends an “atmosphere of hope and optimism” for service users, with “a clear focus on their emotional and psychological needs”. I was never assigned a primary nurse during my stay and never saw a copy of my care plan, if indeed one existed.
Ultimately, this means I’ve left hospital without a clear plan of care, and with only the side-effects of a traumatic admission. It’s an impossible situation to be in while trying to keep yourself alive through a mental health crisis. The ‘choice’ between being totally unsupported or poorly supported is a catch 22 I’m still scared I might not survive.