Mental health is a sensitive topic. People do tend to shy away from it, even today with the fear of the association and stigma attached. The worry that your making it up, you’re not a coper or ‘it’s all in your head’ make mental health a taboo subject. I think the problem with Mental health is that it is not visible or tangible. However, just because you can’t see it, does not mean it is not there. You can’t see or feel oxygen but we accept it is essential for life.
There has been quite a brave stance on speaking out about mental health issues on twitter recently, with many people posting about their personal experiences of dealing with their condition, whether it be depression, post natal depression, and Bi-polar disorder . I actually haven’t seen anyone write about experiences of suffering from schizophrenia yet but I am sure and hope that it will happen. People need to be more aware.
So where am I coming from on this? Have I experienced mental health issues? So far in life I have been fortunate that I have not experienced any acute form of mental illness. I have however treated people in their acute stage of illness back when I worked as an Occupational Therapist in London. My first job was working in an Acute Mental Health hospital in East London and it was my passion. Due to me being a newly qualified OT I had to rotate onto a different area of healthcare after 6 months and this moved me from mental health to physical health and it was there that I lost my want to be an OT. So this is me trying to inform you a bit more about mental health from a health professional perspective.
So what did my job involve?
I worked on a ward where we had some very poorly patients. It was then a locked ward as the clients at this point of their illness were either at risk to themselves or others. Mostly themselves. Symptoms, depending on the condition varied, it could range from self neglect and care, withdrawn, no inhibitions, aggression, high arousal, lack of libido, delusions of grandeur, hearing voices, and heightened emotions.
Sectioning sounds like a very frightening word. To be locked up. The thing with sectioning is that you have to be deemed without capacity, meaning you are not capable of making rational decisions for your own well-being due to your ill-health and therefore doctors are allowed to take over your care. This is important as the condition is out of the control of patient, and often they will refuse care and support. You could argue that if you refused treatment for cancer, that would be accepted, but only if you were not experiencing symptoms like believing you are related to the Royal Family (delusion of grandeur) with it! To refuse treatment of physical health you still have to be deemed of sound mind.
In the first few weeks of admittance I would go to do an initial interview. I would be lucky if the patient was willing to talk to me at this point. Usually I would be waiting for their medication to kick in. This has its own issues, as although ill, the patient was not stupid, and if they did not want to take their meds, they would find ways to trick staff and very successfully on some occasions.
At this acute stage there is no reasoning or rational explanation. You cannot educate at this point. The treatment is very clinical. However once the medication does start to relieve symptoms that is when I could come in.
We ran relaxation groups, Cookery schools, Self esteem course, anxiety management, self-care classes, art therapy, psychotherapy. Often patients would only come to begin with because they were desperate to get off the ward, but slowly and surely the sessions started to work and the patients could start to see the benefits. Within weeks of their care we would be out again into the community and then looking at returning to home and ensuring a key-worker and care package if needed was in place.
When I retrained as a teacher and I would talk to high school students about mental health, and they had very limited knowledge. As far as they were concerned it meant crazy. They did not see it as unwell, but as odd. Re-educating their understanding was something I loved.
We would go to the drama suite and I would start by asking if anyone had a health issue they didn’t mind talking about. Usually some one had an allergy or diabetes to discuss. We talked about treatment, how it affected life and whether people were different towards them. The answer was always no. It was accepted that they had a ‘physical health’ condition that required treatment.
The condition they are mostly interested in is schizophrenia, and is commonly misunderstood as split personality. This is not the case as all. It is not Jekyll and Hyde! Most commonly diagnosed by hearing voices or experiencing delusions of grandeur schizophrenia is a frightening place to be in its acute stage however, once treated and in control, with support, medication and therapy a person can live a ‘normal’ (if such a thing exists – I know I am still searching), happy life. That is not to stay they won’t experience relapses or triggers that set it off, however this is no difference to a heart condition that has been well medicated and in control that suddenly relapses.
I then went on to trying to explain what hearing voices must be like. I would get one volunteer to walk around the room and two other to follow and obstruct but not touch their path by saying things to them. Inevitably you could see the student starting to get frustrated and we would stop before they got cross. I explained how upsetting hearing insulting things in you ears must be and that at least during this task they
1. Know it is made up/drama
2. Know what and who is causing it.
But to now know you have heard something but the body to the voice not be there must be terrifying. You may start to believe the radio is giving you messages or the T.V is talking to you. That could be considered a realistic conclusion. The problem by this point is however, that no-one else can hear the voices. The sufferer become paranoid and often fears conspiracy. They worry about harm to themselves or their family.
Hopefully this is the point at which the medics become involved.
We moved into paranoia and depression and the link to drug use. The area in which I teach is considered the most deprived in the country and drug and alcohol use within families is high. I always explain it as the chicken and the egg..which comes first? The answer is in fact debatable. Now whether someone was always prone to a mental health condition and the drugs exacerbated it, or it caused it will never know but it is a huge risk. In my experience drug use and mental illness in the extreme cases (usually excluding depression – although many would then self medicate) went hand in hand. often we were treating dual diagnosis of a mental health condition and an addiction.
I have witnessed many people with acute mental illness get better. I am lucky that I have been fortunate enough to be involved in that care. I will never truly understand what it is the person actually experiences and nor will I ever pretend to. I can only report on what I see. However, mental health illness is real, it is there, and it needs to be acknowledged. Just because you can’t see it, does not mean it is not there.