The Cost of Care
The Review of seclusion, restraint and observation of consumers with a mental illness report, published by NSW Health in December 2017, argued that the most pressing reform would not come in "resources, but a difference in leadership, values and compassion."
"A skilled workforce is vital to the creation of a therapeutic environment and the implementation of any strategy to improve patient safety. The review team heard repeatedly that many staff were recruited to work in mental health inpatient settings with little or no previous mental health experience or skills. Some staff working with mental health consumers knew little about trauma-informed care or its relevance in restrictive practices, and in some cases expressed views and opinions that reflected stigmatising attitudes towards consumers."
Clearly, there are complex and systemic issues at play which must be addressed, as the report highlighted:
"Disappointingly, there were several witnessed examples of leaders lacking the courage to address stigma and discrimination shown towards consumers, sometimes by mental health staff, and at times by emergency department staff, NSW Police and NSW Ambulance representatives."
What follows is a short story based on a journal entry I wrote during my stay in a mental health ward.
...
Last night I read 137 pages of Dumas’ Count of Monte Cristo. I asked Claire to bring a copy to the hospital as I was craving the connection to Edmond’s suffering. Now I wish I also had a decrepit old man to teach me.
I don't know how I ended up here. It's as if something short-circuited and the computer shut down. No doubt the doctors will call it an “episode”. That's all well and good, except that I have to call this “life”.
As I lay in bed last night and waited for the tormenting torch to flash through the window panel, lighting me up like a depressed Christmas tree, I experienced flashbacks to my post-grad graduation ceremony at Macquarie.
“You are our bright future!”
“We will look to you!”
“Success beckons!”
Less than a year later and I'm here. Two degrees. Jill Roe Prize winner. Merit Scholar. Post-graduate scholarship. A published thesis. And now I'm in a no-frills room designed to stop me from diving off the deep end of life.
There are no laces in my shoes. No string in my pants. The razors are blunt. My phone has been confiscated, despite the fact that I have a wife and one-week-old baby outside these panic-stricken walls.
“Rules are rules,” the nurse recited after I asked for my phone. After kicking up a fuss, I was made “involuntary”.
I'm not writing to try and prove that my being here is a conspiracy. Some of the reconstructed stories patients — especially men — tell about the "injustice" of their being in this mental health ward are literary-worthy. Unfortunately, I'm not at that stage of detachment. What I will say is that when I finally agreed to go to hospital for help, I thought I was going to be shown a room where my wife and baby could lay with me and we could all just rest. Together.
Soon I'll have to leave this room and eat breakfast. The dude serving breakfast won't make eye-contact or say good morning, he’ll just ask for my room number. This made me think about Jewish family members who were branded with inhumane numbers.
There's one person I don't mind eating with and listening to — Elizabeth. She is a softly spoken, middle-aged woman who possesses a ravaged face. It's clear that she was dealt a bad hand at birth. Despite all of the shit she's had to endure, she still smiles. It may be meek, but it's one of the most genuine smiles I've had the pleasure of observing.
Since Elizabeth and the other polite inmates often pass the time in their rooms, I am often forced to sit and try and block out the brain-dead noise around me. A pack of what sound like detoxing and deranged men pace the open plan ward like a pack of dogs waiting for owners to return with dinner. All the while they slur about the essential things in life: “cunts”, “drugs” and “Lithgow” (jail).
If that's not enough to send you up the wall, the nurses and staff appear to hate their jobs. They sit behind protective glass and occasionally look up at the animal banging on the glass. When they do “the rounds” armed with pills, they say hello and then fuck off. I almost had to tackle a nurse to ask if I could shave yesterday.
Apparently, if you stay here long enough and don't flip out, you can have some time outside the padlocked ward. That's about all I can hope for as they won't let my baby in here, and any visitation with my wife has to be supervised. I wanted to remove the nurse’s head from her shoulders when she said I couldn't have alone time with my family. To consider, even for a second, that I would do anything to my wife and babe is madness. I'd rather not see them if that's the case. I know my baby won't remember any of it, but I can't stand for her to see me with a chaperone. Call it pride. Call it whatever you want. It's not happening.
I’m still waiting for the brain trust, the ones who squat behind the protective glass, to answer my question: How is this place meant to help?
Claire kindly smuggled a radio in so that I could listen to the ABC and create stimulating conversation in my mind’s eye. They'll probably take the radio from me as I could eat the batteries or use the old-school antenna to choke myself.
The last question I want to pose before finishing this journal entry and heading to breakfast is this: How are places like this actually helping the poor souls who pass through the padlocked doors?
