Kept in the Background
- Author:
lorn Merchant
Drawing on his own experience as an in-patient, the author suggests some simple ways of making life in hospital more beneficial, and perhaps shortening the length of stays, and expresses some reservations about public attitudes which still face patients when they return to everyday life in the community.
To criticise the already outstanding facilities benefiting mental patients while presenting bright ideas of our own would be unfair until balance sheets with all details were displayed and preferably published. And then we could pretend that we understood! How many have the slightest idea of what it costs to keep a mental patient even if he is not continually treated? I have heard wild estimates five times the amount suggested by an equally ignorant person. Most certainly though, those who recover partially and receive sickness benefit at home after discharge are causing a lesser burden to the State while allowing a sicker entrant to be dealt with quicker. Which should put paid to the evil myth in our advanced culture that everyone in professions connected with mental illness, to justify their places, are opening their arms to receive us once again ‘inside’.
The only refuge I never saw cruelty during the course of several stays, at the worst there was a minute minority of indifference?but in some cases it may have been the only refuge. For example, patients like me were termed pests, because it is hard to comprehend why helpful reassurance worked only after much repetition.
It has often been written that an apathy and depression comes to long-stay patients so that they behave mechanically at set periods of each and every day. I can confirm that impression. But to alter this is a tremendous task calling for even more dedication rather than advances in actual therapies, although these, too, are appreciated.
It would ease patients’ tensions if the threat of a less popular ward, such as a ‘disturbed’ ward, was never used to discipline but resorted to only if all else failed. Patients have taken refuge through their failure to adapt to even a reasonably benign world? is it fair that the threat of a greater adjustment should be held over their heads in their asylum?in the original meaning of this strangely outcast word? My minister father preached Heaven, but never Hell, and he brought me up with love, rather than fear of punishment.
Many a patient still reeling from the shock of entry would be happier if he knew where he stood in relation to the community he has just left. The improved patient, with at least one source of security outside, should be encouraged as strongly as a tiny tot setting out to school. His happy vision of his own rehabilitation should be strengthened and supported, rather than being offered a five-to-one bet that he will return soon. Some are retained until immediate paid work awaits them?had this been the yardstick in my case I might have been a lifelong passenger. I had to break that sequence of returning. This I did eventually, without resort to blood relatives, and now I am ‘uncle’ to six young tenants in my happy seafront home, in a situation free from all hostility. A low maintenance drug has served me at least as well, at home.
Institution food is dull and I forced it down with little relish. Once home, I bought and prepared my own food, a careful choice including well-tried Health Foods?proven products rather than competitive wonders with their ingredients from all over the world. Soon I was better and stayed better even while now actually facing the deep bereavement from which I had fled. I found that prescribed drugs served well in 47 partnership with superior nourishment?why all this ‘civil war’ between the producers of each? Could not a little more first-rate food be more regularly used as the support of the patient whose stay might thereby be shortened?
Outings and entertainments seem to be arranged sensibly for those that can benefit, as long as the right of refusal remains?there should be lots of right of refusal. But the dreary task of Industrial Therapy? putting into boxes thousands of messy paints and glue! Protective clothing, please! I ruined a good suit in a couple of weeks.
Self-help books
A word about mental hospital libraries. I enjoyed their well-stocked shelves catering for most tastes. I agree that orthodox medical textbooks would be out of place because many patients would identify themselves with ailments on every page. But the ‘pep’ book written for the layman’s self-help, such as the works of the late Dale Carnegie, can help some people towards a better understanding of themselves. Carnegie’s books, written in his homeland without Welfare State, contain much of the ‘sink or swim’ advice. Specialised comfort is provided in ‘Loneliness ?an explanation and a cure’ by Doctor J. B. Hoskisson?one book, read at home, that would have helped me in the hospital library. Many such easily readable books give either specific or general support. Provided that some care was exercised in the lending of such books to the right patients, surely a shelf of self-knowledge would serve a purpose? Even extracts from these encouraging books might be displayed? in much the same way as several are now on my own mantelpiece.
For the young and responsive, the utter boredom and even hate for the hospital way of life?not, I emphasise, for their guardians?should provide a motive for a final discharge if they really want it so, because they do not stand to gain through sickness. Luckier than many, I returned to material security but how much luckier are those who return to the real affection of a partner.
In my ward was a beautiful woman who cleaned the rooms vigorously each day. Otherwise I was surrounded mostly by old men and the contrast she provided reminded me of the outside world and all to be gained there. Her very presence caused the rowdy to check their speech. She did more good, in an utterly innocent way, than our cinema shows and entertainments. Vive la difference!.
Lady doctors are popular in men’s wards and vice versa. Let’s have more mixing, or even an appropriate nostalgic perfume to blot out the clinical smell. A sad result that I experienced after ECT was that it seemed not to be selective of memories that it expelled. On the first day home we pass, without recognition, our more recently formed friends. They are hurt and next day they ‘pass by on the other side’.
Prejudice then snowballs. ‘Is he violent?’ was a landlady’s whispered doubt when, for harmless change, I looked for ‘digs’. It is surprising that in this enlightened age so many notions are retained which haunt a man in those delicate days and weeks of his new freedom and, more pathetically so, his craving for appreciation and communion with those from whom he has been away.
It still remains necessary to educate more fully those members of the public who think that it is sufficient that the mentally ill are no longer chained up as peepshow exhibits and it still remains a priority for public tolerance to allow the man who has been ill and is taking his first tentative steps into his new world (or back into his old one) to put a foot wrong from time to time without the fear that one little slip will result in an outraged telephone call and the risk of a swift return journey to the hospital.
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