Behind Closed Doors: Stories from the Psychiatric Ward

In 2020 I spent some time working as a Mental Health Advocate on psychiatric wards. I supported people who were detained under the Mental Health Act (1983) to express their views and wishes about the treatment and care that they received and/or was being proposed. I attended ward reviews, best interest meetings, care planning approach meetings, tribunals, and various social care meetings to support clients to express their needs, ask questions that were important to them or to speak on their behalf. Upon receiving referrals for a new client, I would have access to their name and what ward they were on. I did not know why they had been sectioned and/or what diagnosis they had been given. When I met clients for the first time, I had no pre-conceived stories or judgements about who they are. This ensured that the power remained with the client and their story rightly remained theirs to tell…when and how they wanted.

I met some amazing human beings with incredible stories. People full of life, resilience, joy, hope, grief, regret, and despair. But what struck me was the resilience, always the resilience. The will to go on. The will to find joy and happiness in each day. The longing to connect. To belong. To matter. To be heard. The undeniable and innate intuition that all human beings hold to trust their own inner knowing about what it is that they need to be better, to feel better, to live and the medical model’s ability to deny and drain them of this.

I met a woman in her thirties. She had been repeatedly sectioned over the years. She was struggling to stay awake during our session together, experiencing drowsiness, dizziness, fatigue, blurry vision, slurred speech, memory loss and muscle weakness. All symptoms of the medication. We spent a short time together whilst I tried my best to communicate her rights. She told me her baby boy died 10 years ago. She then told me that it was following this bereavement that she was diagnosed with bipolar disorder, sectioned, and prescribed long-term, ongoing, and often lifelong medication. Here she was 10 years later still with unresolved grief, sectioned and highly medicated. People asking her for her food order and laundry needs, nobody asking her about her baby boy.

I met a young woman, recently sectioned. She wasn’t allowed out of the building; she wasn’t even allowed out of her bedroom due to covid restrictions. She was trapped, stripped of her autonomy, anxious and afraid. She was trying desperately to regulate her nervous system; for her that meant attempting to have a cigarette out of her bedroom window. She was treated like a naughty and defiant schoolgirl who needed to be suppressed and controlled and often on psychiatric wards sinisterly that means sedation…against will. A nurse on the ward warned me about her, told me not to go near her, that there was a risk to my safety and if they were me, they would cancel the meeting. I ignored them and went to see her anyway. She curled up on her bed with tears in her eyes. She turned into a small child in front of my eyes. This woman does not want to harm me. She is traumatised. She wants reassurance, love, connection. She needs maternal touch and warmth. I dream of a warm, maternal nurse who can take care of her, re-mother her, help her to feel whole again, to trust again...but there are no nurses like that on this ward. I look into her eyes, and I see the pain of child sexual abuse, an all-too common and unacknowledged story on the wards. She speaks with conviction and sense. A woman who knows her own mind. A woman who knows what she wants and needs. She’s educated, she knows the pharmaceuticals and she knows the side effects. She experiences involuntary muscular movements known as tardive dyskinesia from the antipsychotic medication, it involves sudden, jerky and/or slow twisting movements in the face and body. She is ashamed. We spoke to the nurses about her needs and her concerns regarding the medication. I promised to come and see her the next day. She was admitted to a high-risk unit. I never saw her again.

A young man approached me on the ward one day. He fell to his knees and prayed for forgiveness. He spoke of his partner, he felt he had let her down. I spoke to a nurse, suggested that he may need some emotional support as he was experiencing deep regret and grief. The nurse considered this and after a short while stated that his behaviour was simply due to his bipolar disorder. So, the drugs continued and so did the grief.

I could go on and on, sharing story after story of people being unseen and unheard. The effect of psychiatric institutionalisation fulfils the prophecy of their pathology. People in pain, traumatised, shut behind closed doors. Hidden. In the shadows. These people, our fellow human beings are representative of problems on a much larger scale, within society, within the shadows of the collective psyche. The parts of us we hide away, lock away, suppress, dilute, kill. The parts that grieve, the abandoned, fearful, angry parts…full of feeling, full of truth, full of life.

To sit with people who feel crazy because that’s what the world has told them…and listen to them, ground together, until you connect core to core, and now…now they know that they aren’t really crazy…is one of the most worthwhile things I can do with my life. Working as an Advocate allowed me a unique opportunity to use my voice for my clients, this offered me a sense of what it would be like to be sectioned. To be powerless, dismissed, ignored, to be underestimated. To be the one who gets in the way, challenges the status quo, doesn’t agree, has needs. As a person who has experienced significant trauma and all the psychological, emotional, physical, and spiritual impact that it has on a person, this left me feeling intimidated and frightened for my own autonomy; I became very aware of how fragile it can be given external circumstances and influencers. I loved my job. I loved my team who were a group of self-aware, kind people. I loved my clients. I left due to the increased workload when I started my studies as a therapist, but I did not want to leave and one day I hope to go back, in some capacity. To be amongst some of the most courageous and inspiring people I have ever met, to sit with them in their pain and their joy and support them in settling deeper into their core, their inner knowing and trust it. But what I really hope for is systemic change, a shift from the pathological medical model to a holistic approach that values everyone’s story and their innate wisdom. A system that nurtures and nourishes every being with the respect and care that we deserve. That reminds us what it is like to feel whole again.