Today I got angry after reading a tweet. Just a regular day then, you might think, except this one made me so angry I have had to blog for the first time in months. I was reading a thread about a conference on “rapid tranquillisation”. For those who don’t know, on a psychiatric ward this means administering a drug, generally by injection, which knocks the patient out. Patients usually have to be restrained by staff for this to take place. I am very, very fortunate that I have never been restrained or injected, but I can assure you it is difficult to watch, and I have read enough accounts by those who have been subjected to it to know that it can be utterly traumatising (if you want to know more, @Sectioned_ has blogged about her experiences extensively). I had to back away from the thread pretty quickly, because I found reading about RT being discussed in a very theoretical, dispassionate way – what combination of drugs works best? Oral or injectable? – distasteful and disturbing.
The anger part came in though when I read this tweet about minimising distress for people who have been rapidly tranquillised:
Environment is so crucial in helping people manage distress. Little things ie. flashing lights, dirty conditions don’t help mental health. Keeping things simple is very important.
Little things? Excuse me, but – little things? Having to live in squalid conditions when you are not permitted to leave, for weeks or maybe months, is a “little thing”? I don’t think so.
Earlier this week I read this blog from Recovery In The Bin, a critical theorist and activist collective that challenges dominant mental health narratives (I urge you to follow them at @RITB_ ). I was saddened but unsurprised to learn that on top of staff indifference and medication errors on the ward, the blogger had had to put up with a dirty, unpleasant environment:
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.
I have been on three different psychiatric wards and without a doubt the worst environmentally was the inner London unit that I was admitted to in spring 2017. The shared shower room smelled so awful that I washed my body and hair in my bedroom sink for the 17 days I was there. I shaved my legs there too, foot up on the side of the rather high basin like a ballerina at a barre. When I used the toilet in that shower room I looked at the perpetually wet floor where the water never drained away and decided that, quite apart from not wanting to stick around in the foetid air, I didn’t want to put my bare feet in a perpetual puddle of bacteria. There was a separate toilet on the corridor that was about the size of an aircraft loo (why, I don’t know – the corridor was wide). It smelled like a train station toilet that never gets cleaned, so I had to hold my breath as I peed. The small size and the stench made me feel both claustrophobic and nauseous.
Someone who was not very well smeared poo all over the sink and toilet in the shower room. I don’t bear them any ill will. But it took over 36 hours for the room to be cleaned, so in the interim all the woman on the ward had to use one shower room and we were a toilet down. There didn’t seem to be much of a sense of urgency.
I was, as was the author of the RITB blog, “de facto detained” – I wasn’t under section, but I wasn’t allowed to go off the ward either, not even with a nurse. Even though I go into hospital voluntarily, I always feel a bit like I am in prison while I am not permitted any leave. On this ward, the view from my window of a blank, grey concrete wall and some razor wire didn’t exactly dispel that sensation. The unit was on the same site as a general hospital and I thought of going over there to see if the toilets in the public areas were any better. I would happily have walked for a few minutes to avoid the pervasive smell of damp and shit. But of course I couldn’t.
That ward had mice on it; we saw them scampering about near the telly. They came up through a large hole around a pillar. Pest control experts had been brought in, but they said that there was nothing they could do, it was down to the Trust’s estates department to come and fill in the hole. By the time of my admission, the job had been on a waiting list for months.
Would you put up with this situation if you were on a general ward? If your relative avoided washing because the facilities stank so badly, would you think that was good enough? Is it acceptable to have to hold back vomit when you use the toilet on NHS premises? Are you content to watch mice scamper where patients have to sit to eat the toast they force down with their night meds?
These are not the little things.
Image shows a blue and white sign with the words “Now wash your hands”. This image was found on Flickr and may be used for commercial purposes and/or modified. It was produced by Peter O’Connor
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