Friday, March 1, 2013

Australian psychiatric hospitals like One Flew Over the Cuckoo's Nest? I don't think so

The last time I wrote a post in response to a newspaper article was when the Sydney Morning Herald's Good Weekend magazine published a piece on Zanax and it's over use. In The Xanax (and other benzos) dilemma: My story I talked about my experience with benzodiazapine addiction and how my addiction was allowed to flourish while in a private psychiatric facility.

Now I want to respond to another story in the Fairfax press. Inside a psychiatric ward was published on the Daily Life website earlier this week. Author Kasey Edwards writes about her friend's experience in a Melbourne psychiatric facility. Now I don't know what hospital Ms Edwards is referring to, and as it is in Melbourne I know it's not one of the three psych hospitals I have been admitted to, but I take real issue with the article's negative generalisation of psychiatric hospitals in Australia.

"If your idea of psychiatric wards comes from One Flew Over the Cuckoo's Nest, then you're not wide of the mark", writes Kasey Edwards.

From my experience of three psychiatric hospitals she couldn't be further from the truth. Talk about sensationalist journalism! Never did I see any patients catatonic or frothing at the mouth or in straight jackets or talking about killing themselves because they wanted to escape the dreadful place they were imprisoned in.

Between 2007 and 2009 I had six admissions to three different psychiatric facilities so I have a fair bit of experience with this.

The article talks about a "$9,500 per week" hospital so Ms Edwards must be referring to a private facility. All three hospitals I have been admitted to were private. I cannot talk about the public sector because I have no experience with it.

The first time I was admitted was to a small private hospital in a beach side suburb of Eastern Sydney. The hospital cared for drug and alcohol (D&A) patients as well as patients with serious mood and anxiety disorders. I was admitted for drug and alcohol addiction as well as depression, anxiety and post traumatic stress disorder.

Yeah, it wasn't fun. People were not happy in that place - everyone was pretty fucked up so come on, of cause it wasn't a laugh a minute. We had rules and schedules to abide. Breakfast, lunch and dinner were served at specific times. We had to line up for our meds. Sometimes the nurses weren't as sympathetic as you'd want them to be - especially when you're begging for your second PRN Valium in an hour because you're coming down hard and it sucks. Sometimes you had to wait a bit for your meds, but usually the nurses were able to get everyone sorted in a timely matter.

"Patients being forced to assume child-like behaviours"? If you're managing a ward with let's say 30 patients of course you are going to have schedules and you're going to have to line up together for meals and meds. When you are admitted to a hospital you are under the care of that hospital so there are going to be only certain times that you can leave. There are procedures for signing in and out of the ward if you want to go to the shops. That is so no one goes AWOL unnoticed or hurts themselves.

That first time I was in hospital I was pretty terrified and I probably did look like a "skittish kitten that had been kicked". Being so new to any type of therapy was scary. I had only once before, very briefly, been on antidepressants so I was new to psychiatric medication as well. I was put on an ever changing cocktail of meds trying to find the right combination for me. It was not easy. In fact I had a pretty hard time of it.

One combination of medication brought on the most shocking restlessness. I couldn't sit still and my mouth even started quivering making me stutter. And then the meds they put me on to stop the restlessness caused me to slur my words for a couple of days. The first time I took Seroquel I had the most horrific night terrors I thought I was dying in my sleep. On both occasions, when I asked to speak to a doctor about the side effects the drugs were having on me, the medication was changed immediately.

My second and third admissions (both D&A, PTSD and attempted suicide) were at a different facility on the other side of the Sydney Harbour Bridge. This is where I did come into some grief. I've discussed it in detail in my previous post. More set up for mood disorder patients than drug addicts, I got into trouble with another patient, after spending a total of 10 weeks there. The only reason I left was because I was kicked out.

My fourth (D&A) and sixth admissions (post natal depression) were to a larger hospital in the inner western suburbs. Having several wards, it catered to drug and alcohol, mood disorders and post natal depression sufferers.

On my fourth admission I was kicked out for drinking (read the Dad Question Part 3) and on my sixth I was seriously sick with post partum thyroid disease which made me extremely anxious to the point I thought I was losing my mind again.

The fifth admission in between was back to the first hospital to wash out of Effexor (just like Julie in the article). I was on a very high dose of the antidepressant because of the then undiagnosed post partum thyroid disease I'd been suffering for four months - extreme anxiety, excessive sweating, 'brain buzzes', insomnia, paranoia - just presented like I was an over anxious new mum.  I was falling apart but no one thought to test my blood for thyroid issues. Anyway, I'll get over that one day.

Now for some generalisations that I experienced at three very different psychiatric hospitals in Sydney:
  • All three hospitals had schedules and rules to follow. This is like any hospital, mental or not.
  • All three had good, bad and indifferent staff. From the psychiatrists you saw once or twice a week for private one on one sessions, to the psychologists you saw in daily group therapy, through to the psychiatric nurses who were around all the time, there were some great practitioners and some crap ones.
  • Never, ever did I have to take a medication for a prolonged period that made me feel bad or had adverse side effects.
  • Never, ever did I hear a patient say they'd rather die than stay in hospital a minute longer. On the contrary, I met so many patients, especially women, who didn't want to leave! Hospital was a safe haven. A place where they could rest and gather themselves before having to go back out into the scary big wide world.
  • Never, ever did I have to talk a doctor into letting me discharge myself. Never.
  • Once I had been around the traps a few times there were others who were inpatients at all three hospitals at the same time as me. It was like a revolving door. So many people came in and out just to go back in again.
  • Not once did I ever feel over-drugged or that I had 'lost my agency'. In hospital I felt a greater sense of control which the routines help bring about. The outside world was where I felt out of control. So often I wanted to feel out of it, to escape from my reality, my flashbacks, but the therapy was there to help me deal with what was waiting for me on the outside. 
  • At all three hospitals I always had a sense that the staff were preparing you to leave, not trying to hold you indefinitely. Group therapy sessions of CBT (Cognitive Behaviour Therapy) and mindfulness were given to arm patients with the life skills to deal with life on the outside. And anyway, there are waiting lists to get into those hospitals. The doctors are not going to hold you back if they deem you fit to leave and you feel ready to go. Not when there is another patient out there desperately waiting for your bed. 

So Kasey Edwards has given one account of her friend's experience in a psychiatric hospital and her personal experience of visiting that friend. I am sorry Ms Edwards' friend had such a terrible experience when she was in hospital. But to call out that "we need to focus on the type of care mental health patients are receiving" as if it is all bad and that "it's likely that the 'cure' will be worse than the disease" is, in my belief, misinformed and rather dangerous.

What if some frightened person with serious mental health issues read that article and then became too scared to go to the doctor to seek help because they're worried they're going to be sent to the mental asylum where people are not allowed to leave?

Please, if you are not feeling ok and need to seek help, do so without fear of Australian psychiatric hospitals.

If you do need assistance these sites maybe helpful:
Alcohol and Other Drugs Council of Australia
Beyond Blue
Black Dog Institute



Teegs_88 said...

The generalisations were really worrying. It worries me that people who need help, won't seek it because of the words written in that article. Thanks for sharing it yesterday.

The Babbling Bandit said...

That was my reaction too. I thought the article to be dangerous with its negative viewpoint. I hope it doesn't put anyone off seeking help if they need it.

Rachel Eldred said...

I'm so glad you took the time to write about your experience, Vanessa. I must say the article in Daily LIfe scared me quite a bit, because I have little personal experience of psychiatric hospitals. But, yes, sensationalising one story is insensitive to others who may need to seek help. Your voice is particularly important given your experience. And I love your honesty. Thank you!

Kylie Purtell said...

I have no experience of psyhciatric hospitals and hadn't read the article you refer to. And this is exactly he problem with making generalisations and the mainstream media in general. I really hope that article hasn't done too much damage for those who genuine need and want help but might be too afraid. You should submit this post and ask for it to be considered for publication as a response to that article.

My said...

Very nicely put Vanessa. Help is out there, support and after care is also a large part of these institutions, as we both know. Without their help lots of people wouldn't be back in the world as functioning members of society.. Love your work. said...

Thanks darl! It's not all bad in here is it. Love your work!

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