Many people are starting to argue that the mental health system in the United Kingdom is in a dangerous place. There is a serious lack of funding with cuts being disproportionately made to mental health services. However, very few of these articles and opinion pieces – of which there are many – provide a real, first person perspective of the care provided.
The sad truth is that mental health treatment has been reduced to a lottery, where people who end up in the system will have vastly differing experiences depending on which unit have beds available. The institutional environments and corresponding rules and regulations can be as distinctive as chalk and cheese. Not only this, proximity to facilities is highly variable: you can be as far from home as an hour, or as close as five minutes. All of this is contingent on where beds are available. Within facilities, the doctors monitoring patients display a wide amount of subjectivity, with different doctors reaching different assumptions on the best course of action for a patient. The conclusion is thus: depending on where you go, the experience can be entirely different.
Having had experiences of two mental health facilities, one in Ormskirk and the other in Lancaster, I feel I can draw a first hand picture of the ‘Mental Healthcare Lottery.’ Both services I was offered were well staffed – who were often caring and compassionate, clearly doing the job because they wanted to make a difference. However, both were very different in the layout of the units and the attitude towards patient care.
In physical appearance the hospitals were remarkably different. At Ormskirk, the facility was set up in quite a similar way to an average hospital. We had rooms which were shared or individual. We also had a single community area where people would socialise or watch television. Adjoining this was was a quiet break room, in which everything was turned off by 12.00pm and was locked. This left people who suffer insomnia or difficulty sleeping with little stimulation at night. Some found it possible to talk with the night staff, which was always helpful for them. Even so, the units doors, floors and such were very much hospital issue, keys were often carried by staff to open doors which made you feel like you were imprisoned more than anything else.
This was in direct contrast to the Orchard in Lancaster, which was a new facility. It felt more like a home rather than an institution. The atmosphere was warmer and although some may criticize extravagance for the patient, it was vital in keeping people at ease rather than being on edge and feeling like a prisoner. There were no keys jangling, as instead people were issued with cards that opened the doors. The rooms were far more homely, all were single bedrooms ensuring privacy and time alone when we wanted or needed it. For example, there was no need to ask to go for a shower because you had one in your room.
The difference in rules and regulations were stark. One example is that at Ormskirk people were only allowed into the outside areas once an hour for 5 minutes and despite the area being secured with a high fence and a ‘fetching’ picture of sunflowers. It seemed there was no budging on this on this policy – I even asked if I could sit outside for an extra five minutes and was told it wasn’t allowed. People were quite clearly institutionalised, lining up at the doors ready to go out for a quick smoke on the hour, every hour. This ‘privilege’ could also be easily revoked. In one incident when two plastic knives went missing from dinner, it was threatened that unless they were found no smoke break was to be allowed for anyone. The rules at times did seem rather random and also confusing, for instance I wasn’t allowed my laptop charger in case it was used as a ligature, but I was allowed my shoelaces and sometimes my belt.
In contrast, the Orchard doors to the outside were always open and there was ample space in which to stroll and talk if you wished to other patients. Going outside was never an issue and something so simple can be remarkable for people’s wellbeing. Time was never an issue either, admittedly because the facilities were better that you could be in the communal lounge at any time and it not be a problem. But nothing was turned off at night and people could come and go as they pleased. In general it had more of a relaxed attitude.
I am of course very grateful to the nurses and doctors who have helped me back to health at both facilities and the continuing treatment I receive. It is clear they are not the problem within the health service, but the real problems are evident. Sadly it is a lottery on what kind of care you receive when in a psychiatric ward and I hope that changes soon, so everyone receives the same standard of care.
By Sam Mace
Image Credit: RHiNO NEAL