Michelle Petrie is a new contributor to Nerve. As an ex-patient in mental health units she believes that ‘I have been given a voice through Nerve magazine’ to express her views about being institutionalised.

By Michelle Petrie

The ‘lunatic asylum’ in Rainhill on Merseyside was closed in 1991. People couldn’t be ‘sent away’ any more. The old hospitals had shut and been replaced with a better system of community care where people couldn’t be institutionalised again.

Or so it would seem. Has this new system become a revolving door system of GPs, psychiatrists, hospitals, A&E, community nurses, supported accommodation, crisis teams and occupational therapy where once in the door, a person can spend their whole lives going round and round in institutionalised care in the community.

Once a person enters the system through a GP or a psychiatrist they are given a diagnosis and become a patient. They now have bipolar, schizophrenia or a personality disorder. They are given drugs in line with symptoms and perceived behaviour.

A patient’s symptoms are subdued by medication and the patient is coerced into complying with treatment, ‘as this will make them well’. They are, however, often subdued and overwhelmed themselves; frequently suffering side effects of medications like tremors, stiffness and a shuffling gait, making them stand apart as ‘someone with mental health problems’.

Once ‘in care’ a person may have regular Care Plan Approach reviews where care is discussed. If, for example, you are anxious it will be ‘cured’ with further medication and anxiety management at a day centre. If a person is lonely they are also sent to a day centre. Once in the system you are sign posted to another part of the system and your life is valued and reviewed, put on a care plan or star plan. Then the only contact you receive is with either fellow patients or staff.

You are encouraged to be a ‘good patient’, letting others make decisions for you. Eventually a patient can get where they cannot function without support. Every decision, even small ones like what clothes to buy, making GP appointments and buying toiletries are made with support. People grow a learned helplessness and lose, through coercion, the ability to do things alone.

A person can find themselves going from crisis to crisis, facility to facility or in long term supported accommodation, which has replaced hospitals. A person may enter a medium or high secure unit, the next stage may be prison. A person may also find themselves using drug and alcohol dependency services. Institutionalised and forgotten about.

People who regularly self-harm or attempt suicide often find themselves in Accident and Emergency until they are ‘patched up’ and sent back out to the crisis team or put into hospital for short or long term stays. The sad thing is self-harm can end in death. People cannot get any long-term plan of action going from crisis to crisis, often ‘known to services’ seen as ‘difficult’, and life is not good for anyone going in and out of hospital all the time.

Staff themselves are underpaid and under pressure to medicate and find answers to all problems when sometimes there are none.

Service users themselves can be guilty of forming a ‘sub culture’ where they identify themselves as mentally ill, as in ‘bipolar’ or ‘emotional unstable personality disorder’, and feel ‘normal people’ wouldn’t understand and so stay in the mental health system. People get to find responsibility and independence frightening after a life of institutionalised care and do not want to leave the system.

However, ‘if you are looking for a way out!’ what is it?

I see psychotherapy/ psychology as part of the answer. This is where an individual is given space to see how they relate to others and how others relate to them, and seeing how a person is best placed to increase their quality and enjoyment of life.

Services like good quality housing, Citizen Advice Bureau, solicitors and the welfare state help us. Yet another large part of re-joining the world outside the system.

Imagine Mainstream are an organisation (though closing in September due to the Government cutting funding) who help people back into work, volunteering, education and leisure activities in the wider community. People benefit from organisations like Writing on the Wall (WOW), Movema, Burjesta Theatre and sports centres.

I myself, as an ex-patient, have been given a voice through Nerve magazine. Living and mixing in the world away from mental health services can be the way forward. It’s good to find groups of friends where you have something in common other than mental ill health.

1 Comment

  1. Community care is obviously an improvement on institutionalisation but often ‘care’ is either too much (as the writer says any decisions are made for the person) or too little, too late (sectioned and escorted to hospital).

    Mental health issues aren’t glamorous and don’t attract sufficient health , housing and care funding.

    Michelle makes great points about not being defined solely as mentally ill and the need to make friends outside of ‘the system’.


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