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Richard McLean – An excerpt from his book ‘The Shrink’ - WhatCausesMentalIllness.com
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I began to think that melancholy was a dialect that only some people knewor could even hearand in my conversations, I sought these people out.
Virginia Heffernan, "A Delicious Placebo"
   

FAQ  


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Word Cloud  


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Glimpses

Richard McLean – An excerpt from his book ‘The Shrink’

Details

Richard McLean – An excerpt from his book ‘The Shrink’

I remember first walking down a long lino corridor that leads to the psychiatric inpatient unit, when I was lucky enough to have the experience of being a ‘consumer consultant’ for a time, with a psychiatric service.

Hearing testing, Eye care, the dentist, the doctors, and even the palliative ward where people go to pass over, are all located together in the hospital. However, in a seemingly symbolic way of representing the theme in society, the mental health ward is separate, isolated, distanced.

It’s my first day on the job as a Consumer Consultant. My autobio­graphical book, ‘Recovered, Not Cured, a journey through schizophrenia’, changed my life, and was the biggest job application I think I’d ever written.

My new peer, M, points out the Electro- Shock therapy rooms as we go through locked door after locked door, to which I now have the key, or more accurately, electronic swipe card. I had assumed that shock therapy had ended around the time of ‘One flew over the Cuckoos Nest’. There was a lot to learn.

Walking inside, I felt a pang of guilt I was intruding; I had never been in a psychiatric ward. A lot of the people I met however, did not seem as ‘sick’ as I remember being.

I spent a lot of time in that place... Yet I’ll never forget my first impression.

It’s a pleasant warm day, yet I have a long sleeved shirt on, to impress, the kind Mum would refer to when she would always suggest, ‘Wear one of your nice shirts’, to family functions, instead of the art-school-bleck-pop-punk I usually wore.

The most obvious thing about the psychiatric ward is what was referred to as the ‘Fishbowl’, or nurses/doctors station. It’s a long, central room that is behind locked doors and huge panes of glass.

It’s where the computers are, where the doctors and nurse hang out, where the cigarettes are rationed out-one an hour to some- and the place where I painfully witnessed person upon discordant person crave for attention through the thick glass, often in futility.

There are long corridors which lead to tiny rooms, each with a bolted down single bed and a small window. There is no décor or decorations. Just plain walls and place to store some clothes.

Outside in the courtyard, there are a few plastic chairs and two tables. This is where most people sit and endlessly smoke what cigarettes they can muster, (or can afford), and look over the working class suburb in the west of Melbourne, a place itself saturated in stigma.

They pendulate between this environ­ment, and the free-of-stimuli (except the TV), lounge that is inside, looking into the fishbowl. Meals were on time, and everyone lined up with plastic plates and utensils. There was an increasing amount of art from arts therapy on the walls, which I thought needed to be budgeted for much more.

Everything is bolted down, secured, or too heavy to pick up, so nothing can be used as a weapon. The carpet is fairly grim, and the chairs tainted with piss, mostly from Slavika, (name changed). I had a soft spot for Slavika, a long-term inpatient.

Here, psychiatric drugs are used to treat the symptoms of ‘mental illness’. They are also used to make the person more manageable.

But oh, the wonderful conversations I had in there. RD Laing’s term ‘acutely empathic’ comes to mind.

Time there for a person varies, yet is supposed to quite short-from 5 days up to two weeks. The people working in the field, from psychiatrists, to clinicians, to social workers, and consumer consul­tants, worked hard, with limited resources-and the beds were almost always full. It sat ill-at-ease with me though, when I would sit in on staff meetings, and the quantity of in/out people would be recorded and monitored, as if by a machine-like entity.

This time in the ward is enough time for the clinicians to drug the person enough that their symptoms recede or disappear. Enough time to place people into a frame of mind, where they will fit into society with more grace and less burden. Drug company reps would regularly visit the staff, with all amount of pens, post it notes, and food discussing the benefits of the latest anti-psychotic from particular drug companies, to the new psychiatrists.

Any epoch of time in that place would make you feel discordant. Sometimes I left there walking up the long lino corridor back to my office with tears in my eyes and anger in my heart, and a feeling of relief I didn’t ever have to endure that environment whilst I was ‘psychotic’.

Despite these ideal time frames, good old Slavika, has lived in the inpatient unit for nearly two years. She has a dual disabil­ity I am told-she has a mental illness accompanied by an intellectual disability.

There is simply no-where for her to go. So here she stays, watching the affected and often familiar people come and go over the months, and walking up to the fish bowl, pleading for cigarettes. I wish I had a dollar for every time she asked to see her case manager, or be allowed to walk to the shops.

Seclusion is a room with a mattress. It is supposed to be used in the context of ‘least restriction’, and only when the patient is uncontrollable, actively sui­cidal, or as the last resort to treatment. It’s a small room, with no clock or chair, just a bed with restraints.

To control Slavika, she is threatened with seclusion. ‘If you don’t behave-you’ll go in there!’ one of the high up workers says. To be honest, the worker is trying to run a ward with limited resources, not enough funding, and also try and look after all the other people in there. She has no choice. Yet it made me sad that the threat of seclusion would make Slavika fall back into line.

So she obeys. She is a solidly built European heritaged woman with huge googly eyes, always fondly calling people ‘Daahling’, and kissing and hugging everyone. I have seen and heard her being dragged to that seclusion room... And does she pack a lungful...an animalistic purge so raw, and powerful, makes you think twice to not pay her the attention she direly needed when she asks to see her case manager.

It seemed her dream to be married, and she was fond of me. Another client whom must have been familiar with her told me to tell her I was married to avoid the flirting and adoration from her-which I did-and she rarely called me ‘Daahling’ again.

I always feel awkward when she asks me to see her case manager-that futile lament-the correct answer is to say: ‘Slavika, the outside world doesn’t care about you-you are forgotten, trying to reach a nurse or your doctor to get you out of here or even take you for a walk to the milk bar is futile. Just accept that you will be locked up forever, because in actual fact Slavika, I am helpless. My hands are tied, you are helpless, and the staff are too.’ The staff did all they could...There were simply not enough resources. But a persons home should not be an inpatient unit.

Validating my own clichéd bigotry for a moment, I think to myself she looks ugly, sounds stupid, looks like this is where she belongs at first glance. I’m angry with myself. But looks and sounds can be deceiving.

One day she appears in the courtyard carrying a Bible and ripping the pages out-I asked her to stop, for destroying books, in my mind, was an abomination. She insists everyone take a page. She is making noises and looking ugly, she invades peoples space violently thrusting them pages.

Then she moulds into something else all together by saying, ‘The people here need to be more spiritual’.

Months after this the most beautiful piano music, a classical piece, emanated from the coffee/art room. ‘Who’s playing that piano?’ was the discussion in that moment. After walking up - there she was, gracefully yet passionately belting out a quite complicated concerto.

This was a person who was part of the character of the ward, I will never, ever forget her.

Yet the first person I met on the ward was someone else all together.

I only met him once. I wonder, as I do of a lot of people, where he is now-if he is even alive, and was he ever validated to find contentment?

I walk out onto the grass in the sunshine, and see a young bloke sitting looking out to the landscape, in these western suburbs of Melbourne. It will have been the first psychiatric patient I speak to, the first of thousands in my short lived career in that particular role.

Hi!’, I say, ‘Mind if I sit down?’ He looks away after seeing the photo ID around my neck, thinking I am a clinician, in my ‘nice’ shirt.

I’m the new consumer Consultant’, I say. He asks what it is, and the moment I tell him I have schizophrenia and am there to listen to him, his rapport and features are instantly welcoming-this is usually the response from clients whom feel they can relate to someone who has experienced similar experiences.

He has negative words tattooed on his arms in an old english font. I’m shocked to see the state of his wrists and under his forearms. They have deep wounds all across them, from years of self harm. I don’t look again.

I am instantly stoic-I can handle anything-and we chat.

We chat about a creme he has heard of that reduces scar tissue, ‘You should see how people look at me on the train’, he says in disdain.

He originally went to the Alfred hospital because he decided, and believed, he was going to kill himself. One look at his violent and unco-operative past however, the staff denied him access to the hospital, literally throwing this meth-amphetamine addicted young man onto the streets.

He retold how he crossed the road, and walked straight to the shops, found the first sharp thing he came across, a fluo­rescent light, smashed it, and began to slice up his arms. Once more.

With no more money to satisfy his addiction, and years of being in and out of psychiatric inpatient units with no relief, I’d imagine he looks at the deep futile blood clotting wounds up his arms, and curses his bodies durability.

He told me he made his way to a mates place where he takes a whole tray of Zyprexa, the anti-psychotic prescribed to him. His mate finds him when he arrives home some time later, and calls an am­bulance. He is un-conscious. The ambos quickly resuscitate him, his stomach is pumped, and he is then taken ironically to the Alfred, where he regains consciousness, is whisked off to the psychiatric ward, and ends up groggily in the morning sitting in the sun next to me, on that devastatingly beautiful day.

The cops are after me’, he says. Ahh, I know this all too well, having been familiar with delusion in the past. I think to myself: I am the perfect candidate for this job. But I ask him why the cops are after him, validating the holistic concern of any delusion he might have, as experience has taught me there is a rhyme and reason to madness.

As it turned out, he was on a Community Treatment Order, (CTO), which meant he was legally bound to take prescribed medication, because he was considered a danger to himself and/or others. He seemed to me blandly at peace, maybe for him it was a relief to be back in the I’m sure familiar ward, back to a safe place, back to being ‘off the grid’.

Under this CTO, he had to report daily to his psychiatrist, whom then confirmed the police of his whereabouts. After his three day spree of ice, he told me that most likely the psychiatrist had reported him missing to the police. What I incorrectly assumed a delusion, turned out to be totally valid and real.

I tried to think of the most appropriate reaction and a solution.

Can you give your psychiatrist a call to make sure they know where you are? That way the police wont be looking for you’. He didn’t mention any family.

I cant’, he replied.

I could empathise with this bloke, after some of my experiences with psychiatrists, I assumed dis-trust and non-compliance with his doctors. Yet I asked anyway why he couldn’t call.

I haven’t got fifty cents.’ He continued staring out into the landscape.

I took him inside to ask management for a 50 cent coin to make a phone call. Clients, or ‘consumers’ as we called them, (as in a ‘consumer’ of a mental health service), can only make a call from the ward phone, at a charge of fifty cents, and all mobile phones are banned. When you’re in the ward, you’re ‘off the grid’.

I find myself looking for his nurse, or a doctor, or ANYone to help. To no avail. I ask the kitchen lady whom I might speak to. She directs me to a nurse, darting down the corridor, avoiding Slavika’s constant pleas. The nurse informs me to look on the whiteboard-every client is given a nurse under the nurses name. Each nurse has the responsibility to address around 6 people during their shift.

I have no idea who this person supposed to be helping him is, and neither does the young man. When I finally locate the nurse, and tell her the problem, I am directed to his doctor. When I find his doctor I am directed to the manager.

When I talk to the manager, and explain the situation, he seems embarrassed, even ashamed, and the young man is whisked off to the fishbowl, given fifty cents, and directed to the blue pay phone on the wall. The exchange was so swift when we get to the phone he realizes he does not know the number.

I feel helpless.

The next day I storm into my bosses office, where I propose writing an article for ‘The Age’, about the appalling state of these poor people, the total lack of understanding and financial resources. She is appreciative of my enthusiasm for the role, yet informs me of the issue of confidentiality. She tells me my job is on the line, and that it be more appropri­ate I praise or improve the service than bagging it. I found it hard to work under such limitations, the red tape and bureaucracy, and the hierarchies.

As the weeks go by, I am deeply traumatized by what I see and experience, and take these experiences home with me, angry and sad. Sometimes I was overjoyed too, let it not be forgotten to say. I had not learnt to professionally distance myself from my day job. I guess I’m not generally enabled with clinicism, we still need all types of people to contribute to the mental health crisis though.

When I go home, I battle my own illness and have great empathy for those the same as me.

I loved those people, and mostly felt I understood them. It was such a wealth of shared experiences, different to ‘the outside’, the ‘normal hum-drum world’...that opaque and ostracized little paradise of light, dark, struggling, hope, comedy, bravery, tragedy, creativity, and individualism.

Richard McLean is an author, advocate, and artist from Melbourne Australia. He has written three books, including 'The Shrink', from which this writing in 'Glimpses' was loaned; all are available from Richard’s website at http://www.egoandsoul.com.

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