Outpatient and community services for mental health problems
Experiences of outpatient and community services The majority of mental health care is provided by services in the community. People described using day centres, day...
Here, people describe what it was like to be in a psychiatric hospital or on a mental health ward in a general hospital. For experiences of being admitted to hospital see ‘Being sectioned under the Mental Health Act‘. People described going through a range of emotions when they entered hospital, from feeling upset, helpless and confused to feeling happy (see HY Leung’s story) and relieved.
Several people refused to talk when they first arrived because they felt concerned about what might happen, including one woman who felt she would ‘never be able to call myself normal again’. Others felt they had no one to turn to, although some people did make friends during their stay. Although some had visitors while in hospital, not everyone felt they could trust or talk to their visitors. One woman had a visitor who told her, ‘if you don’t cooperate with them then I am not going to come and visit you anymore.’ [See Sara below] People also mentioned feeling as though no one understood or believed them while they were in hospital.
Some people said they felt hospital staff had been very good and caring: ‘The staff were okay, really good. Some of the staff you can get on more better than others, but all the staff have been really understanding because I’ve been in the same hospital all the time. The staff get to know you.”
Others felt staff could be indifferent or unsupportive, including one man who thought they had ‘lost all humanity’ and talked to him in ‘regimented way’. One woman found it difficult because no one could understand why she wanted to self-harm (see ‘Anxiety, negativity, mania & loss of energy‘). Another woman said her community mental health team were good but being in hospital was a ‘different ball game’ [see Dolly below]. One man accused staff of drugging the patients (see Michael’s story) and some felt their treatment was affected by their ethnic background (see below).
A few people felt that the high number of hospital staff who were recent immigrants were unable to understand them, partly because they didn’t understand British culture and that was part of their identity. Others thought that professionals from a minority ethnic background would be better able to understand and identify with them (see ‘Outpatient & community services‘).
Many people found it difficult to identify with other patients in hospital, either because they were unwell or because there few people from the same ethnic background as themselves. One man said he was attacked by a patient because he is Black. Many people felt vulnerable because of the sometimes unusual behaviour of other patients. Some felt afraid and described conflicts, threats and attacks. Mixed sex wards were unpopular.
Although some hospitals were described as OK – for example, one man described a respite unit as ‘somewhere where you could go and relax’ – many people recalled mainly negative experiences using words such as ‘horrendous’, ‘horrible’, ‘harrowing’ and ‘traumatic’. A few people had been in hospital recently, while others were hospitalised in the 1960s and 1970s: ‘I had two voluntary admissions in the 1990s in a modern psychiatric ward in a general hospital. A vast improvement on the old Victorian mental hospital building I had stayed before’. One man who had never been in hospital saw them as ‘nasty’ places. Some said the hospital was dirty, including one man who had asked his doctor to admit him to hospital after he attempted suicide.
In hospital, there can be a variety of activities or occupational therapies ‘that will pass the time ’til you get better’, including watching television, videos or DVDs, playing games, exercising, going on trips, sewing and cooking. A few people remarked that in hospital there was ‘nothing to do, so that was driving me mad’.
Many people disliked being in hospital on have been sectioned under the Mental Health Act, even if they knew it was the right thing for them. This was because it meant they lost their freedom and couldn’t leave if they wanted to. Even informal patients might be on a locked ward. Because hospital is a ‘closed environment’ one woman remarked that your behaviour can’t go unnoticed. Others mentioned how there was a strict routine in hospital (see Anton’s story) and they were treated ‘like cattle’. A few compared hospital with prison, including one woman who recalled how her suitcase was searched (see Jay’s story).
When in hospital, many people were given some form of treatment, including medication, talking therapy or electroconvulsive treatment (see ‘Talking therapies & ECT or our section on experiences of ECT). A few people also described having little choice about taking medication, including one man who felt he was heavily medicated because he is Black – something he felt indicated institutional racism; he later accepted his treatment, forcing himself to trust the staff (see Devon’s story). One woman said ‘most of the time you just try and dodge your medication’ [see Mae below]. (See ‘Prescribed medication & side effects‘ and ‘Not taking prescribed medication‘). One man, however, found it difficult to access care for his physical health (see Michael’s story).
Some people described experiencing or witnessing discrimination and thought that the mental health system was institutionally racist (see Devon’s story), ‘we’ve had a lot of problems in hospital and the way they give you medication and the way they restrain you. Most of the times the nurses: hands are tied but some of them can be real bullies.’ Others felt assumptions were made about them and their needs.
Another man was made to wear a straightjacket on one occasion but said if he was treated differently, he didn’t think it was because he is Black.
A few felt that hospitals weren’t culturally sensitive and failed to provide a range of culturally appropriate food. One woman found it difficult to communicate without a translator and was very concerned that the doctors would misinterpret her behaviour.
A few people said they were discharged because of their behaviour (drug taking, violence) and failure to co-operate [see Mae above]. Others were gradually released, at first coming out during the daytime only, or going on a daily basis to a day hospital. One man said he was eventually released because he was not ‘genuinely ill’, although he felt they gave him a more serious diagnosis instead. Others considered the implications of being hospitalised, including one woman who felt ‘very, very lucky to get out of the psychiatric system, because a lot of the people don’t manage that’.
Experiences of outpatient and community services The majority of mental health care is provided by services in the community. People described using day centres, day...
Here, people talk about their experiences of being admitted to hospital, in some cases using powers provided by the Mental Health Act 1983, or 'being...