Hospital based treatment for depression
Getting a bed in a NHS psychiatric hospital usually happens when someone is considered very ill (e.g. a danger to themselves or others). It can be voluntary or through being 'sectioned'. Sometimes it can be difficult to get an NHS bed, and one woman once felt she had to act-up a little to get one. If someone has private health insurance, they may be able to go to a private psychiatric hospital. Hospitals also have Accident and Emergency as well as Outpatient departments which people use when they do not need to be admitted to a psychiatric hospital.
Felt she had to present 'dramatically' in order to get into hospital.
And were you suicidal?
I was feeling suicidal. I was also quite violent at times. I mean in my own doctor's surgery, I swept all the things off his desk you know. I mean I did realise I was really ill when they called for an ambulance to take me into mental hospital. The same time there was a part of me, kind of watching what I was doing' saying, "Right, well make it really dramatic." I wasn't pretending exactly, but I knew I had to make a song and dance to get heard.
He felt he got better care at a London-based outpatients clinic compared with local services.
Experiences of NHS psychiatric hospitals were mixed for some of the people we interviewed. In most peoples' experience, psychiatric hospitals did not usually live up to highly negative community stereotypes (e.g. as lunatic asylums, a place for 'nutters'). But people (as well as families) who had negative and stigmatised impressions of psychiatric hospitals could feel ashamed and fearful about being hospitalised. Especially in past times, there were aspects of NHS hospitals that were very poor. One woman described a 1970s experience of a psychiatric hospital “like something out of Dickens”.
Describes her mother's shame about her hospitalisation. (Played by an actor)
Describes an experience of sexual misconduct by a member of staff at a hospital over 20 years ago.
Yup. He didn't rape me. And I have to say that I consented. And this was four days after I had thrown myself in the reservoir.
And he was an Indian doctor, I mean a properly qualified psychiatrist who was working at the hospital. I at the point where I was rescued from the reservoir, I was put into an emergency ward, and he was one of the doctors on that ward. And he approached me sexually and I kind of, half-agreed. And then, of course, was told not to tell anybody. And it was obvious from what he told me that he'd had lots of encounters of this kind. So I didn't tell anybody. But looking back, that was my first experience of sex.
At twenty, which in those days wasn't as late as it might be in these days.
You weren't well enough to'?
To know what I was doing. But of course I felt guilty, because I felt that I could have said no. But obviously my own, the own body's own natural desires at twenty are quite strong. So that was my first, and to tell it to explain just how it affected me emotionally, it was a year before I could look an Indian man in the face. I am not a racist person at all, and I don't feel that way now, but it took me a year, every time I saw a male Indian, I would recoil. That was the association with the attack.
Describes a negative and frightening experience of an NHS hospital in the 1970s.
More recent experiences of hospitals included positive experiences. For instance, people reported getting better medication in hospitals, as well as consultations with health professionals (e.g. psychiatrists, nurses, occupational therapists); much needed rest; physical and creative activities; emotional support, 'relief about being in the same boat' as others, and counselling/therapy. All such experiences could be helpful.
Describes the comfort felt when she realised in hospital that others felt similar to her.
Describes getting excellent care at an NHS hospital outpatient clinic.
Describes getting helpful treatment and partaking in beneficial activities in an NHS hospital.
While you were in the hospital?
While I was in the hospital, I think that must've been towards the end of my six months. So that, and that was by the chap he was the best' he was supposed to be the best one of the cognitive therapists I was told [papers rustling]. And I did find that, find that very useful.
So just things like that, a few things like that with cognitive therapy. You know I think they helped quite a bit. It was a sort of beginning of self, self-help, it was an experience that I could do something for myself. And I was also doing a lot of things like pottery and so forth, I was good at that. They gave me a few, some extra time to do that on my own because I was very keen on doing that. So I got back into painting which I hadn't done for many years, and I had a box of paints in the hospital and stuff by my bed that I could, that I could use. I mean I did drawings of other patients, even one or two people paid me for drawing their children which was very, which helped quite a bit.
Being able to paint and do pottery, how, how did that help?
Well it was something I' just something I loved doing, and being able to do something that I really loved doing, it made a huge difference I think.
Not all the problems in NHS hospitals have been fixed though. Certainly, there were mixed feelings about the care now available in the NHS. There was a sense that some staff care and the experience could be empowering, but also ideas that NHS hospitals are geared more to 'containing' patients, rather than really demonstrating care. There were numerous accounts of an over-emphasis on medication, or staff who made little attempt to engage with patients who were depressed and in need of encouragement.
A number of people also described how they had become 'institutionalised' in short time periods and so needed to learn how to live in the real world again. Those who had been on mixed wards found the practice of mixing depressed patients with other non-depressed (yet seriously ill) patients disturbing.
Explains that while some staff do care and you can feel safe in NHS hospitals, staff can appear...
They have been there when I've needed them. They have contained me. It's like a kind of'. I look at the psychiatric hospital as a kind of intensive care unit for mentally ill people because it's only really quite'. if you are in a crisis that you go in there.
You are having something really major going on. Otherwise you'. there is no way you'd get in there. So it's kind of an intensive' it's a kind of containment. It's a place of safety. When I am in there I feel contained and I feel [pause] I suppose I feel safe.
Believes there is an over emphasis on medication for sedation in the NHS hospital she went to.
He feels that hospital staff need to be more engaging and nurturing of depressed patients who...
Some, some nurses I believe, part of their training is to treat mental patients as being normal people. Well that's alright looked at from the point of the view of say you are capable of doing things like shaving yourself so' but on the other hand, they're not like normal people in that they' they're mostly having a very strong experience of their own worthlessness, they need to be built up.
And I mean, there are one or two things like, for instance, the office on the ward, there's' you often have nurses who are sitting in there. They may be sort of on duty at the time, but they're sitting in there, and they're not welcoming to you they're sort of waiting for you to come in and draw yourself to their attention. Then it can make a huge difference, in fact to the whole atmosphere of the ward I think. If they are just sitting there, and there's a feeling, well I don't really want to be bothered with any patients at the moment, which I mean that happens as well and that is, it's, that isn't very good I don't think.
Did not like the NHS hospital she went into when she could not get into a private hospital.
Because my insurance [pause] cover hadn't run out but because I was seeing a NHS psychiatrist and he was concerned about me and, ultimately, he sectioned me, they refused to transfer me to a private hospital because I was specifically under a NHS consultant, and they felt it was inappropriate to change that.
Who's they, the insurance?
I think the combination of the insurance and the doctors. And I was furious [laughing], absolutely furious about that because it was a horrible place. I can't remember the exact event that precipitated me going into hospital, I think it basically...it had got to the point where my husband felt he couldn't cope with me. So I... I did go into hospital and I remember putting a plastic bag over my head in there, and I remember that the nurse just took it off my head, didn't say a word to me and walked away. And it just really, sort of enforced the feelings that they just didn't care at all.
It really symbolises what you're saying about that system.
So, and then I didn't eat for 3 weeks while I was in there, and they didn't seem to notice.
Describes how she became institutionalised in an NHS hospital by the routines and safety, making...
There were routines, mealtimes, getting up times, medication times, OT times. There were routines and I had no responsibilities. I didn't have, because I live, I'm single and I, you know, I pay a mortgage on this house. I have responsibilities, I have to work to pay the bills and things, and the bills need to be paid and the cat needs to be fed and, you know, I don't have children but I have certain responsibilities and suddenly I had no responsibility. I was being cared for, or I was in a place where I didn't have to think about anything, and nobody could touch me.
Some people had private health insurance that allowed them to get a bed in a private hospital. Private hospitals were described as akin to a nice “hotel”, generally with staff who appeared engaged and “caring”. There was a wider range of treatments that were more readily available than in the NHS, including complementary therapies (e.g. group therapy, massage, yoga, meditation). However, private hospitals were not always highly rated. For instance, one woman escaped from a private hospital while suicidal and thought that the staff there were mostly agency staff.
Was pleasantly surprised by her welcome at a private psychiatric hospital.
She could see we were both very tense, very nervous you know, sort of looking round everywhere, trying to work things out. There were people everywhere. You've got nurses walking around in you know normal clothes. You've got people that are living there, you've got family and friends that have come to visit people living there, you've got therapists, psychologists, psychiatrists, doctors, GPs everybody in this place. Just bobbing round, doing their own thing, completely uninterested in you.
Says that while some nurses did care in her NHS hospital, there was more care that felt genuine...
Whereas in the NHS it was like'. when, if you needed to talk to somebody, if you wanted a nurse at all you had to go to them' and you had to say you know, 'Look I need someone to talk to', rather than' Privately people can see you need someone to talk to, or a nurse was allocated to you and so many people, and you had to have some private time with them everyday, whatever. Whereas in the NHS it was like, if you were lucky, if you went to say you wanted to speak to someone, it wouldn't necessarily be there, and then because as I say they were all too busy. And you might be lucky to see one that day, you might not, by which time you might be in a worse state.
And there were several times when I was in an even worse state because there was no one to talk to there when I needed to. But then I can't knock all because some of the nurses there, some of the nurses are generally genuinely there because they want to care for people and they were different. But there's an awful lot there who' you felt as though it was people saying to you, 'Oh, for goodness sake pull yourself out of it', and, 'Get yourself together', which you don't want, it's the last thing at the end of the day. I just don't think that there is enough, in regards to, against private and NHS, there is just not enough funding to be able to' I don't know, train the nurses in a certain way. I think that nurses in a private hospital are trained totally different to ones trained in an NHS, you know, there was a hug there when you needed it in a private hospital, but there was nothing like that in the NHS .
Experiences of accident & emergency departments in hospitals were mixed. After suicide attempts, it is possible for people be met by a lack of empathy or even hostility from staff who may not comprehend their mental despair. Nevertheless, some non-mental health professionals can be supportive.
Describes a suicide attempt where he was not met by empathy by hospital staff.
And'. I can remember being almost unconscious, and with a doctor and nurses around the bed. And the doctor said to one of the nurses, "Go and get so and so' we've got about 10 minutes or he'll be gone". And I could hear him, and I just thought, "I wish you'd leave me alone. I'm warm and comfortable. I don't want this". But they did their stuff and got me round [pause]. And that was'. that was not nice because I'd frightened my wife, which wasn't fair.
And I also had to run the gauntlet with the medical people who were something less than sympathetic. But they were looking at it from a medical point of view. So that's not my place to judge what they were saying. But it was not any easy thing' and I must have been in quite a deep state of depression to' to contemplate that [pause]'. Yeh I regret doing that.
Describes a suicide attempt where the surgeon was keen for her to tell at least one parent about...
But when my dad was there the surgeon came in and asked if I'd told him yet. And then of course I had to say, no I hadn't, so he went out, and my dad asked what all that was about, and so I told him that I'd had depression for a while and I'd been taking antidepressants, and that the reason I was there was that I had cut my wrists.
And you know he just looked stunned for a while, and didn't say much. Like I said, I wasn't very close to him at the time. So he... he then wanted to know if I'd told my mum yet, and I said I hadn't, so then he said he'd bring her up the next day, for me to tell her. So, then the next day they both came up, and he left me alone to tell her and she, she just looked distraught, when I told her [pause]. She looked like a pit had just opened up in front of her.
Last reviewed September 2017.
Last updated September 2017.