Experiences of psychosis

Hospital Treatment and Compulsory Care

In this summary, people talk about their experiences of being admitted to hospital, in some cases compulsorily via powers provided by the Mental Health Act 1983, or “being sectioned”. This law changed slightly as a result of the 2007 Mental Health Act to include supervised community treatment (i.e. increased powers to treat people in the community) and a broader definition of mental disorder. Rethink provides information to people about their legal rights and what someone may be going through (see ‘Resources’ section).
Only a few people we spoke to hadn’t been to a psychiatric hospital at some point in their lives. Several people had been to hospital a number of times. People sometimes sought help from their GP and were then referred to a psychiatrist who thought they should be admitted; others ended up in hospital because they had taken overdoses. A few people were taken to hospital by the police following serious concerns about their behaviour. A couple of people who went to A&E thought that they were dying or had other physical health problems such as heart palpitations, but eventually they were admitted to a psychiatric ward because of serious concerns about their well-being and safety.
What happens when you are ‘sectioned’?
To be sectioned, three people (an Approved Mental Health Professional [usually a social worker] or nearest relative and two doctors) must agree that the person is suffering from a mental disorder (e.g. schizophrenia, psychosis or bipolar affective disorder) and needs to be detained for assessment or treatment, either for their health and safety or for the protection of others. However, people can also be admitted to hospital as ‘voluntary’ or ‘informal’ patients.
Being admitted to hospital
People ended up in hospital for a variety of reasons. Arwen was found by someone she knew wandering down the road in her nightdress and was taken to a doctor, who arranged for her admission to hospital. Later she remembers being very frightened in hospital as she thought an electric drill was talking to her. Colin was round at his friend’s house and his friend thought he had taken an overdose, so took him to hospital where he had his stomach pumped. When they couldn’t find anything physically wrong with him, they eventually transferred him to a psychiatric ward. Rachel had stabbed herself in her liver when unwell and was transferred from a surgical to a psychiatric ward.
When people talked about being admitted to a psychiatric hospital, they often said that they found this a very confusing and distressing time. Sometimes they were completely unaware of what was happening to them as they didn’t know anything about psychiatric hospitals, or were too distressed to be able to understand. Nada even thought she was being taken to prison and was about to be executed. Some people felt they would be better at home and didn’t want to be taken by force, but Arwen said that when she was unwell hospital was the best place for her.

Graham describes going to his GP, who explained to him that he needed to go to hospital.

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Age at interview: 47
Sex: Male
Age at diagnosis: 22
So I came back and it was a fairly sleepless night and we went to the GP the next day, and she again, sometimes they have got professionals that are superb and she was really, really good. She, she put me in a room on my own after I’d explained myself and by then, I was really quite inarticulate and articulate and my body was making all sorts of jerking movements. And she phoned the hospital and said I had to go there straight away. And by then it was sun shiny and every bright reflection was a spirit in my mind. So on the journey to hospital I was, I was hiding in the well of the car from spirits and we got to the hospital and I was seen by a psychiatrist quite quickly and in the room, he was interviewing me and then the phone rang and it was a person in huge distress. She was obviously suicidal and I immediately assumed that I was beaming evil thoughts down the phone and that I was causing her to be suicidal. So I ran from the room and hid in the courtyard. And a nurse came out and she was really nice. She was very calm and she just crouched near me and just encouraged me back in. And then I was admitted to hospital. And that was quite hard. Just because, you’re going into a large institution and you’re very distressed and you’re very confused and basic things like where you’re sleeping and how to eat and what all the other people are doing and whether you’re allowed to smoke or whether you’re not, was just bewildering. So... I just got very frightened and I spent most of the first day hiding under my bed. And occasionally nurses would gather round the bed and then give me haloperidol sort of to take which was horrible. And I didn’t want to take it and they were just saying I’d got to, because it was good for me. And yes, I was just obsessed with, with these evil spirits which I thought were changing my thoughts. Getting rid of the evil, and not touching anyone. I thought if I touched anyone especially those I loved they would be infected by evil. And I thought all I, the only thing I could do was to go to the woods and get rid of my blood. And it’s only about 6 months ago that I found out that I was sectioned then.

Pete describes going to his GP, after which his dad took him to hospital.

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Age at interview: 48
Sex: Male
Age at diagnosis: 30
Can you describe your admission to services?
I can the first time was very, very frightening, the GP had come and he said, “I think you should go in hospital.” Now I was ignorant to Mental Health and I mean very, very ignorant, so I never thought of the Mental Health Services I thought he was going to put me in a general ward I thought ‘nurses fussing around for a couple of weeks that’s not too bad’, you know? [Laughs] so me Dad said, “Well I’ll take him.” And he took me to the local Psychiatric Unit and it was a real eye-opening experience it was absolutely filthy there was people laid on the corridors, there was double mattresses on single beds, it was really, really frightening as well. Anyway and I was put in this, this like observation room and this female doctor came to see me and asked me what had been happening so I tried to explain, and the, her next comment really, really shook me because she actually said, “I’m going to start by giving you a rectal examination.” And I couldn’t understand why, I thought it was an elaborate plot, they just want to abuse me again and the fact it was a female saying it and I would been abused by a female. So I tried to run away I run out, I ran, tried to run out the hospital, and at this point I hadn’t been sectioned, and this nurse said, “You can leave but if you leave we’ll section you.” Which I’ve learnt, I found out its illegal because it’s coercion. So I decided to stay and me behaviour spiralled out of control and I was sectioned under the Mental Health Act.
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Margaret had a frightening experience at A&E when she thought her heart was stopping.

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Age at interview: 41
Sex: Female
Age at diagnosis: 27
Well I was, oh let me think. I was, yes, in [place] I actually thought my heart was going to stop when I was just so terrified. So I flee to A & E and I was getting a commentary and they were telling me all about psychiatric drugs, and I didn’t even know what they were at that point. I found out later, all the names that they’d and they said, “You’re going to have an aortic aneurysm.” You know, [tch] and I was only a young thing [laughs]. I was only in my twen… twenties, 27, yeah. And so I fled. And nobody came to help me in A & E. They just put me in a room and left me there and I was so distressed that I thought, right I’ve got to get up to [place] So I was quite a way away and I walked like two or three miles to the train station. And it was in the middle of the night, so none of trains were running. So I got a, taxi which was something like £180 to [place]. Got to my brothers. And when I was in my brothers he popped out to the shopping earlier in the morning. It was morning by then, and his answer phone came on and he gave his normal message and then he actually left a message as well and said, “There’s a gun in the third drawer down in the bedroom drawers.” You know. And then a couple of minutes later, the answer phone went off again and gave his whole message, and then another message, “There’s some razor blades in the bathroom cupboard.” And so then when he came back from the shop I said, “You know, that you’ve left some, why did you leave those messages on the answer phone?” And he went to check it and he said, “Well, there’s, nobody’s left any messages.” So this was all my… It shows how powerful, they can actually imitate an answer phone machine in a very psychotic state. So of course I didn’t trust him at all. He was, he was out to get me and he just left two messages. I didn’t know it was, I wouldn’t have thought that was possible to come from inside your head. And to actually hear an answer phone. And so I thought I had to escape. And that’s when I escaped. And you know, made a, booked into a hotel and made a suicide attempt. It’s quite important to say I did not want to die but at the time I was extremely distressed and just wanted to be released from the voice as my mind was being tortured. Which didn’t quite work out how I’d planned. And the voices were with me, all through that, just goading me on the whole time. 
So encouraging you to commit suicide?
Well just having a ball out of it. Just, you know, I had, you know, my Dad’s voice, when he used to scare us as a monster when we were children. That was going on, and … [laughs] It was, you know, it was... quite a horror film really. And that didn’t quite work. I sort of panicked at the last minute because I thought I was going to end up, you know, brain damaged or something, because I hadn’t quite done the job properly. And so I was taken to the A & E to 999 to hospital. I think they found me in the lift or something. And ..
What did you try to do?
Oh overdose and cut my wrists yes. And alcohol and you know. And then I think I have a quite, about a three hour operation, a repair operation. So I was in hospital in [place] for a while. And after I’d had the general anaesthetic I’d completely touched, lost touch with reality you know, I thought I was in some kind of virtual reality. I wasn’t sure if I was dead or alive. The antibiotics, they were, the IV’s they were giving me, I thought they were embalming me. And I thought I was on the top of this hospital ward in this hospital being experimented on, and they were chopping bits off of us gradually. You know, it was just a horrible nightmare.
But anyway, then I was shipped back to, back to [place], and yes, then... I started on the tablets and that helped. 
Whilst most people didn’t want to go into a psychiatric ward, a couple said that they were frightened but also a bit relieved, as now someone was going to take them seriously, or that something was going to be done about their distress. Most people were almost completely unaware of their legal status when they were first admitted, and a couple of people mentioned wanting to ring the police for assistance as they felt they were being unfairly held.
Life in hospital
Many of the people we spoke to had spent quite a bit of time in hospital. After people had been admitted they sometimes wanted more information about what had happened to them, or even simple things like where to keep their things or where things were. Often it was the other patients who helped them. Several people said that they were surrounded by people who were more unwell than they were. When people are held under a section of the Mental Health Act they can leave the ward only with the permission of their doctor – under Section 17 of the Mental Health Act. Initially this may only be for short periods in the local area and whilst escorted by staff.

David tried to walk off the ward and was sectioned. At first he was frightened by the strange...

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Age at interview: 40
Sex: Male
Age at diagnosis: 18
And so you got admitted into the hospital. What was that like?
Well when I was first was admitted I came in voluntary and honestly I tried to walk off the ward and they give me a three day section, you know, an assessment section but I know when I arrived, I know I was a right place by you know, I stayed there.
And how did you find it in hospital?
It was all right yes, yes. I was, I felt safe, I was not in the right place. It was a bit frightening with all the strange behaviour going on, you know, but yes … but like I say I felt that was the right place like, you know.
And what happened then?
Oh gosh. Well my social worker said I had eight admissions over five years. So I was in there for a while. My first admission I was there five months. Five months in the gate house and four on the wards and what not. It was all right. The hospital, [name] is a big old Victorian asylum I was at, so now you know, but … I met people, people that I am still friends in there. So … it was all right.
You got on well with them?
Yes. Yes. Most of them.
And what were the staff like in hospital?
They were okay, like. I don’t know. You have your favourites, and the ones you don’t like, you know. But yes, it was all right, they were professional you know  

Dolly was on a mixed ward where some men wanted sexual favours from the women.

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Age at interview: 39
Sex: Female
Age at diagnosis: 22
Can you remember being in hospital?
I , well I remember the first time I was in hospital. It was horrible because it was a mixed, a mixed ward and you know, a couple of the guys were really aggressive and wanting kind of, you know, sexual favours. And I did think that the time that these, you know, women are at their most vulnerable. You know, especially the ones that were depressed and can’t even do anything, and having kind of guys being quite aggressive about their sexual advances, you know. How is that supposed to be therapeutic to the person?
Yes, that was the only interaction you had with the nurses was during the medication time.
So, you know, the boredom of just sitting. All you had to, because I was on a four-bedded bay unit, with no privacy. The only thing to do was to watch TV really. And... and what made it worse the TV wasn’t even properly tuned so … it’s just. But there’s so many cases, they don’t know, they stare at the, you know, things, and not really absorb it. But I wasn’t really very heavily medicated for the first few days and I was as bored as hell really, and I thought if I was going to spend any more time in that, you know, in that ward, I would be really, you know, literally rot away. But I kind of got, the only kind of really support I have to say I got was from the other patients. So you know, there was many a time I was crying on the ward and no nurse came to comfort me. It was you know, for the patient. And there was one lady, I’ll never forget this, she went, she saw that I was crying, she went out, to the kind of drinks machine and she bought me back a can of Cola to cheer me up. And I thought that was just so sweet, and when you’re feel very like, vulnerable and very alone, and attacks, that kind of little bit of humanness and a little bit of compassion makes all the difference. So you know, that’s what I …
And then, you know, they told me, me the, you know, like the tricks of the trade [laughs].
Tell me about these?
Oh stuff like, you know, what you should say to get out as quickly as possible. Which I did, you know. Basically they said, “Just lie, about how you feel. Lie through your teeth. Tell them, if they ask you can hear things, say no. You know, if they ask you if you’re paranoid, no. I’m fine.” And that is exactly what I did. Like I think, my second ward round. I said, “Oh I’m fine. It was just a bit of stress I was going through.” And they discharged me.  
Several people talked about psychiatric wards in negative ways, e.g. as being dirty, noisy, frightening and chaotic, with some staff who did not seem to talk to the patients. Graham talked about seeing simple indignities, such as an old man who was admitted and didn’t have a belt, so had to hold his trousers up. Others found day-to-day life in hospital boring and didn’t like the food and the general conditions.

André had an unpleasant experience of staff and the diet available in a secure unit he was in.

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Age at interview: 29
Sex: Male
Age at diagnosis: 23
Obviously don’t expect to be given beluga caviar and champagne, but likewise, I’ve got a piece of cheap steak, frying steak in my fridge and that’s just not cheap to give them cheap frying steak. That’s no expensive to give with a cup of tea if they want one. It is not expensive to, even in prisons to have an exercise yard to go outside. Those sorts of things are not expensive. I mean obviously NHS cuts corners so does [Name of hospital]. But they cut corners in that institution on purpose. Perhaps to make you aware of your existence. Perhaps humility. Make you face up to who you are. But obviously I’m not a murderer. I’m not a rapist. I’m not a paedophile. I’m not a drug trafficker. I’m trying to think what other things it can be. So all of them, you know, I’m in the wrong environment. If they try and make you face up to who you are. Anyway.
What was your experience of the staff like in there?
Well they were blowing whistles and things. They used to do their concentration camps. When they are Jews to go off, but when […] I think, when they have taken off the drugs, they start blowing whistles to get stumpf comments and that . And they were doing a similar thing and of course they were lazy, the staff, extremely lazy. And I, because I was allowed carbohydrate and the only thing there was a pack of biscuits, but they wouldn’t give them to me, even though they had like, you know, like 300 in the store cupboard, and also they wouldn’t give me fruit. They wouldn’t buy any fruit. It’s bad for diet. 

Andrew was in a county asylum in the 1970s and would have found life bearable, even though...

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Age at interview: 59
Sex: Male
Age at diagnosis: 24
And what was life like for you in a county asylum?
Well I would have accepted life in a county asylum. I would have accepted living in a ten bed male dormitory with no privacy. I would have accepted packing soap or assembling valves in industrial therapy for £1.75, so I could buy tobacco and I would have accepted that, and I would have even accepted the disgusting National Health food and many people accepted that as a sort of a version of sort of living in some kind of military barracks. Perhaps people who’d been around since World War II and National Service. You know, there were quite a lot of those people in 1974, because National Service only came to an end in 1962. So you had all the people who were still quite fit and young and active, and had their lives to lead. And they’d either been through World War II or been a National Serviceman. So kind of being a male dormitory and having menial tasks to do and that it was a bit like being in the army possibly. So there was that kind of element to it. I would have accepted that, but they did insist on giving me these horrendous injections which produced dreadful side effects, and that was sort of deal break for me. I was always trying to get myself discharged so that I could escape the side effects, the akathisia, the restlessness of the injections and that was the basis of my revolving door time. But I would have accepted life there. And many people over the years did find the asylums to be their home. And despite the privations and the conditions of life, where we had no privacy, you had to, you had to put up with communal resources all the time, your sheets and your clothes were all washed together with other people’s. And the general conditions of the asylums. And those people found it home. 
However people also mentioned positive things about being in hospital. For example, people made good friends whilst there. Some people said they got help from understanding and kind staff. Graham said that when he had slashed his wrists a nurse was wonderful and looked after him, and Janey said that she got hugs from the staff she knew in hospital. She also said that good care was when they knew her ‘as a person’ rather than a patient. Rachel said that she had a good psychiatrist with whom she could discuss her psychosis rather than just being involved in a ‘hoo haa’ about whether she would take her medication, whilst another man spoke about doing art work that he enjoyed while in hospital.

When Janey was first admitted she used to be bored, but now she brings a book, a pad and pencil...

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Age at interview: 52
Sex: Female
Age at diagnosis: 29
What was your experience of spending time in hospital?
I would always be in the same hospital. I suppose I’ve got used to its limitations. Don’t mind it. I’ve worked out a way of make, creating a space that’s my space. So even though it’s, it is, it’s a mixed ward, there were separate dormitories. It’s usually four people to a dormitory. I can, even though it’s curtains, only curtains around us, I can make that space mine now. So it’s a safe place to be in. Occasionally if you’re lucky you get a single room, but that’s not very often. Made a lot of friends in hospital. Have worked out what is edible on the menu. Usually these days, I can remember when this first happened to me, I used to be bored stupid, because there’s nothing to do in hospital, apart from you know, agitate the nurses, or talk about the doctors or something. Nowadays I’ve just got a set of pencils and an art pad, and just take that with me, and do that. Or read something. It’s a great excuse for reading really simple literature, you know, Jilly Cooper or something. Because nothing you can’t really read anything more complicated than that, because your brains not working properly. So it’s a time when you can read some real trash novels.
And you’ve worked out these strategies now. What was it like when you were first in hospital?
When I was first in hospital I hated it. I didn’t know what to do with myself. It is very difficult because you genuinely cannot concentrate. If you’re really, really distressed you can’t read either, and so a lot of time in hospital pacing around a lot, being given extra medication for all sorts of things. Being held down and given medication occasionally. Trying to escape occasionally as a sort of spontaneous user group forms where you all get together, and, and it works really well actually. Talk about things that you have in common and so say oh that happens to me and the way I deal with it is like this, and you learn from people around you.
So what sorts of things have you learnt in that way?
Things I was learning. The questions the doctor asked, I always remember this particular group, and this is 3 o’clock in the morning. All of us, the doctors had, had sounded as if they didn’t believe. They also kept asking the same questions every time you saw them. So my, what I deduced from that is that he doesn’t believe me. He’s going to keep asking until he gets the right answer. And I thought why is it? Why is he doing this to me? It turns out that’s the way he dealt with everyone. And we didn’t know it. And so it’s very comforting to hear other people say he did it to them as well. 
Many people we spoke to were now treated at home, by Community Mental Health Teams or Early Intervention Teams or Home Treatment Teams, instead of going into hospital. You can read more about these, and the transition from hospital to home, in the ‘Experiences of Outpatient and community services’ section or in the ‘Resources’ section.

Last reviewed July 2017.
Last updated April 2014.
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