Tthree years, seven months and 19 days. That’s the time I spent in prison in the psychiatric system. I look back on my years in inpatient wards with a mixture of grief and sorrow. And I still wonder: Is institutionalized care really the only option for the most critical cases?
When I was 27, I had a psychotic episode. Psychosis is relentless. It preyed on everything I knew about myself, leaving a dark void of a person. I was sectioned under the Psychiatry Act and detained against my will in the hospital.
I arrived at the department depressed and delusional. A psychiatrist quickly diagnosed me with bipolar disorder and prescribed medication. My mood lifted; the doctors fiddled with cocktails of drugs until the delusions subsided. Being here was a vacation for my mind, a place of security, a place to get better.
But life in a psychiatric ward is regulated and controlled. I took my medicine at the same time every day, ate at the same time and slept at the same time. I lost my autonomy: the staff dictated when I went outside and for how long. They counted the cutlery after each meal before I was allowed to leave the dining room to check that I had not taken anything I could harm myself with; all sharp objects I owned – razors, tweezers, even glass makeup bottles – were taken from me and stored in the safe. I was wanted every time I came back from going outside.
I know this was done to protect me, other patients and staff – but it was suffocating. As an 18-year-old, I had wandered across Nepal on my own – now all my freedom and autonomy had been taken away.
In the year to March 2021, there were 53,239 new detentions under the Psychiatry Act – an increase of 4.5% compared to the previous year. Mental health professionals will tell you that they always avoid keeping people out of hospitals if they can: long hospital stays can lead to addiction and institutionalization, rather than the autonomy and freedom people need to recover in the long run.
Currently, 8 million people are excluded from NHS mental health care because they do not qualify as sick enough, and a further 1.6 million who do so are on waiting lists. With this in mind, it’s easy to see how mental illness can get out of control. This crisis in care means that the idea of supporting people like me in our community, where we can get professional help together with a network of family and friends, is becoming more and more distant.
I met patients who had been sick in psychiatric wards for years – some even decades. It’s not life. I got used to the alarms going off all day and night while the staff hurried to the bedroom of the patient who had most recently self-harmed. If a patient could not be handled, they were led to seclusion, a completely bare space. The goal of putting them there was to reassure them. I could hear their cries and cries and it still haunts me.
Once, a fellow patient stopped taking his medication and had relapses. She wrote exclamations on the walls in ink, destroyed the department’s garden, and smashed her bedroom window with a snooker ball. Another day a patient came into my room and swallowed the batteries from my remote control to the television and had to be driven to the emergency room. After that, I never learned to leave my door open again.
I owe the staff of my department my life – their inexhaustible energy and supply of compassion and patience gave me back my dignity and self-esteem. I learned the importance of taking care of myself. “Self-care” has been hijacked by advertisers as a millennial middle-class figure, but it’s so much more than an expensive hot tub. It is to make sure I take my medication on time. It is to ensure that I am not under too much stress professionally or professionally. It’s cultivating my friendships and support networks. Most importantly, self-care is a mentality; it is to forgive myself and prioritize time and kindness for myself.
I also started an Open University course while I was hospitalized. It gave me goals, drive and motivation. I was no longer just a patient or a diagnosis; I was a student with ambitions and goals.
Still, I question whether I really needed to be in the hospital as long as I was beyond my first crisis period. I was, as Sylvia Plath wrote, imprisoned by the bell jar, “stowed in my own sour air.” The jar – my mental state and the rules of the institution – suffocated me over the years as I struggled to get better. The psychiatric ward taught me many things, but primarily it taught me how important freedom is. We need to have a national conversation about whether the best way to treat patients with severe and lasting mental illness is to leave them in psychiatric wards.
When I recovered from my illness, every step towards becoming free was a small victory. I gradually started to worry about my appearance when I stopped bothering when I first got sick. When I was discharged, I went for long walks in the park, read and wrote in cafes and went out drinking with friends. Regaining my freedom was like going from sepia to color. I still think back to my time in the psychiatric ward and wonder how my fellow patients are doing. Are they out now, living their lives, or are they still confined to the maze of hospital life? I pause, and then I move on. Now I have to write my own story.