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All in the mind by S.B. Rahman

In this weeks edition to our Olympia Extracts is an example of the consequence of bad mental health called, All in the mind by S.B. Rahman

 

 

 

Commanding Voices

 

 

Eyes were everywhere. Watching your every move. Ears were open. Listening to your every word.

 

“Medication time, ladies!” shouted the nurse. This was hospital, but not an ordinary one. This was a psychiatric unit. Full of women with mental health problems. These ranged from paranoid schizophrenia to manic depression to bipolar affective disorder, as well as personality disorder.

 

Julie Brown had been admitted on Section 3 of the Mental Health Act (1983). She had been in and out of mental health services ever since she was a teenager.

 

Julie grew up in a household where domestic violence was rife. Her father was an alcoholic, who beat her and her mother senseless. Julie and her brothers witnessed these violent episodes all the time. Julie started playing truant at school. Julie was introduced to cannabis when she was only fourteen years old. Around this time Julie experienced her first episode of psychosis. It was terrifying for her. The voice in her head got louder and louder. It was telling her to do some horrible things to herself and the people around her.

 

By this time, her father had been in prison and her mother was on her own. Her mother noticed the changes in Julie’s behaviour. So did her friends at school. Julie had her first admission around the age of fifteen. Her mum could not cope and Julie needed professional help. Even Julie knew she wasn’t right within herself. However Julie was not ready to accept she had a mental illness. She believed she would never be accepted in society again, if people knew about her condition.

 

The first night Julie was a psychiatric inpatient was the worst time in her life. She saw other young girls cutting their wrists, sticking things in their arms and inserting objects into their genitalia. This was like a nightmare. How could her life have turned out this way? Once her father had gone to prison for GBH, Julie thought her and her mum and brothers could make a fresh start for themselves after years of pain and misery.

 

Sadly, that was not to be. Julie now faced the biggest challenge of her life. To overcome the demons in her head and get better. Maybe even plan a future for herself. As Julie reminisced about her past hospital admissions, a new lady was brought in. She was screaming and attempting to hit staff, but nurses were holding on to her, about four of them. Julie sat in the day room with some other patients just to keep her mind off being in hospital and her preoccupied thoughts of self-harm.

 

“So how long are you here for?” asked one of the patients.

 

“Up to six months they say on a Section 3,” replied Julie.

 

“I’m Priya Sharma,” a young Asian girl introduced herself.

 

“Nice to meet you Priya. My name is Julie Brown”. Julie and Priya got chatting about each other’s psychiatric history. Priya experienced her first episode of psychosis when she gave birth to her first and only child nine years ago. It was particularly bad for Priya. The stigma of mental illness in the Asian community was very bad. However, Priya seemed like a strong independent woman who did not need any approval from society.

 

“Before my illness, I was a successful solicitor. I had everything going for me. A nice husband, a dream home and a new baby to look forward to. However, fate had other plans,” said Priya.

 

Both of these ladies were in the vicious cycle of mental illness. They were coming in and out of hospital with no real hope for the future. Priya’s husband had since left her and was filing for divorce. Priya’s son was being looked after by her mother. Priya missed out on most of his upbringing due to her mental illness and hospital admissions. There was no going back now. Julie offered Priya a cigarette. They both sat in the courtyard smoking.

 

“Do you have any children?” asked Priya.

 

“No, I’ve never had a long-term relationship with anyone. It’s best if I don’t have any kids,” replied Julie.

 

Julie and Priya came back indoors in time for lunch. The food in mental health units was miles better than a general hospital. That’s why so many patients put on weight. And some medications make you put on weight. There were a few options to choose from as well. Over the years, Julie came to know that some patients actually prefer to be in a mental health unit than out in the community. This was apparently due to the fact that many like the company in hospital. The food was cooked for you and there were no bills to pay. For many who had no family or any prospects, it was ideal to be in hospital.

 

The clock seems to slow down when you are in hospital although there are so many activities to choose from; board games, TV, magazines, books, computer games, as well as planned activities with an occupational therapist. The time does not seem to pass. No matter how many activities you do. The bedrooms are en suite. With all these facilities, patients shouldn’t be complaining, right?

 

Wrong, despite all these great facilities there is bullying between patients, violence against staff from some patients that are unwell. There is no set date when you can leave hospital.

 

As Julie lay awake in bed, she thought about her mum and her brothers. What were they doing now? Suddenly, her thoughts were interrupted. A nurse came to check on her. This was another feature of psychiatric units. Checked on every five, fifteen and thirty minutes and some were checked hourly. This all depended on your risk assessment, apparently. A torch being shone on your face, just as you were trying to sleep.

 

“You alright Julie?” asked one of the nurses on duty.

 

 “I’m fine, nurse, just trying to sleep,” replied Julie.

 

“Do you want me to give you something to help you sleep?” asked the nurse.

 

“No, I think I will try to sleep on my own thanks, nurse,” informed Julie. That was another problem in these places; being dependent on medication to get you through the day and night. Julie was determined not to become dependent on medication. She wanted to help herself as much as possible. Julie went for breakfast in the dining room. There were not many patients up for breakfast, mainly because they were so sedated and drowsy. They would sleep until lunch time.

 

“Mind if I sit next to you?” asked a young girl with a strong Jamaican accent.

 

“No, of course I don’t mind,” replied Julie.

 

“I’m Marcia Bailey,” informed Marcia.

 

“My name is Julie,” as Julie introduced herself. “Are you on a section or informal?” queried Julie.

 

“I’m on a Section 2. What about you?”  asked Marcia

 

“I’m on a Section 3. I have had numerous admissions to hospital,” replied Julie. “Do you fancy a cigarette?” offered Julie.

 

“Please,”, replied Marcia. The two ladies walked onto the patio to smoke their rolled-up cigarettes. In psychiatric hospitals, cigarettes are very popular. Almost all the patients will be a smoker; if they were not before then they will become a smoker. It is seen as a way of relieving stress and anxiety. Julie told Marcia her life story and about how she ended up in the Florence Nightingale Psychiatric Unit. Marcia had had a terrible upbringing. Her family were not supportive; she had three children from three different fathers. Although Marcia was born in the UK, she was actually brought up in Jamaica.

 

Marcia only finished her GCSEs. However, she fell pregnant with her son at the age of sixteen. Then three years later another son followed. Another two years later Marcia had a daughter. All the men she had been with had treated her badly. They used to beat her, take her benefit money and hurl abuse at her at every opportunity. All of Marcia’s children had been taken into care. They were all on the child protection register. In a way, Marcia was relieved they had been taken away. Marcia knew that they would be looked after and no one could hurt them. Although it was difficult for Julie to relate to Marcia’s situation, as Julie did not have any children. However, Julie had witnessed domestic violence with her parents. Her mum was beaten black and blue. In mental health services, there are so many other factors that have an impact on a person’s life. Drugs, alcohol, childhood abuse and domestic violence.

 

In the day area or ‘TV lounges’ there were other ladies sitting on the sofa. Some were dribbling, some reading magazines and others talking to themselves. Julie spotted a nurse walking up to her.

 

“Hi Julie, my name is Felicity and I will be your named nurse. Is there anything you want to ask me?”

 

“I have been admitted to this unit on numerous occasions nurse. Thank you, but I think I know what to expect now,” informed Julie. Julie spotted Priya sitting in the corner, so she and Marcia went up to her.

 

“Hi, I’m Marcia,” as she introduced herself to Priya. Priya nodded at her and smiled.

 

“Are you alright, Priya?” asked Julie, looking concerned.

 

“Last night, nurses restrained me and gave me two injections,” replied Priya, looking quite sleepy. Julie understood. Almost all the patients that have had an admission on a psychiatric unit will have gone through this procedure. This was what they called ‘rapid tranquilisation’. This was used to calm patients down. Some would sleep for days. A nurse would be holding your head, one on each arm and one on each leg. They would inject into your buttocks.

 

The whole time you would be lying on the floor, face down.

 

“Priya, I am here for you,” reassured Julie.

 

“I don’t think I can take it anymore, Julie, this hospital, being away from my family. I think I need to leave forever,” Priya mumbled.

 

“I hope you are not saying what I am thinking. Please don’t try to take your own life. There is light at the end of the tunnel. You can start afresh when you get discharged from hospital,” Julie reasoned with her. Priya did not say anything.

 

Marcia planned to go out shopping. She would be escorted by a nurse to the town centre. Patients were able to get leave, even if they were sectioned under the Mental Health Act 1983. Only if the doctor deemed the patient to be fit and not a danger to themselves or the public. This is called Section 17 leave. The people in the community were scared when they saw people like Marcia or Priya. They thought patients would harm them. Mental health carries so much stigma. Even in in the 21st century.

 

“Get me some fags when you’re out, Marcia,” requested Julie. “I will pay you back,” reassured Julie.

 

Trading, borrowing money and selling drugs is so common in mental health facilities. You can’t get away from it. Boredom is a major issue. How many times can you watch TV, read magazines or play board games? Julie was really worried about Priya. How would she cope if she lost her family? Her husband was such an unreasonable man from the way Priya described him, it seemed like he would do all he could to keep Priya away from her son.

 

Julie decided to confide in one of the nurses about her concern and worry for her fellow service user, Priya. So Julie approached one of the senior nurses called Fola. Fola was an experienced nurse who was of Nigerian origin. Julie had known her for years as she had been admitted to hospital on a number of occasions.

 

“What is troubling you, Julie?” asked Fola kindly.

 

“It’s Priya. I’m worried she will do something to hurt herself or worse, take her own life,” informed Julie.

 

“What has she been doing, Julie? Does she have anything on her to harm herself?” Fola asked, looking worried.

 

“I can’t be sure. But I think so. You know about her past and how she cuts herself,” replied Julie.

 

So Fola and her colleagues decided to search Priya’s bedroom but not give any clues as to the reason for their concern. “It’s just a random search, Priya. Nothing to worry about,” reassured Fola.

 

Nothing was found during the search. Priya knew it was coming so she hid the tiny razor blade in a place where the nurses could not find it. Buried in the garden. When the timing was right, Priya would get this piece of weapon out,use it to ease the pain and stop the years of torture. This piece of sharp metal would transport her to the land of peace. No voices, no abuse and definitely no worries.

 

Marcia, Julie and Priya decided to share a take away pizza. It was Saturday night after all.

 

“How are you feeling, sis?” Marcia asked Priya.

 

“I’m fine. Everything will be alright. I’m seeing my son next week,” replied Priya. Her voice seemed more cheerful. That’s great, thought Julie. Only she could not help but worry. Had she secretly given up the fight to get better and get her son back? Julie could not be sure, but she would definitely keep an eye on her. Julie and Marcia were outside in the courtyard enjoying a cigarette. Julie decided to open up to Marcia about her worry over Priya’s mental state.

 

“I think one of these days she will end it all,” said Julie quite bluntly.

 

“Maybe you are right. But when someone is so determined, what can anyone do to stop them ending their life?” reasoned Marcia.

 

The day of the visit arrived, but there was no sign of Priya’s husband or her son. Priya sat in the quiet room for an hour. When she came out, Julie and Marcia went up to Priya and gave her a hug.

 

“I’m fine, girls. I’m strong enough to take whatever trouble I encounter,” reassured Priya.

 

“You don’t look it, Priya,” explained Julie.

 

“Let’s go for a cigarette,” suggested Marcia. So the three ladies went out into the garden for a cigarette to alleviate all their worries.

 

The atmosphere was really tense, Priya decided to start the conversation. “Look girls, thanks for your support. But you really don’t have to worry. I won’t do anything,” stated Priya.

 

“Look, sis, we care about you. Your son needs you,” pleaded Marcia. Priya knew what the girls were saying made sense. But the voices were taking over her entire life. Every waking minute of her life was tormented by these commanding voices.

 

“Let’s go back in, it will be tea time soon,” suggested Julie.

 

“I think I will stay out here for a bit longer, if that’s ok?” asked Priya. “I could do with the fresh air,” Priya reasoned.

 

“Yes of course it is,” replied Julie. As Julie and Marcia made their way back to the ward, Priya knew what she was going to do. Priya went to the back of the garden where she had buried her razor blade. She picked it up and hid it in her pocket before heading to the ward to join the girls for dinner. Dinner wasn’t so bad as the girls enjoyed fish and chips. They also enjoyed a good chat.

 

But soon the chat was interrupted with the call of “medication!” from the nurse in charge. “It’s that bloody time again!” complained Marcia. Julie and Priya laughed. As the medication round finished, the three ladies retired to their bedrooms. Priya knew that tonight was the right time. There was no going back.

 

Priya got out her note pad and pen. She wrote two letters. One to her son and one to Julie. Priya knew she was on fifteen minute checks, so she had to come up with a plan where the nurses wouldn’t be able to interrupt her plans. Priya approached one of the nurses on the night duty. Her name was Claire. “Please nurse, can I have a bath plug, I really fancy a good soak in the bath,” pleaded Priya.

 

“Alright, seeing as it is before 9.30,” sgreed nurse Claire. Priya took the bath plug, went into the bathroom and locked the door. All those years of torment were about to be over. There was a single tear that touched Priya’s face when she thought of her son. However, she quickly reasoned that he was going to have a great life without her. Priya took out the razor blade as she got into the bath.

 

Priya put chewing gum into the lock, so even if someone were to try and interrupt her plans, they wouldn’t be successful. Priya cut slowly into her wrists, both of them. Blood started pouring out of her arteries. Priya slowly started drifting off.

 

It was coming up to fifteen minutes since Priya had been in the bathroom. The nurse assigned to do the checks approached the bathroom, but nearly slipped as it seemed like the floor was quite wet. However, the colour on her face changed when she realised blood was coming out from under the bathroom door. The nurse pulled her alarm. Within minutes, staff rushed to her call. However, the nurse started panicking when her key would not open the door and the key was stuck.

 

“Priya!” shouted the nurses but there was no response. With all the commotion going on, the other patients came to have a look. Julie was in her bedroom but was curious to know what all the noise was about. As she heard the name “Priya”, Julie felt a terrible feeling in her stomach. As if she was going to be sick.

 

“What’s happened to Priya?” quizzed Julie until her eyes caught the sight of blood on the floor and her jaw dropped. “Smash the door down!” demanded Julie. “We’ve got to save her.”

 

“Come on, ladies, back to your room.” one of the staff pleaded.

 

“We are doing everything we can. Someone call an ambulance,” shouted Claire. Another staff member managed to break the door down.

 

But it was apparent. There was no sign of life in Priya. Julie could not settle in her bedroom knowing what had happened. However, she was told to stay in her bedroom every time she tried to leave. The ambulance took Priya away. She was pronounced dead at the hospital. Most of the patients were too distressed to sleep. Julie came out of her bedroom and demanded answers. Marcia joined her at the nursing station.

 

“Please, nurse, tell us what has happened to Priya,” begged Julie and Marcia. Claire, the nurse who was in charge of the night duty, took the girls to the quiet room. The look on her face said it all. But the words were too distressing.

 

“I’m sorry girls. Priya was pronounced dead in hospital. She lost a lot of blood. Her family have been informed.” Julie and Marcia broke down, comforting each other. Julie and Marcia could not sleep, so they stayed awake all night in their bedrooms thinking about Priya and how they should have spotted the signs. Maybe they could have even prevented this tragedy from happening. But deep down, Julie knew how determined Priya was as a person, so no one could have prevented her from taking her own life.

 

Morning came and went. The ward was tense from the events of the previous night. Julie was sitting in the courtyard smoking a cigarette, when one of the ward staff approached her. They handed her a  letter.

 

“This was found in Priya’s drawer. It’s got your name on it.” Julie looked terrified. What could the contents of this letter be?

 

“Thanks, nurse,” said Julie, taking the letter and putting it in her pocket. Julie went back to her bedroom and opened the letter.

 

“Dear Julie, Thank you for everything. The support you provided and the friendship you gave me. You always looked out for me. There was nothing anyone could have done to save me. Don’t blame yourself. My time had come to leave this world. Please look out for my son. He does not have a mum anymore, but I don’t want him to forget me. Please tell him I love him. Please tell him I did not want to leave him behind, but I am weak. I had to give in. Look after yourself, always. Love Priya.”

 

Tears were rolling down Julie’s cheeks. Julie knew she had to stay strong. She had a purpose in life. Priya’s son had already lost his mum. But Julie knew she had to honour Priya’s wishes and keep her memory alive. This was a turning point in Julie’s life and the road to recovery began now.

 

 

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13/05/20

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