Psychiatric care must be guided by humanity

Lucette Davies is trained journalist, activist and NHS campaigner who spent many years in the psychiatric system both as an inpatient and in the community. These are Lucette’s words.

The UK’s psychiatric system has been through many phases. From the early days when people were simply ‘contained’ often at the request of families. To a dreadful state where treatment options included cold water baths, insulin comas, leeches and blood-letting.  The UK has in the past at least been able to accept these approaches were wrong and change. I hope our country can do that again soon.

As the number of psychiatric conditions listed in the DSM expands so too does the number of people diagnosed as mentally unwell. And as increasing numbers of people are now experiencing social problems such as poverty, hunger, housing problems and insecure, low paid work more of us are suffering mental distress. Alongside all of this the likelihood of a person recovering from a diagnosable mental health condition is decreasing.

Surely this should be enough to prompt a major review of how we treat mental distress?

Following on from some alarming documentaries and media reports of abuse in psychiatric hospitals our Government has ordered a review of inpatient treatment. But it would seem this review is aimed simply at stopping the sort of abuse that these documentaries have uncovered.

As somebody who has lived through many years of psychiatric treatment I am painfully aware of how common abuse is in inpatient settings. But I feel more alarmed by the whole approach of inpatient settings which can feel abusive even if abuse is not intended.

Walk into a psychiatric ward and it is unlikely anybody would see it as the sort of place they would want to go if they were feeling distressed.  Wards are generally cold, clinical settings which can be noisy and often dirty.  Patients are given diets of highly processed unappetizing meals and it is common for patients to develop malnutrition after a few months.

It is also common for patients to be moved hundreds of miles from their homes when inpatients beds are limited. In my case as I was moved around the country in a state of deep depression it felt completely disorientating. I was left after several years with an unsettling feeling of not understanding where I was. Contact with my family became obviously restricted and I lost touch with real life completely.

Treatment these days largely consists of medication. But mental illness or distress is a complex, emotional experience that is affected by physical health, social experiences, life history and immediate surroundings.  When a person is in the midst of inner turmoil to tell them they have a chemical imbalance is to ignore that individual’s humanity.

I find it staggering that we continue to treat human beings in this way. Especially when the statistics tell us it isn’t working. Psychiatric staff are often well-trained in a clinical sense. But so often I have felt they seemed to forget that their patient’s were humans like themselves. Should it not be a guiding principle of psychiatric care that staff must consider whether the treatment they are giving is appropriate for a human being in deep distress?

Patients such as myself are often blamed for our failure to co-operate with their treatment. I know for me when I was finally offered treatment that felt humane my co-operation followed. As did my recovery.

Mental health treatment can be destructive. But remembering a patient’s humanity can turn a life around.