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 our ‘Resources’ page).
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.
Graham describes going to his GP, who explained to him that he needed to go to hospital.
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Pete describes going to his GP, after which his dad took him to hospital.
Pete describes going to his GP, after which his dad took him to hospital.
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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.
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 behaviour of other patients in hospital, but then he met some friends and found the staff to be professional.
David tried to walk off the ward and was sectioned. At first he was frightened by the strange behaviour of other patients in hospital, but then he met some friends and found the staff to be professional.
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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.
Dolly was on a mixed ward where some men wanted sexual favours from the women.
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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?
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.
André had an unpleasant experience of staff and the diet available in a secure unit he was in.
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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 conditions were harsh, had it not been for the side-effects of the injections.
Andrew was in a county asylum in the 1970s and would have found life bearable, even though conditions were harsh, had it not been for the side-effects of the injections.
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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 into hospital.
When Janey was first admitted she used to be bored, but now she brings a book, a pad and pencil into hospital.
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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 on the ‘Resources’ page.
Last reviewed July 2017.
Last updated April 2014.
Last reviewed July 2017.
Last updated April 2014.
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