Care-less mental health services

My last interaction with the mental health system in South Australia reinforced my view that Emergency Departments are no place for people in the throes of a mental health crisis.

In the middle of last year, I forgot to take my lithium for a couple of days, and I felt good. Great in fact. Of course, the crash when it came was savage. In a matter of hours, I went from being able to taste colours to suicidal. I took a big handful of pills and hoped for an inky nothingness. Alas, there was no peace from my chaotic thoughts, as soon after taking the pills I developed akathisia - an inability to stop moving, brought on by antipsychotic drugs. It’s like restless leg syndrome, on steroids with a panic attack thrown in for good measure. It’s terrifying. Dying became a secondary consideration, I just had to make the movement stop, and so I called an ambulance.

The akathisia continued to get worse and the ambos strapped me down. It was horrific. Waves of all-consuming panic engulfed me and by the time we reached the ED I was a flailing, wailing, panicked mess. My memories from here are patchy. I remember lots of yelling, some of it me, lots of it from the ED staff, yelling at me to ‘stop it’ and ‘calm down’, ‘don’t be so silly’. I remember big hands holding me down. And I remember another layer of panic because I was naked apart from a flimsy bathrobe that was open. I briefly had the presence of mind to be mortified at this. I also remember thinking, don’t you know I can’t stop this? I know what akathisia is, why the hell don’t you? Eventually, I was given an injection of something and was knocked out.

I awoke on a ward, groggy, to an older male psychiatrist and a large group of students talking over me. He was regaling the students with my ‘antics’ in the ED. Evidently, I’d ‘put on quite a show’. He dropped an appointment card for me to see a psychiatrist in a few weeks’ time next to my bed, and was off, still chuckling about what had happened in the ED. I was too confused to ask any questions. As I slowly came to, I realised I was sore all over. I lifted my hospital gown and found I was covered in bruises – legs, stomach, handprints on my shoulders and arms. When I got up to go to the toilet, I discovered I had a badly chipped front tooth. I heard someone in the nursing station describe me as ‘the overdose in bed three’ and learned I was in a cardiac ward. Nobody told me why. I asked how I got the bruises and was told briskly, ‘no idea love’. While the psychiatrist was with me (all of 3 minutes) friends had dropped in clothes, which was just as well, as I was soon told by an orderly that the bed was needed and that I had to get out.

I dressed, found a cab, and on very shaky legs, left the hospital. I was never formally discharged. I was never followed up. I never found out what happened in the ED. I only found out why I was in a cardiac ward, weeks later from my psychiatrist. The bruises healed. Working has been a bit hit and miss since these events and I haven’t had the spare cash to fix the tooth. It acts as a reminder of a situation I will try my best never to get in again. But sometimes when you have a mental illness, your best isn’t good enough, especially when up against care-less mental health services. This isn’t my only traumatic ED experience and I’d love to think it’s my last, but I also know how mental illness can derail hopes and good intentions. I keep thinking that how mental illness is treated in EDs must surely change. I read the reports and plans, I contribute to the reviews and surveys and I try to be hopeful. What else can you do but try and be hopeful? But gradually as the layers of trauma build up and impact your life in ways most people don’t understand, hope becomes harder and harder.

Image by Alex Colville

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