Sanctuary? Inside an NHS Mental Health Unit

The relief was palpable.

After three days in limbo at my daughter's flat in London, a place at a mental health unit had finally been found for me nearer home in Trafford.

Back up the motorway to Sanctuary.

First impressions were markedly different from 'One Flew Over the Cuckoo's Nest.'

No dragooning, no strip search, more informal.

"This is much better, Dad", said my son.

I thought so too. It was now five Days since my suicide attempt.

At last, this was somewhere I would find help with the thoughts of Sarah and Angela still pounding through my head and heart.

I prayed that being here would soothe my very soul.
But what was this place?

There were patients here who, clearly - even to my layman's eye - were mentally ill. Others who appeared almost catatonic and under strong medication (shades of Jack Nicholson again). Some had been sectioned. And there were others who appeared perfectly 'normal'. Like me.

It was a mental health unit alright - you could tell that by the locks on the doors - but the range and depth of each patient's condition, appeared to vary widely. Or wildly.

Still, it was sanctuary for now.

A consultant psychologist spoke to me for an hour, concentrating on my 'suicidal ideation'. I suppose that was to be expected - safety first.

We talked about the sudden break-up with Sarah (Woman No 1), a bit about Angela (my employer and Woman No 2) and hardly anything at all about my yo-yo-ing blood sugars and out-of-control diabetes.

Not for the first time, I was struck by how little account was taken of my physical health - and the consequent impact on my mood and mental health.

So much, again, for parity of esteem.

The consultant prescribed much stronger anti-depressants, which would take two weeks to kick in, but would help me find the sleep I longed for.

She tried to re-assure me that my life was still worth living.

But I was on my own. Alone.

There was no point in explaining. No-one understood.

"I feel like this because I can never get the love I have craved since my mother (Woman No 4) abandoned me as a child," I told the psychologist.

Her colleague winced.

I knew why I was suicidal, chronically depressed, not fit for life in the 21st Century. But the understanding didn't change the way that I felt.

Anyway, best to knuckle down and just get on with it. If I didn't, I would be sectioned. And the ignominy of that would be too much.

Sleep dominated the first few days. Exhaustion does strange things to your head, as well as your body. Sleep appeared to be the most effective remedy.

I was shocked at a friend's assessment that I had finally broken after months of pressure, stress and strain. And the continuing heartbreak over Sarah.

But it was true. I was a broken man.

Meanwhile, the mental health nurses were struggling to deal with my diabetes. I had to report to the office before every meal to test my blood sugar and inject the required insulin under supervision. They too, would not let me keep my insulin pens and blood glucose meter. Presumably they feared that, in my fragile mental state, I would try to kill myself again by injecting too much insulin and lapse into a coma.

Bizarrely, this reasonably fool-proof method of ending it all had never occurred to me before. I guess because for 30 years as a diabetic, I had always seen insulin as a life-saver, not a life-ender.

"But I need to see what I am eating first, so I can try to calculate the amount of insulin I need to take", I protested when this thrice-daily reporting ritual was explained to me. This threw the duty staff nurse for a while. It seemed the hospital canteen wasn't up to revealing the carbohydrate content of its meals. What to do?

"Sandwiches", I offered. "They should have the carb content on the packet?"

Sandwiches it was. Then after a while, I progressed, at tea-time, to a diet of ready-made halal or Caribbean meals.

Progress. But only up to a point. With every shift change, I had to explain the problem again to the nurses. My daughter even carefully typed out instructions to post in the staff room. It was never put on the notice board.

Then came the killer. I waited patiently outside the staff room one morning, for my breakfast insulin dose. And I waited. And waited. Then I went away and came back again. Ad nauseam.

Too busy, too stressed, the door remained barred. The NHS under pressure.

Eventually I gave up and tried to sleep in my bare room. No insulin, no breakfast, no lunch, no anti-depressants.

Hours passed. I didn't move. By the time my evening visitor arrived, I was, like some of the other patients, virtually catatonic. And if the means had been to hand, I would have ended it all there and then.

There was a cover-up of course. No-one took responsibility. No acknowledgement of any failing. No apology.

After that, my daughter smuggled in another insulin pen and a blood tester for me to use secretly.

But it broke my trust in the system. Again.

In the two weeks I spent on this mental health unit, I was never given any therapy for my mind. The unit's 'Activities' Notice Board stayed blank. No one ever went into the games room - the pool and table tennis tables stayed silent. Only the TV blared in one room, like a loud narcotic.

And my fellow inmates, as I came to regard them, wandered aimlessly around the corridors, or sat chain-smoking in the enclosed courtyard. The bins overflowed with rubbish, the pavements were littered with fag ends, the patients left unkempt and uncared for.

The black humour surfaced regularly. There was one particular in-joke that those of us who could summon up a coherent sentence, often used: "This place is driving me mad."

So it was.

Whatever this place was, it was not the best place for anyone suffering from depression.

So I played the game. Behaved myself. Did not speak to anyone of my 'suicidal ideation'. Or the jumbled, crazy thoughts that still kept pounding in my head. Did not do anything crazy or stupid. Did as I was told.

At least that way, one day I might get free, unsectioned. Unlike Nicholson in 'One Flew Over the Cuckoo's Nest.'

But the best was yet to come.

Next: The coup de gras