by AB Morgan
‘Anyway, I must impress on you to be careful not to overdo the acting, as you may attract too much attention which would result in treatment being administered early on in proceedings, and there may be consideration of the use of an injection. You must avoid this. Remember, as the prof said, you will be expected not to swallow any medication given to you. Unless you have a headache or need a sleeping tablet in which case, please make sure you know what you are being given. Here is my top tip. If a nurse or doctor offers you “something to help you relax”, this may not be a sleeping tablet. Always politely decline. However, if you have been prescribed treatment with tablets, then you must pretend to take them. Please don’t get caught hiding or disposing of medication otherwise, again, you may be required to take liquids or be given an injection. Simply become model citizens, and show the staff how you have recovered from whatever took you there in the first place.’
Mark realised that this was far from being a tame assignment. Injections meant needles and he hated needles. He’d rather risk humiliation by chatting up a girl and being rejected, than have an injection.
Lewis James then returned to his favourite subject of the law. ‘If you are placed under a Section, you must appeal at the earliest opportunity. You should be given the details about your rights if you are placed under Section, but no one automatically appeals for you. If you do unexpectedly end up on a Section 3, which is highly unlikely unless you have done something stupid, then appeal immediately. This is why we insist that, as soon as you are admitted, you show no further strange or bizarre behaviour. If you are already odd or bizarre then frankly you are on your own.’
There was a ripple of laughter around the room at this comment.
‘The team on the ward in these hospitals are there to look after you and help you, and we are only interested in the skill and ability of those staff to assess and identify mental illness, and only to treat if this is necessary. They are also under pressure for beds to be freed up, so if you are not requiring care and treatment then your discharges should be relatively swift. We anticipate two weeks maximum, and that would only be if things did not go as well as planned.’
Linda raised her hand. She had been remarkably contained, and appeared to be focussing on every word and gesture from Lewis James. Mark assumed that she had become transfixed by his matinee idol good looks.
‘Could I ask about the patients we will be on the ward with, and will we have our own rooms, and could you explain the usual arrangements for use of the bathroom and toilets and such like?’
‘Ah! Yes, lovely lady,’ Lewis replied. Charlie and Mark looked at each other, and tried not to allow themselves a chuckle at the thought of Linda being described as lovely. ‘These are indeed most important points. Let’s look first at the practicalities. Not all hospitals are the same, but in general there are a mixture of single rooms and small dormitories. Many places are well appointed, and others a little tired looking, shall we say. There is usually access to a payphone so you can contact John Starkey, Prof Hugo, or myself. We advise taking a couple of ten pence pieces with you, but you should not take wallets or purses full of money. Only have with you a minimal amount of cash for necessities. Nor should you have any of your own ID in your possession. I’m sure that is an obvious point, but worth saying nevertheless.
‘Now then, other information: those of you who are tobacco addicts may be relieved to hear that psychiatric wards have a smoking room, which should be home from home for those of you who are normally based in newsrooms, if the one here is anything to go by.
‘The bathrooms are basic and adequate, but be aware, there is the facility for staff to unlock the doors from the outside, and if patients require special close observation because of a suicide risk, then the member of staff will need to be present within the bathroom and the toilet. I know, not nice.
‘I reiterate, please do not over-act, and be your usual selves once admitted, and your privacy will be assured.’
Stopping and looking at them all again, pausing for a while, he then said in a slow and measured manner, ‘The patients in acute psychiatric wards are there because they are not well. They require care and treatment in the same way that anyone would if admitted into a general hospital ward. They come from various walks of life, and will have different stories to tell. I said at the beginning that I would dispel some myths … here goes. Despite what sensationalist journalism would have us believe …’
Lewis gave a knowing look around the table before continuing. ‘Most mentally ill people are not, I repeat not, violent and dangerous. They may behave through fear in an aggressive or hostile manner because they genuinely believe they are at risk of harm.’
Lewis went on, ‘If my food were to start tasting bitter, for example, I might think I was being poisoned, but who wants to poison me? Actually in my case there are several possibilities … but you get my drift. The vast majority of patients who you’ll meet on the wards, will be obviously mentally unwell, but remember, these are people like you or me, who deserve to be treated with respect and dignity. So I ask you, when you write about your experiences, please maintain the confidentiality of the other patients. As in the case of any other interview you hold, you may be confident about asking permission to report their story. However, if you think that person does not understand the implications, then be professional and don’t identify them.
‘On one important note: please remember that it is an offence under the law in this country to aid a person who is detained under Section in absconding. I’m saying this because you may feel sorry for one of the other patients, and they may be desperate to leave, but you must not collude or collaborate. It’s illegal.
‘Also, please give respect to the staff members who are trying to do a stressful job in difficult circumstances.
‘Let’s face it, journalists do not get this opportunity often, if at all, because you are not usually invited to the mad hatter’s tea party. This time you are going to be at the party, but don’t enjoy yourselves too much. Are there any more questions?’
‘Yes. Could you explain a bit more about possible treatments, and things like electric shocks, and how we would avoid that if it was prescribed,’ an anxious female researcher asked.
‘Indeed. No need to worry so much. You will not be offered ECT. This is for extreme cases of intractable depression, and rarely in cases of acute schizophrenia. So please do not fret about that as a possibility, this isn’t “One Flew Over the Cuckoo's Nest”,’ said Lewis James, looking deliberately at Linda, who smiled in response, without the need to say a word.
‘Possible treatment with medication can range from antidepressants to antipsychotics, but again, you will not swallow these tablets, as we discussed earlier. By the way, you should not allow your fellow patients to know you are disposing of tablets.
‘Other treatments … psychology and such-like is rarely available on the hospital wards, but you will usually attend activities, group sessions, art and occupational therapy of some kind, to fill your days.’
‘What’s the issue with a Section 3?’ Charlie asked earnestly.
Lewis was more than happy to go into detail. ‘A Section 3 carries with it a number of wider implications. If you are subject to this particular Section of the Mental Health Act, then you can be treated for up to six months and if necessary it can be renewed for a further six months. That’s a long time out of anyone’s life, especially for a medical treatment. It deprives people of their liberty when, let’s face it, they are not on the whole, criminals. The consultant psychiatrists are in a powerful position: to be able to grant periods of leave, to approve discharge from a Section, and to renew Sections.
‘Section 3 is usually applied to those individuals who have a known diagnosis of a severe mental illness such as schizophrenia for example. Wider implications include granting of visas for foreign travel. These may be restricted if you have been detained on a Section 3 at any time.’
‘Oh shit,’ remarked Charlie. ‘Not such
good news for foreign correspondents then.’
‘That’s why, young man, I have made it clear that should this happen to you, you need to appeal immediately and inform me. Remember these Sections should not end up appearing on any documentation that applies directly to you. As we have already discussed, you will have a false identity so it is therefore not possible to add a Section 3 to your own CV. But they are legal forms of detention at the time they are in place, and you would have to comply with the requirements imposed.’
‘Ah, right. Got you, finally.’ Charlie admitted that he was not necessarily keeping up with the specifics. Mark was relieved that Charlie had asked this question. He too had become confused as to the differences between Section 2 and Section 3. Now it was clear. Don’t get Sectioned.
‘But,’ added Lewis for dramatic effect, ‘you would have to be unlucky to come across a consultant who would put you on or keep you under a Section. In the worst-case scenario if you did, you could be forced to accept injectable medication, and that can be mightily unpleasant. I was going to say that nobody has ever been known to die from psychiatric medication being injected … but that is not strictly true.’
‘Isn’t it?’ Mark queried. ‘How bad is that stuff?’
‘It’s rather like any medication. You could potentially have an allergic response to it. However there are some unpleasant side effects that can be experienced with antipsychotics specifically.’
‘I think it is really important that we are told about these,’ insisted Linda. ‘After all, you instruct that we spit out tablets or at least that we do not swallow them, but what if we do accidentally, or they give us liquid or an injection. I think we deserve to be told what to expect in the event that we are better at swallowing than spitting stuff out.’
Charlie choked on his coffee at this comment, which was laden with innuendo, but he did not look in Linda’s direction. A few of the other journalists, who knew Linda of old, looked down at the table, stifling any wayward titters.
‘Fair enough,’ Lewis agreed, ignoring the comedy moment. He then produced a printed acetate sheet, and placed it on the projector. Mark looked at the list of long and unfamiliar words as Lewis defined them, one by one. When he had finished, his audience appeared to be in a state of slight shock.
‘Good God, according to your descriptions, the risk is that if we take this stuff, we could end up as a shuffling, dribbling, restless but stiff zombie incapable of thinking or sex or even … possibly dead. That sounds utterly desperate,’ remarked Linda accompanied by nods from her fellow experimenters around the table.
Lewis was quick to respond.
‘In most cases people only experience a moderate level of sedation, and if they’re unlucky enough to get these other side effects then there are medications to counteract the problem. As we said, don’t swallow them, don’t over-act, and you will be fine.’
17
Plans
The group chatted animatedly, which Lewis took as his cue to initiate a planning session for their attempted admissions to psychiatric hospitals across the country.
‘Can I suggest,’ he offered, ‘that you get yourselves together, and generate ideas about your back-stories and your plans to attempt admission. Feel free to make your suggestions as wild as you like, but remember that as extreme as your imagination may be, I doubt you will top what actually takes place in the reality of the psychiatric admission ward.’
The noise level in the room rose over the next hour or so as the researchers, the journalists, and the experiment lead team entered into debating all sorts of weird and fanciful plans, a number of which they ran with, and others that were scribbled down, crossed out, and thrown in the bin. They soon realised that they needed to avoid anything involving violence or potential harm to themselves.
Linda devised what she said was a sure-fire plan. Her plot would involve dressing in a crown and robe and deliberately laying in the middle of a road, on a pedestrian crossing so that she didn’t get run over. If her outfit was accurate enough, and she gave regal waves to drivers and pedestrians as she lay on the zebra crossing, it would be plainly evident that she was indeed mad. She identified that the ensuing traffic chaos would result in a rapid response from the police at least. ‘If I’m in luck, I should bag myself a policeman and a fireman or two. There’s something incredibly kinky and sexually dynamic about fire fighters,’ she said. ‘Red hot.’
Charlie stuck with the bridge idea, but thought that adding a tutu or dressing up as a gorilla would give him more of an air of insanity. This addition to the basic plan was not well received, and Charlie was asked to reconsider.
After a while and a gentle brainstorming of ideas from around the table, Charlie came up with an improved proposal. His newest offering involved behaving as if he thought he was being followed or threatened, and had therefore run to the bridge to leap into a river in a desperate attempt to escape his non-existent persecutors. This received full approval from the group.
Jock went for a Monty Python-inspired plan which involved repeating the sound ‘Nee’ at every opportunity, while pretending to ride a horse via the use of two coconut shells being banged together, skipping through a market or shopping centre. He was already planning embellishments to this idea, such as rearing up at certain people or lampposts for added effect.
The ideas were reviewed and debated vociferously amongst the groups. Important points such as ensuring they were sober at the time, were agreed. This was particularly relevant in the case of the more theatrical of suggestions, because there was a distinct possibility that if there was so much as a whiff of alcohol, the individual could easily be taken to police cells, and charged with drunk and disorderly conduct.
A handful of ideas were positively received. One of the researchers, Andy, turned out to be a keen amateur actor, and he devised a plan to present himself at hospital asking, via a written letter, to be given a scan of his brain. His story was that he was being monitored by the Russian KGB, and had been implanted with microchips in his ears. He was requesting for these to be located and surgically removed. He would inform the recipient of the letter that he was unable to speak because he was being recorded and would request replies to be whispered or preferably written down for him to read.
Lewis James gave the young man a round of applause. ‘Bravo young research boffin, this is a workable plan likely to guarantee a psychiatric assessment. I wonder though, how you are going to explain your beliefs once admitted to a ward?’
After a discussion, during which the whole group debated whether the contents of the letter would be seen as describing symptoms, and thus introducing bias, they modified the details. Then there was a light bulb moment from the young researcher Andy, who announced, ‘Perhaps I could say I found an insect in my ear, and had misinterpreted the noises it was making.’
‘Genius!’ replied a highly excited Lewis James. ‘More like this please and we shall have a high success rate.’
At first Mark had struggled to find the right inspiration, until one of the research team pointed out what was staring everyone else in the face.
‘What you need are five loaves, a few fish, and to gather a large crowd of hungry followers, while looking all Jesus-like and doing other such miracles.’
‘Of course.’ Mark berated himself for his lack of imagination. ‘It’s so bloody obvious.’
He asked if he could be allocated to a hospital somewhere near a train station. In his mind he was trying to imagine how on earth he was going to draw enough attention to himself and use his Jesus looks to his advantage.
‘The difficulty is gaining enough attention if you are going for a religious performance,’ confirmed Lewis James. ‘The great British public is, on the whole remarkably tolerant, extremely polite and mostly avoidant of confrontation. They will usually gently ignore the odd bit of religious fervour. However, your idea of a train station is sound, but you will need to make a bigger splash than just walking about as if you are praying. You can’t s
peak remember, at least not in understandable English.’
Mark realised that he was in a fortunate position. His father was a retired high-ranking member of the Foreign Office, which resulted in Mark being privileged to have lived in far-flung countries, often for years at a time. His mother was of ‘Persian ancestry’ and she proudly announced this whenever asked where she was from. His parents had met, fallen madly in love, and run the gauntlet of disapproval from both their families in order to marry. This was not quite as romantically testing as it first appeared, because Mark’s mother came from a Christian family who lived in the Sultanate of Oman. After their initial misgivings, the whole family had been immensely supportive and loving. Mark, courtesy of his parents, had the benefit of first-hand experience of living in Oman, Turkey, Cyprus, and across the Middle East, learning the customs and gaining an understanding of the different cultures as he grew up. Most usefully he learnt the languages, including various Arab dialects. Helpfully his mother’s family imparted wisdom and knowledge about the history of that part of the world that no westerner could ever hope to comprehend.
Mark confirmed his mastery of languages to Lewis James, and suggested that a scrambled version of a Middle Eastern type Esperanto might be a useful tool. He and Lewis both thought it was too much of a risk to make use of one foreign language. No matter how obscure, there was always a slim chance that someone in the vicinity of Mark’s planned station platform performance would understand him. Having pondered the possibilities, they finally hit on nudity as the incitement to an arrest by police. Then, with any luck, he would be referred for a psychiatric assessment.