I hardly even know where to start on what happened over the last 24 hours. After voluntarily admitting myself to a psychiatric ward at Highgate Hospital, I soon realised it was a frightening and unsafe place, with half-naked people screaming, spitting and shouting throughout the whole ward, and staff doing little too stop them. I’ve been on psychiatric wards before I moved to Camden – and yes, there are some extremely ill people in such places – but this was chaos.
I’d arrived at 6pm. I realise there are resourcing issues in the NHS and I realise this was the day of the junior doctors’ strike, but as it happens this ward did not appear understaffed – when I arrived on the ward it had a ratio of 1 staff to 2 patients. What was obvious was a culture of contempt within the staff team for the service and for the patients, with one staff member standing around bragging about how she “couldn’t wait to get out of here in six months” Only one member of staff introduced himself to me. No other staff member smiled at me or said hello. No one told me about meal times, medication rounds (in fact my medication was missed once – the staff seemingly forgot about me – and the other two occasions I had to chase nurses round the ward telling them I needed my meds – there seemed to be no system in place for dispensing meds at regular intervals), no one told me who staff were, I had my valuables removed with no receipt and was told I could not have them back, no one mentioned the role of care plans/keyworkers, who would be my assigned worker for the shift, where I could get a cup of tea, where the fire exits were…it was terrifyingly shambolic. I phoned my boyfriend in distress and he could hardly hear me over the cacophony of noise outside my bedroom.
I was especially afraid that I would not be able to sleep, as the ward had no sense of day or night. On previous wards I’d been on, evening staff had a routine to create a calming atmosphere by dimming the lights, speaking more quietly, and even offering patients a milky drink. On this ward the staff walked around the bedroom corridors shouting to each other with no regard for patients who might be sleeping. The lights were glaringly bright and even though you could switch off your bedroom light, every half hour staff would remotely switch on a light in your room to check on you through the observation window.
At 10pm, unable to deal with the noise and threatening atmosphere, and convinced that being here would not help me get better, I asked for my belongings and tried to leave. The person on the desk, who wore no ID – so I have no idea of their position, be it nurse or support worker – told me I couldn’t leave until I’d seen the doctor. I asked them if, (not having yet seen the doctor) I had been formally admitted to the ward. If I hadn’t, then I wished to leave.
I was not given a clear response. I was told “you need to be seen by the doctor” but when I asked again if I had been admitted (as since I’d been on the ward I’d had no medical, been given no information and in fact nothing except a thorough search of my belongings and the removal of my phone and laptop charger, medication and anything sharp); the official simply repeated, you have been admitted because you are here.
I stood and “queued” at the nurses station for two hours until the doctor finally appeared. During this time I experienced patients climbing on the nurses’ station, spitting in boxes behind the station, constant screaming and shouting and staff doing little to manage, calm or soothe distressed or angry patients.
At midnight I finally saw the doctor with another ward official, who I had asked to be present as a witness. I sat down and again asked if I had been admitted as a patient to the ward. She replied “that’s what we’re doing now” so I said “well in that case, I don’t want to be admitted and would like to leave, please.” I explained that although I was very depressed and anxious the atmosphere on the ward was in no way therapeutic and was exacerbating my symptoms.
The doctor was adamant that I could not leave until she had spoken to me. I asked her several times for written information about my rights as a voluntary (“informal”) patient but she refused to give me them “until she’d finished admitting me”, despite me repeatedly saying that I wanted information on my rights before we continued with the process.
At 2.30 am, after the doctor had finished her paperwork she presented me with a factsheet on informal admissions. The first paragraph read “The patient must give informed consent to their admission. They must be informed of the restrictions that will be placed upon them BEFORE they are transported to the hospital ward”. This was my first sight of this information.
I told the doctor I hadn’t given informed consent and that I believed they were unlawfully detaining me. She responded by telling me that there was no way they would release me because it was the middle of the night (despite the fact I’d been trying to leave since 10pm, and my boyfriend, who I’d phoned in distress and asked to come and help me, was waiting outside in a cab). I had a “choice” of remaining as a voluntary patient or she would place me under a section of the mental health act compelling me to stay against my wishes. This section 5(2) of the Mental Health Act allows the hospital to detain you for up to 72 hours, and carries no right of appeal.
I realised I had no choice but to remain “voluntarily” but asked for it to be noted that I’d made the decision to stay under duress and headed back to my room. There was a patient asleep on the floor in front of the fire exit, and outside my bedroom, two patients were having a party, playing music and singing at the tops of their voices. When I said to the ward nurse “it’s 2.45am, how am I supposed to sleep?” he responded that “he’d ask them to turn it down” but couldn’t do any more than that.
The whole place was threatening and frightening and it was unbelievable to me that they’d place someone whose main presentation is anxiety into such a place.
At 9am the next morning I phone the Borough’s Mental Health legal manager, who is responsible for the Deprivation of Liberty Safeguards which relates to the section of the Human Rights Act that says you have the right not to be unlawfully detained. He informed me that by being threatened with a Section I’d been coerced into staying and that in fact the nurses had no authority to prevent me leaving when I’d originally asked at 10pm.
He phoned and spoke to the consultant who, although she advised me to stay in hospital, judged that I was not “sectionable” and was therefore free to leave.
The whole experience was terrifying and traumatic, and should never have been allowed to happen. Everyone I dealt with that night had a shocking lack of knowledge of, or regard for, patient’s basic human rights.