Drivers for the revolving door
Between 1974 and 1991 I had about a dozen admissions and discharges to and from the NHS psychiatric system. The locations were the East Sussex Asylum at Hellingly, Oakwood Asylum near Maidstone, and also four weeks were spent at Eastbourne District General Hospital Depatment of Psychiatry. This was the revolving door. I believe that this situation still persists for some people in today's slimmed-down NHS, and that there is a revolving door for the 80,000 inmates of the UK prison system involving mental health.
There are two glaring issues with my revolving door time. Firstly, the main driver for my repeated failures in the community were due to the asylum system's insistance that I had medication by injection. This produced a horrendous side effect, called akathisia. The peculiar thing was that after an injection, invariably given humiliatingly in the backside, you could not rest or get comfortable. Akathisia is from the Greek for 'not to sit' or 'without sitting'. So for a week you would not be able to sit still for long, to stay in one place, to have a conversation, and for me as a recent academic, it was impossible to read a book or a paper, even to watch a favourite programme on television. My only way out of the brutal supervision to have this form of medication, was to be a model patient and to go to IT (Industrial Therapy not Information Technology) (packing soap bars into boxes) and OT (Occupational Therapy - making soft toys) and to get discharged to a hostel or similar place in the community. I usually got a job or had a tax rebate for being on the sick, and then I would just go. No more supervision from the hostel warden to remind about the next injection. No injections, and...bliss. Not to have to endure akathisia for one week out of every two (injections were typically given every fortnight). However this meant also that I had no antipsychotic effect, and would soon succumb to the delusions and paranoia of schizophrenia. I would live as a vagrant, and frequently have a brush with the criminal justice system. This would result in me being returned to an asylum, and the same failed treatment would be reinstated. Hence: 'We need to give you medication by injection as you have not been taking your medication.' 'But I only refuse medication because it is given by injection. I have never refused pills.' 'No, we have the backup of a section of the Mental Health Act or a condition of a probation order. The law says we do what we want, and we say you will have injections in the backside.' So for the caring National Health Service and the hypocratic oath, not to notice that I suffered extreme torture with akathisia is condemnable. For this not to feature in a change of medication is damnable. It was the opposite of caring.
The second condemnation of the asylum regime is in the attitude to my status. I first presented at Hellingly asylum a few weeks before Christmas 1974. My parents had brought me there. I had no criminal record, had worked on my father's building sites (even carrying hundredweight bags of cement with my artificial leg - how cruel was that) and was most importantly a summer final examination failure at Reading University. I was discharged from Hellingly before that Christmas being told there was nothing wrong with me. They could not help with any aspirational aspects of having achieved three years' study, and could not apply for an honoury aegrotat degree in light of mental illness. My status as a graduate with problems, with the possibilty of a future, was not supported. I was returned to the rough circumstances of life with my parents, and in due course had a fight with my father in a short time. I left and had nowhere to stay, so slept in my car. It was winter. I ran out of money and filled the car up to run the heater, and drove off without paying. Even in pre-CCTV 1975, the police caught you for that. I was returned to Hellingly with a criminal record - there was no attempt by the appointed lawyers to put in a plea of unfit to plead - and they then said at Hellingly : Ah! You've got a criminal record - yes we know that, come in. This is better than being in one of those nasty prisons, why didn't you say? We've got no idea about all this highfalutin' student and academic stuff, but now you're an old lag, we've got just the thing. Injections of Depixol in the backside, a bed in the 10-bed male dormotory with a curtain for privacy, and you can go to IT and pack soap into boxes for two hours morning and afternoon. That'll help with the tobacco.'
So every time I was discharged from a mental institution, I was being set up to fail. The main driver was that I would escape supervision to have injections. There was no possibility of me regaining a prosperous lifestyle. I could not just become a merchant banker overnight upon discharge. Every job I got was another start at the bottom. Perhaps sweeping floors, perhaps some sort of clerical occupation with no prospects, and being passed over for promotion. A dead end job with every penny being spent to run an old banger to get to work and living in extreme poverty. While everyone else was buying property, going on holiday, getting new cars, and inflation was roaring - and I was getting left further and further behind. I remember one place that was a bed and breakfast in the middle of a field with no heating in the winter, atrocious food, and the obligation to have those dreadful Depixol injections. I was not only going nowhere, I was going backwards. As on another couple of occassions, that ended with a suicide attempt. I just saw no way out of it. So I bought a stock of aspirins from several chemists and took them with some lemonade in a London hotel. When the result was just that I wretched continuously and did not die, I called the Samaritans on the room phone in the early morning and was taken to St Thomas's hospital. There they pumped my stomach, put me on a drip for three days and sent me 'home', wherever that was. I ended up back in the East Sussex countryside at a place no-one ever went except if they had business there, Hellingly Hospital. To be put back on injections yet again, to look forward to another discharge with another escape from injections. By this time any thought of regaining an academic career was in the dim and distant past. I was now cast as part hopeless mental case and part vagrant. I was not capable of gaining any proper work, and as the discharges and readmissions progressed, I had more and more gaps in my work history as I got into my late 20's and into my 30's. My spells of vagrancy had left me with no fear of a criminal record and how that might affect my future. The damage had been done. If I needed petrol to run a car engine and I had no money, I would merely fill up and drive off without paying. If I needed a bottle of milk and it was six o'clock and the milkman had been there already, I would take from a housewife's doorstep before she got up, why not? There would be no consequences for my already stained record. It was the pits.