A personal account of “New Zealand’s worst mental health ward” actually providing excellent care
It was reported in June that the West Coast mental health unit was the worst in the country. But what it lacks in shiny new fittings, it makes up for through its delivery of the service. I know this because I've spent the past four weeks staying there.
I was admitted to a mental health ward because I'd been experiencing a relapse with my bipolar II and could no longer manage it. Mental health wards are not places that people are lining up to go to.
My admission was on the basis that I needed to have my medication looked at and a decision was made to change what I was taking. This needed medical oversight. I also live two hours away from the hospital. The medication I'd been on had been in my system for eight years. The body doesn’t easily give that up.
I've used the mental health system since I was 19. I'm very familiar with community mental health but it was about 12 years ago that I had my first inpatient unit stay. It didn’t go well. My second stay in 2014 was even worse. I had an admission to this very same ward. It was being overseen by a psychiatrist who quite frankly was a bit of a bully. There was no Occupational Therapist. Staff weren’t engaged with what they were doing. The ward was lacking in overall direction and professionalism. to the point where I laid an official complaint with the DHB. I also wrote a poem about it when David Meates, CEO of the WCDHB was quoted saying “Mental Health Services were value engineered and not part of the business plan” for the new hospital build. Can you imagine what it's like to be told you aren’t valued enough to have somewhere to go when you're sick?
I returned this year to find the ward in a very different state but still in the same building. It's only fitting to praise the team because of the difference they've made to my life. To be blunt, they saved it.
The changes I noticed straight away was that the ward had received a lick of paint and new curtains. Oh! How I loved those new curtains. They kept the draught out that still whistles through the windows from a blustery cold southerly. On the wall in the entrance I noticed a timetable with activities. This was when I discovered the DHB had secured an Occupational Therapist (OT) from the UK. The OT was my saviour over those four weeks. She helped keep me distracted when I was feeling the side effects of tapering off meds. She introduced me to sensory modulation which involves using your senses to self manage and change your emotional state. I also got to try a weighted blanket for the first time. Weighted blankets have soared in popularity recently but I learned they are only of therapeutic use if used for up to 20 minutes at a time, are ten per cent of your body weight, and they are not to be used for sleeping.
It’s not easy handing control of your brain chemistry over to a complete stranger. But that’s what you do when you come into the ward and meet the psychiatrist. The doctor won me over quickly when she demonstrated to me she had read all of my notes and had a good understanding of my history. She listened and showed she was willing to walk beside me to help me get well. It’s a refreshing approach and one that hasn’t always been in place in our system. The team as a whole are like a large family. You get to know the nurses beyond just their names as they share their own life experiences and hobbies. You find yourself learning from each other. Even the cleaner would talk with me every day about how I was. This kind of whanau feeling allows patients to become more relaxed.
The menu had improved immensely from my last stay and was extremely good for hospital food. I learned to adjust to dinner being served at 4.30pm which I fondly called "late afternoon tea" because who was I to complain? I was getting my meals cooked for me and I didn’t have to do the dishes. I was also entertained by the two ward cats, Daisy and Sissy, who have grown up here and are full of personality. Luckily for me I don’t have allergies so I would allow them into my room as much as they were willing to spend time with me. I have a dog at home and I missed him immensely.
When talking to my girlfriends about life on the ward I told them about the pool table, private spa bath and cooked meals. They asked if they could come and stay for the weekend to have respite from their children. These types of casual conversations about the ward helped me feel more ‘normal’ about being here. I live in a small town, which means that people generally watch out for one another. Like most small places, however, there's an underlying gossip mill. I learnt a long time ago to front foot my illness because what the community didn’t know they made up and that hurt more than the truth. Being open about my journey has allowed others to come forward and tell me their stories or ask for support. I don’t pretend to be a professional in this area but I can help connect them to the system - a system which is still clunky and hard to navigate especially if it's your first time.
While I waited for the old medication to leave my system and new medication to kick in, my days on the ward became a haze of daily walks, baking, art and crafts, meetings with the psychiatrist, daily discussions with my nurse, music therapy, animal therapy, writing, reading, watching television, and medication. I finally worked out how the TV programme The Chase works and I taught myself to cross stitch. My mind began to untangle itself and heal.
We are encouraged to socialise as much as we can. There's an open kitchen, shared dining space and big lounge. I got to know other patients and learn their stories. I felt better in my skin because I was around other people like myself who were overcoming mental health struggles and although we had all been on different journeys our end goal was the same - to live the best life that we can with our illness.
If you're assessed as not being a risk to yourself and others, you can have unescorted leave. I discovered the local sauna and sought refuge there most days. The quiet heat envelops me and relaxes my body. Casual chat while out on leave makes for awkward moments, though. Mostly I tried to avoid the questions of; “How is your day going?” and “Are you from here?” I wasn’t comfortable responding with “No, I’m not. I’m just staying on the mental health ward for a bit.” One day in the sauna a young man was adamant that we would have a discussion. So I told him I was from Christchurch and felt incredibly bad for lying. We both expressed our disappointment that more females weren’t using the sauna. We had very different reasons. I wanted less locker room chat around me, and he was looking for a girlfriend. I'm sorry I lied to you Kane. Ladies of Greymouth! Kane seems like a nice guy; he's at the sauna most nights during the week. Go and meet him. He'll definitely make you laugh.
Towards the end of my stay I began to have home visits. This helps you to make you more independent again. I looked forward to moments with my husband and dog. My mother lives in the same area so we would spend quiet weekends together with the occasional outing. It can feel overwhelming to see people again for the first time when you've been so unwell. My work is on hold for the time being. I took leave to get on top of this. They have been very understanding and tell me that me being away is no different to a staff member having to take leave for a broken leg or cancer treatment. I value their response very much and I have come to expect that from an employer because the year is 2021 and it is no longer okay to have any other response but that.
While on the ward I watched the special debate for the report on Zero Suicide Aotearoa. Morbid I know. But this is a topic that is very personal to me. I have an illness that puts me 10-30 times more likely to attempt suicide than the general population and an increasing risk of multiple attempts. Government's approach to supporting groups like mine is frustrating. We need greater access to therapy (which I can’t receive on the Coast), credible educational resources and support groups for specific mental health diagnosis. The last two items are the most helpful and easiest to execute - and yet it's something we just don’t do well here in New Zealand. My support group consists of a bipolar Facebook group run from America.
Chlöe Swarbick was right when she spoke and demanded that we have a Minister for Mental Health. We need to do more work in helping normalise the stories of those who have a mental illness. With the right people around you, you can get to a place where you experience more hours of good in your day than bad. Maybe you’ve had a really bad experience in the system and I am sorry for that. I understand that. I have been there too. But there are places out there that are doing a good job. They need to be given the resources to ensure that they can continue to deliver their good work and improve. They need to be given the recognition of the excellent work they are doing.
When I left the ward I was ready to go and to continue recovery in my community. I left in a much better condition than when I arrived. The team had triaged me and helped piece my fractured mind back together. I will be forever grateful.
Ngā mihi nui ki a koe.
