Psychiatric hospitals: what are they really like?

Before Christmas, we spent quite a bit of time visiting a psychiatric hospital. One of our elderly relatives was ill--suffering from schizophrenia--and we travelled to see her when we could at the weekends.We learnt an awful lot over that period, not only about the illness itself, the therapies used to treat it and the legislation surrounding mental health, but also about the physical institutions in which people suffering from severe mental health problems reside.

People's perceptions of mental illness have, I think, softened over recent years. There probably still exists fear of mental illness, but not to the same extent. It's talked about more openly--is in the media even--and is no longer considered something to be ashamed of.

Our relative has been ill for a long time, so we're very used to the symptoms of mental illness, but this was the first time that we had set foot in a psychiatric hospital. And it was quite an eye-opener. The hospital is situated in an affluent town on the south coast and you reach it via a pleasant drive past what look to be very expensive executive homes. The hospital is indicated by an innocuous NHS Primary Care Trust signpost--no mention is made of 'psychiatric', just 'hospital'.

But once you are on site, things feel quite different. In order to gain admittance to the hospital you have to report to the (very friendly) receptionist, explain who you are visiting, sign in and put on a visitor badge. Much the same procedure as when visiting any workplace, you might think. But going onto the ward is quite different again. The doors are locked, because most of the people on the ward are being detained under the Mental Health Act, which means that they are only allowed out unaccompanied if they have been granted leave by their doctor. All entry to, and exit from, the ward must be noted by a member of staff. Thus, when you arrive at the ward, you must ring a bell for admittance and, because the staff are very busy, it can often take a long time before anyone answers the door. Children aren't allowed on the ward, which meant that when we weren't taking our relative out, we had to meet her in the hospital's designated 'family room', away from the other patients.

Walking around the wards is also quite an experience. The patients are suffering from all kinds of mental health issues. Some are very pleasant and friendly, but others can be unpredictable and verbally aggressive. In the 'acute assessment unit', the ward to which all patients are initially admitted, it is common to see police officers, since new patients are, often, brought in as an emergency by the police.

I wouldn't exactly describe the hospital as Dickensian, but despite friendly and helpful staff, it is undeniably a bleak place, and the locked doors and police presence lend it an air of detention rather than one of caring treatment. Our relative has now been discharged, thank goodness, but there's a high likelihood that she will need to return at some point in the future. And that is something that none of us will relish.