Saturday, 10 November 2012

is it ever OK for a psychiatric nurse to assault a patient?

In September 2011 the Mental Welfare Commission for Scotland held a consultation event on Zero Tolerance, to develop guidance on responding to violence in mental health or learning disability care.  I was asked to give a presentation from the user/carer viewpoint, having had the experience of being both a psychiatric inpatient and a carer of family members who have been in psychiatric hospitals, over a 40yr span. 

In preparation for my talk I reflected on my own experience of being an inpatient, of Hartwoodhill Hospital, Lanarkshire, in 1978 and 1984, following postpartum psychoses and separated both times from my baby.  The last episode following a menopausal psychosis in 2002 in Lomond Ward, Stratheden Hospital, Fife.  From all these experiences I couldn't remember any violence from patients but I could remember force used against me by nurses.  Similarly with my carer experiences.  Maybe I was just lucky.

Although I was instructed to only speak about aggression and violence by patients I really couldn't fabricate a story so had to speak about the use of force on patients, and particularly on me.  I described it as grabbing and jagging, for that's what it felt like in 1978/84.  In 2002, in Lomond Ward, it was different.  In that I entered the ward as a voluntary patient, had a look round the female dorm, decided to leave then was immediately put under a 72hr detention and told that I had to take the psychiatric drugs.  

Because of my previous experiences of psychiatric hospitalisations, and of what had happened to family members, I knew that if I refused the anti-psychotics then I would be forced to take them, or grabbed and jagged.  Therefore I swallowed the drugs reluctantly.  The threat of force was enough to compel me to do something against my will.  And this has always been my experience of psychiatric care, the threat of force whether veiled or otherwise.  Going back to the 50's and 60's when my mother was forcibly treated with many courses of ECT or shock treatment when in a locked ward.

Four months after giving my talk and take on violence and force in psychiatric settings, I found myself again in the carer role, visiting Lomond Ward, Stratheden Hospital, in February this year.  And immediately came face to face with the issue of restraint, seclusion and forced treatment.  Accusations of assault by a nurse on a patient, injury to a patient self inflicted, dehumanising treatment in a locked ward and disrespect of a carer.  And for me two months of vigilant care, a raising of complaints and a resistance to the might of psychiatry.

Over 9 months have passed since the traumatic treatment and I have to again ask the question "is it ever OK for a psychiatric nurse to assault a patient?".  I say NO.  But who's going to take the word of a patient against a psychiatric nurse or group of psychiatric nurses?  And if the psychiatric system continues to support forced treatment, and justifies it in the notes, then how will psychiatric patients ever be listened to or believed?

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