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April 30, 2018 | by  | in Features | [ssba]

A Winter with the Phoenixes: T’s Experience with New Zealand’s Mental Health System

This article is about the mental health system in New Zealand. It is drawn from 2016, when I visited a friend in the Newtown Psychiatric Ward. Two years later, I conducted an interview with him. It is not intended to be a criticism of the system or the staff they employ. Any interpretation to that end is wrong and exploitative of the mental health experiences of many New Zealanders and the people that provide care for them.

Newtown Psych Ward is a focus group for resilient phoenixes shaking ashes from their plumage and cleaning their feathers. These birds, sometimes flightless, are looking for an escape from Babylon’s seven hills, or a solution to their Babylon, or sometimes both because sometimes solving your problems is too much of a task for the constitution of the average person. They are birds, but they are also normal people. I have come to visit one of these people. His name is “T”.

T was admitted into the mental health system following his arrest for displaying disruptive behaviour in public. The police picked him up, and, upon concluding that T’s presentation was out of the norm, they contacted a psychiatric team to assess him. This was a week ago. I found out about his circumstances through a semi-lucid Facebook conversation.

Finding the ward was a task in and of itself. It was like a level in a role playing game. When I asked for directions at Wellington Hospital reception they told me my visit had to be approved by a) staff and b) the person I was going to see. The pity in the receptionist’s eyes was barely disguised.

The ward is tucked away in Newtown. It has no obvious delineation, nor explicit signposting as to its purpose. The reception area is quiet, slightly shabby in a friendly way, and like the rest of the building, gives away very little about its nature. There is a clear perspex screen with holes allowing you to speak to the receptionist. They pass you the visitors register through a shallow bay that allows for an exchange, but no human contact.

They unlock a heavy door and escort you into an intermediary room. This room separates the ward from any other hospital department — you cannot go back through the door from which you came, neither can you pass on to the next room. Nor can the patients come through the door, or see your arrival. You are left alone in this purgatory room for a few moments, short enough for you to be unable to take much note of your surroundings but long enough for you to wonder with some alarm what’s going on.

And then you’re through. The receptionist lets you in from the other side, into the common area. It’s disconcerting in a way; I foolishly expected rows of beds. But of course, patients were playing table tennis, talking amongst themselves, having a cigarette in the garden. T was waiting for me in the garden with his guitar. He played “Pony” by Ginuwine and we talked about what had been going on in his life. He told me the good days were great, and the bad days were often unconquerable. He had been given a notebook. It was emblazoned with a WordArt slogan printed off a Microsoft Word document:

“This is yours. Nobody else can write in it, or look at it without your permission.”

This slogan is emblematic of the patients in the ward, and their rehabilitation. They were experiencing different forms of mental illness and were on their own journeys to recovery. A battered notebook — a temporary stay in central Newtown — was for them.

T felt more inclined to engage with patients who displayed similar symptoms to his own: mania, psychosis, grandiose delusions. T said that he felt a sense of camaraderie with them, and that much of their conversations revolved around entertaining the ideas of their various delusions. In turn, he found it more difficult to engage with patients who were admitted for suicidal ideation, depression, or anxiety, as the nature of their illness wasn’t synonymous with being open and sociable. He was unusually sociable and energetic at the time, so for him, communicating with those patients seldom produced positive results.  He tried not to engage with them, for his own sake and theirs.

They were each on their own journey, counting the days on their own hands. Others could help them, with their permission, but their ultimate wellbeing rested with themselves. It is perhaps a rare time one should be able to be completely selfish. Healing yourself requires you put yourself before all others. I know this is true. Another friend at home considered, in his state of grief, that his friend’s suicide was selfish. But that is as it should be. Maybe if he had been more selfish, we wouldn’t have lost him. Conversely, we are all indebted to T that he was selfish, and cared for himself enough to allow himself to be subjected to a lengthy healing process.

When I went to see T, aware of his arrest, I carried a preconceived notion that the ward was a negative thing, another form of incarceration.  And T thought this way to begin with. Delusions of grandeur and psychosis led him to believe that his hospitalisation was part of a, “big plan” or that, people were “out to get me”. His paranoia was palpable. For him, it was only two or so days after being medicated that the reality of being hospitalised for mental illness began to settle in.

Due to the nature of T’s own condition, he did not take well to the idea of being secluded from the outside world for a temporary period of time.You see, even a phoenix yet to emerge from the ashes knows they have a long journey ahead of them. He was anxious to get “out”, to resume what he thought he needed to do. No one would find it easy to be at peace with a situation where they had no choice but to recover.

But T acknowledged that at the time his symptoms posed a risk to his own wellbeing and to the safety of others —  a controlled environment with effective monitoring was necessary to engineer a return to a daily routine.

This was evidenced by his escape from both the Wellington and New Plymouth Wards. Months later he had returned home to New Plymouth, but of course his condition travelled with him. He felt he had to escape, such was his world at the time. When I visited him, he described his symptoms to me as euphoric highs and dizzying lows. As a friend, I could only fret with worry when I got the message that he’d escaped again. There was nothing I could do for him; in a way this too was part of his journey to recovery.

T believes the process in Wellington achieved what it aimed to do. He was educated about his issues, given appropriate medication, referred to community support groups. He told me though that there’s no universal feeling towards being hospitalised, as different illnesses may cause people to perceive admission into a ward differently.

I read somewhere that the soul always know what to do to heal itself; the challenge is to silence the mind. I think that’s wrong. Or if it isn’t wrong, it’s phrased wrongly. The mind can never be silenced; even at rock bottom we have our own company. The challenge is perhaps better expressed as understand what the mind is saying, pick out a single strand of conversation among the baying horde within a mentally unwell mind.

T told me that, if he could have changed anything about his stay, he would have liked more of an emphasis on his social wellbeing, rather than just his neuro-chemical wellbeing. It often felt like giving him a pill was the only solution to his problems. And maybe, that’s the best way an overworked system can treat mental illnesses. I do not indict the medication prescribed as part of care. But for T, like so many other people in his position, there were myriad other factors such as lifestyle, relationships, habits, and feelings, that couldn’t be aided by medication.

Perhaps with a change in government, those with mental illness may be better able to listen to themselves. Simon Oosterman, campaign coordinator for estimates that mental health was underfunded by nearly $50 million in 2017. At the time of writing, Labour’s budget for 2018 will be delivered in just under a month. An increase in the budget for mental health services is required as a public health imperative. Political rhetoric and social media content can only go so far — the mentally ill in New Zealand can only achieve clarity of voice if they are fiscally enabled to do so. The financial means, and the necessary awareness that travels with that, can only lead to better care for the vulnerable among us.

I do not know where the phoenixes are now. T found comfort and stability with correct medication, a healthier lifestyle, and an open, honest approach to his condition. Indeed, I am indebted to T for being so receptive to a very revelatory conversation. Any increase in mental health funding will not affect him though; he moved out of the country to study and be with family. In this way he is lucky; he was able to lift himself from the mire and remove himself from an environment carrying the reminders of his chaotic days two years ago. For many of the phoenixes though, I fear they are living the same experience in increasingly damaging iterations.


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