Sophie Stockbridge gives an account of life working in Bethlem Royal Hospital, Beckenham, with patients progressing through the psychiatric system on their way to release into the community.
When I started, my mentor told me to first meet the patient and then read their case notes and I’m really glad I did. Every patient I met on the all-male ward seemed to be like any other middle aged man, they all liked to play scrabble, were all keen to get a job and would have deep conversations about football with each other. Except the majority of them had spent the best part of thirty years or more of their lives working their way through the process a forensic patient has to take, in order to be released back into society.
This process would start from the moment they committed the violent offence as a result of them experiencing a psychotic episode. The next step would be to serve their prison sentence at Broadmoor until the Ministry of Justice feels they are safe enough to move down to the medium secure hospital in the form of Bethlem hospital, and eventually released.
My first day as a student on the ward was intimidating, I was handed a personal alarm, a bunch of keys to move around the locked ward and a date for my ‘break away’ training, which is a class for self-defence. However, after meeting the patients I felt much more at ease because despite some of them being very broad men, I could soon see how keen they were to get out of hospital, and would do anything to help that process. They were polite and respectful and despite being somewhat twenty years or older than myself, they would listen to what I could offer them in the form of Occupational Therapy ward based activities.
I ran a healthy living group, which they loved. It included me pouring out different amounts of salt into cups and them guessing what cup contained how much salt they are recommended to have daily, then how much salt is in an average pizza, in a McDonalds burger etc and they were always very shocked. A smoothie making activity was also involved within this group.
I also played football with them one day, as the Ministry of Justice had yet to grant certain patients permission to visit the gym in the other part of the hospital yet (it was pending). However, the large garden was attached to the ward and so I found a loophole. The men, despite looking overweight due to the medication for their Schizophrenia making their stomachs bulge, played for a solid hour and told me it was the most fun they’ve had in months. Other staff members joined in as the game progressed and even the consultant had a look in for a few moments.
One patient, who was released back into the community during my time there on placement, told me how after spending so many of years of his life in Broadmoor and then in Bethlem he thought one of the hardest things he would have to do would be explaining to new people what he had done with his life and, even asked the psychologist to help him fabricate a realistic story instead of having to reveal his real story of committing murder as a result of experiencing untreated schizophrenic symptoms and spending the majority of his life inside secure hospitals. He also told me that all of his friends were either current or ex-patients and that he felt it necessary to end these friendships in order to move on with his life.
I also did a lot of cooking with the patients, which acted as another means of assessing how they might cope if they were to be released and live alone. The patients were always keen to cook for me as well, with one of them even using the food budget allocated to buy me a small dessert. Some would make a bit of a fuss and set the table, put out paper napkins and try to make it as real to a restaurant setting as possible. Whilst we would be eating the dinner they had prepared, they would often ask me what extra activities I knew about I could enrol them in, if I could look for specific volunteer jobs they were interested in etc.
One patient told me how when he was a teenager and didn’t yet understand he had schizophrenia, in his manic state he had booked himself a flight to Israel, and when he got there he soon ran out of money and got by on odd jobs until he could afford to come home. He told me it was one of the more positive parts of having his condition, because it was one of the best experiences of his life.
One patient who was also autistic as well as schizophrenic, would sign up for the one to one cooking because he was an animal lover and found out all of the hospital meat served to him was halal and he didn’t like how the animal is killed using this method.
A lot of the community organisations we enrolled the patients in are fantastic, such as Raw Sounds and Keychanges which try to promote positive mental health through music and Cooltan Arts which do the same but through the medium of art. Or the Southside Rehabilitation Association (SRA) Centre, which offered employment training in catering, printing, cleaning etc. Or First Step Trust, which had its own car garage and the patients could be trained to eventually work on the public’s cars.
Many of the patients’ main complaints were that they didn’t have any families of their own. All eighteen of the male patients I met were single and even when released the community mental health team would want to be informed of any new relationships they engaged themselves in, so that they could help monitor the situation from a distance. Because a new relationship could act as a potential destabilizer for the patient if it were to end badly.