Mike Bush learnt a lot by looking at the services from the other side…
In November 2000, due to a combination of extremely stressful work-related problems and pressures, I suffered a severe mental breakdown. This occurred ironically while I was working as a mental health social worker in a inner city community mental health team, surrounded by community psychiatric nurses (CPNs), occupational therapists and a consultant psychiatrist, all of whom were embarrassed and rather lost for words at seeing their long-established fellow team member losing it at a rate of knots. However, I got on well with the CPN manager and so I spoke to her about my plight, the outcome of which was that we both agreed that I needed ‘professional help’. After a very difficult conversation with a receptionist at my GP surgery, it was finally rather reluctantly agreed that I would be seen that day by my GP — a lovely woman with an interest in mental health issues. After hearing a self-assessment of my dire circumstances the GP said, ‘you know a lot more about mental health than I do: what do you want to do?’ I said that I wanted to see a consultant psychiatrist, and she said she’d make arrangements for me to be seen as soon as possible. Two days later the consultant came to see me at home, where he took a very detailed history/assessment and prescribed major tranquillizers and antidepressants. He was friendly, supportive and kind, and he used a cognitive therapy approach with me, which was very appropriate. Yet despite all this I was terrified out of my mind: everything felt completely surreal and I had a sense of real dread as to what was to become of me. As I was not improving on the medication, and in fact was experiencing strong suicidal thoughts and feeling completely out of control, the consultant suggested that I should attend a day hospital.
I attended the day hospital five days a week for approximately one year. In this shabby, squalid environment, I learnt in every way what it was to be a service user with severe clinical depression. I felt stripped right down to my very core: my status, self-esteem, personhood, even my sense of taste were all obliterated, and emotionally I was totally flat. Worst of all among the many terrible effects I experienced was the inability to take any sense of comfort from another human being. I felt like a walking dead man. The body machine was some how still working, but there was no one at the controls anymore. It had been a very abrupt change – one moment I had been a senior psychiatric social worker, a very busy, ‘together’ professional — the next I was designated a mental health service user, feeling utterly useless, extremely vulnerable, powerless and terrified — not easy things for a man to accept. As a result of this experience, I feel I have travelled light years in my mind in terms of understanding what a hell clinical depression is, and how stigmatization and discrimination is so often the lot of the mental health service user. By my suffering I learnt true humility; I learnt understanding, compassion and kindness from other service users — people who, despite the weight of their own suffering, would reach out to offer a word of support or encouragement to others around them on the same painful path. I learnt that severe mental distress can bring out the worst and the best in people, and in my own case I discovered an awful lot about myself — some good and some not so good!
After some months I was offered some counseling by an occupational therapist, which proved to be a less than helpful experience. At our first session together this counselor began by shooting a lot of questions at me, and shortly thereafter her mobile phone started ringing. She answered various phone calls, and then to my astonishment told me that: ‘this might be important. I’ll have to go’! I thought: ‘Am I not important then?’ Despite suffering from severe clinical depression I thought that could do better than this in terms of counseling and emotional support.
As a social worker, I used to visit people with depression. I had my training, I had read books on the subject, and I had thought I had a good understanding of it. I realize now that I had not had the first idea about how indescribably awful the experience is. This service user experience and perspective has contributed more than I can say to my understanding of mental distress, and has informed my practice as mental health lecturer work at Universities in the Yorkshire area.