If It Helps - why I need to write a book about the psychiatric system

by David Gilbert

October 8, 2019

The illness-laden dreams were back last night. I was sunk in a depressive stupor and telling my father he was a c&<t and that I wished he was going through it. I woke. The ceiling was dark, the birds had not started to sing. I had been back on the ward.

This new book I want to write is not a good idea. Why open the scars that have mostly healed? How ridiculous it is to be setting out to write another book, this time one that delves into my nightmares and what happened to me when I was ill. Why should I explore again and try to find out whether things are any better now?

My new book is just out – one that celebrates the rise of patient leadership. I should be celebrating and taking it all in. This new idea for a book is not a good one.

This morning, social media is awash with tales of racism, polarisation, volatility. Amidst the hubbub, voices rise about mental health and mental ill-health – arguments break out about the lexicon. More and more the public discourse on mental health rises like a tide. Surely this is a good thing.

A new app that supports people to maintain wellness is launched, whilst others wonder whether we have over-troubled our children by making them more aware of emotional distress. It feels like a lot of people who know little about suffering but have ‘ologies’ are fishing for likes with clever euphemisms.

And yet, I don’t hear the voices of the silenced. I don’t hear the narratives about what it is like if you have mental health problems at the further end of the spectrum, where you do need help, but are ambivalent about what is on offer, or can’t get it. To be trapped in a nether world of being too ill for an app, but not knowing much about the zone you are entering – whether you will ever return from the caves of suffering.

There is a lot of noise about mental health. But not much music. Serious music.

What about the underbelly, what about when you need help for significant and enduring distress, when you are bounced between pillar and post, between a GP recommending CBT and the desperation you feel at night, when you don’t know who will catch you if you fall, when the terror of your mind is inescapable. When nothing is on offer and the guilt and shame you feel for not being ‘helpable’ rises to a scream?

And what if you enter a psychiatric hospital - a dark world of containment and fear, the far territories of the mad, what happens in a world when no-one is looking and nobody gets ‘likes’ and there are no followers? What drugs might you be put on? What labels jammed down your throat. Is this incarceration or the journey towards breakthrough?

And then again, what of the cost of writing like this? To dig. To pick at the pock-marks of my arms, the scabs that grew over my injuries. To think of days on the grass bank by the psych unit amongst the litter of cigarette butts by the sodden benches overlooking the cemetery.

Surely someone else can do it. There are plenty of books out there, and good writers. I have healed, I am loved, reasonably successful finally. I need to rest and ‘self-care’

And then a short phrase comes to me: ‘if it helps’. If it helps one person to better understand the world of the psychiatric system. If it helps one person navigate a little the monstrosities of their mind, or how to deal with healthcare practice, if it promotes one discussion between people who work in services and those who use them, if it promotes one sentence in a policy that seeks to change practice…. Then it must be done.

Sod the nightmares. I’ve been through worse. And so have millions of others. I need to write.


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