Thankyou Mandy et al - How small acts of kindness from non-clinical staff helped me recover from mental health problems

by David Gilbert

November 4, 2014

(Some names have been changed)


We instinctively know that all healing begins with kindness. Yet this gets lost in the habitual machinery of the ‘treatment industry’. In hindsight, I can see that my recovery from six years of psychiatric hell between the ages of 25-31 was dependent on small acts of kindness.

I had lost connection with family and friends who could not bear to see the state I was in. I had lost all respect for myself. If others had too, I wouldn’t be writing this.

Dorothy, the cook on the psychiatric unit knew all of us by name. As we queued up for lunch, she always asked how we were and told us about her family. In other words, she treated us like people, not patients. One Sunday, I went for a long walk to battle with my demons. Dorothy hid my roast dinner for hours and served it up for me when I finally reappeared.

Once, a friend put his fist through the window. A gooey trail of blood lined the corridors. I was upset and went to sit on the bench outside the unit. Mandy, the ward receptionist brought me a cup of sweet milky tea. “I know you don’t take sugar usually, but maybe this time?“ she said. And she took her own tea break early to sit beside me.

Adrian the chaplain visited the ward regularly. It can’t have been easy for him. Most of us had lost any faith we had had to begin with. But he listened and listened, without judgement. My first inklings of the deep systemic problems and lack of user-focus in the NHS came when the ward managers decided to lock the unit at 8.00. This meant Adrian could not visit. The ward became a pressure cooker as people were deprived of their evening walk or time in the garden. I’m sure the stats for sleep medication shot up. This was my first evidence of the NHS hitting safety targets but missing the point.

Kevin, the young art therapist, allowed me to rest my head on the table and didn’t complain when I finally layered the paper with more than my fair share of black, brown and grey paint. Yellow and green seldom saw the light of day. He persuaded the nurses to let us visit the local park, a godsend for those who hadn’t seen real green for a while.

Debbie, the volunteering coordinator, encouraged me to return to my passion for writing poetry. In my depressed state, I resisted, until she helped us to produce a ward newsletter and offered me space for a poem. Having my first poem in print was unforgettable and she followed up by finding me a local evening class in creative writing.

I sometimes wonder whether non-clinical staff are better able to see us as human beings – the clinical straightjacket can harm as well as heal. Some nurses were nice to me. Many weren’t, unfortunately. Ditto the doctors. I felt back then that some clinical staff were institutionalised and were more 'custodial' than caring. Now I realise how difficult it must be for staff to retain their humanity, yet remain resilient within such a stressful environment. I also recognise just how much practical and emotional support all staff should have.

But even then, a few shone out. So it is possible for clinical staff to be kind under duress. Lucy regularly said hello, despite me only growling back. One student nurse, who went on to become a psychologist and friend, was the only professional ever to help me develop an activity plan to re-build my self-esteem. One lovely junior doctor played table tennis with me (I’d still like to find out whether he let me beat him).

However, one doctor gave me the worst counselling session of my life in a ward broom cupboard and asked me, rather bizarrely I felt, whether ‘Thanatos’ would triumph over ‘Eros’. Another tested the ward curtain rails for ligature points, stating that he was checking whether I could do “something stupid”. I say this not in anger, but to point out that these small moments – good and bad - matter. They stay with us.

The best thing my consultant did was not medical, but based on deep insight and lateral thinking. He knew I had been a campaigner for better medicines and health in developing countries. As I was recovering, he asked me to deliver a training session on medicine safety for student psychiatrists at the crumbling local Victorian asylum. He allowed me to walk into the place I had been most frightened of as a patient – where I thought I would one day be transferred. I had a terrible fear that I would be institutionalised there and eventually die within its walls. I walked out of that seminar as a human being and a professional with head held high.

There were also numerous small acts of kindness from fellow sufferers, some who are still friends - bringing me biscuits while I was under close observation, taking me to the Chinese takeaway to break the ward monotony and the endless encouragement to keep going.

Bill took me for a pint and tried to get me interested in football again (I am a Leeds Utd fan, so perhaps that wasn’t the most effective anti-depressant). Eddie sat next to me after we heard that a fellow in-patient had committed suicide by drowning himself in a local reservoir. He spent several hours persuading me not to follow suit, at one point reminding me that it would be impossible since I was too good a swimmer. He managed a miracle. He made me laugh.

I am no Christian, but ‘by their deeds shall ye know them’. In my patient and public involvement work, I grow weary of rhetoric and the rise of the ‘compassion industry’. I am also wary of the Quality Improvement movement, with its tools and techniques and grand plans to ‘transform pathways’. Sometimes a patient journey of a thousand miles begins with a small practical step.

Why do I want to write about all this now? Isn’t the past best left alone? After all, it was 99% a terrible time. These sorts of experiences are the fuel for what I do now. But I also believe that finding reasons to be more grateful is a key to further healing. Retrieving learning from an experience, that once felt like a hole in my life, helps me do my work better. So, thank you Mandy et al.

And then there was Susan. Her two year old son had died of a congenital heart disease and she found herself an in-patient. Our first ‘date’ was over cornflakes and chamomile tea in the ward kitchen, and we spent many hours alone in the only private place we could find – the laundry room overlooking the car park. We clung onto each other during the wreckage of our lives and grew to be close friends. And more. We have now been married for 17 years and have two children. Never doubt that love and kindness can flourish in the most inhospitable of conditions.

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3 comments on “Thankyou Mandy et al - How small acts of kindness from non-clinical staff helped me recover from mental health problems”

  1. Lovely lovely writing. As a former MHP I am saddened by the casual cruelty and lack of regard for their fellow humans displayed by so many clinical staff. You are right that staff need good peer and clinical supervision, a place to be supported and have the stress of the job acknowledged in a non punitive manner.

    And the small acts do count, especially a careful reminder by the staff and unit of what people were (and still are) underneath the layers of illness.

  2. This is just beautiful. I was a cancer care patient all this year and I was so appreciative of the ways in which nurses stepped outside the restrictions on their role to share real bits of their human lives with me. So I really agree with you: clinical staff are trying to operate under professional restrictions that formally prevent them from extending the kind of hand you describe.

    I recently told a nurse educator how much of a difference it made to my wellbeing that nurses shared things with me and her immediate response was "They shouldn't have done that." So I understood why the nurses lowered their voices and looked around before telling me something important to them. This gesture of care was exactly what made me think I could survive the treatment in OK shape.

    And it's what I remember about each of them now. Thank you for writing this. I loved reading it.

  3. Lovely post, keep healing, writing and doing your damndest to get change. I don't know whether it is just me but I feel the start of a surge of people who ain't gonna have it anymore

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