Doctor:
John is my patient. I know he is unwell again. He’s getting paranoid about his Facebook account. He’s closed it down and bought a new iPad because he is convinced hackers have got into his account. Again. That’s the third iPad this year. When I saw him last week he said his mum was not his mum, she was an imposter who was working for the police, spying on him. His mum rang today and said he won’t eat any food she has prepared for him because it’s poisoned. He shouted at her and threatened her last night. She found his box of tablets in the bin, the tablets he is supposed to take twice a day to manage his mental illness. John has been in a psychiatric hospital twice this year. He still doesn’t accept that he has an illness and needs treatment.
I visited John at home today with his case manager from the community mental health service. He seemed to be hearing the voices again and could be heard conversing with them in his room in angry tones. He had got his cricket bat out of the garage to keep in his room “for protection”. When I spoke to him I could see that his lips were very dry. I could smell that his breath was terrible and he smelled like he hadn’t showered for several days at least. I know John is very ill and at risk of being violent – perhaps towards his mother. I can see that John’s mother is frightened in her own home and can no longer manage him. I used the Mental Health Act and wrote a schedule to say he must go to a psychiatric facility. John has been violent before and refused to come with us to hospital, so the police were needed to get him there. Once at the hospital, he was seen by another psychiatrist and allocated to a treatment team. The team decided to keep him there for another fortnight. They are going to stop the tablets – which was not an effective treatment as he wasn’t actually taking them. They plan to start John on a long-acting injectable medication instead. When he is discharged home from hospital he’ll be subject to a Community Treatment Order that obligates him to have the injection every two weeks. That should keep him well, keep his mother safe and prevent another admission.
The patient, John:
The police came again. They dragged me out of my room and into their van. I was still in my PJs, I didn’t even have shoes on. I haven’t done anything wrong. I’m not a criminal, I’m the one who needs protection! That doctor is in on it. How dare she have me locked up like this. The neighbours all saw it happen – they’ll still be talking about it – bet it’s on Facebook already. Mum let them in – she did it last time as well. I know she’s been talking to that doctor about me behind my back. Some mother, huh. I knew she was against me.
No one ever believes me, they don’t believe what I go through. They haven’t had their accounts hacked, they haven’t had vicious lies spread about them on the internet.
And now I’m stuck here in this hospital. You can’t smoke in here! They don’t let you out except into a high-walled courtyard and man, there are some scary people in here. There’s nothing to do. The food is crap. The doctors and nurses just say “you have an illness John” and “you need medicine John”. That stuff, that medicine, really is poison. It makes me so zonked out I’m like a zombie, I am tired and fuzzy and I stack on the weight. My mouth is dry and my muscles are twitchy. It slows me down so I can’t do anything!
Now they’ve said I have to have an injection every two weeks when I get out of here. If I don’t, the cops will come for me. My dad got to stop his cancer treatment when it got too much, but I can get forced to have injections which make me fat and tired and that I don’t need. No-one ever believes me.
