Background: Alice is single and lives in an inner suburb of a metropolitan city. She identifies as first generation Australian with a European background. Alice has worked in the community sector and is now pursuing further studies.
About Alice
When she was 32, Alice voluntarily admitted herself to a mental health unit. After staying one night she was made a compulsory patient for a few weeks. On discharge from the unit she said that she was given a diagnosis of reactive psychosis. Alice currently sees a psychologist and a psychiatrist. On her own initiative, she stopped taking medication about six months ago.
Read excerpts from Alice's interview
> Searching for information - Alice found that over the years, information about mental health has 'evolved'. She thought more 'friendly language' should be used in mental health information.
I was very much, you know, what people around me would call fighting the system, for probably a good 12 months. You know of fighting and kind of looking at whatever limited information I could get on the internet. So what information did I get? Oh look, again, I don't think I ever printed them up. But at the time there wasn't a lot on the internet, like you know over the last few years it's definitely evolved quite a lot. So it would kind of, you know, probably be like a Wikipedia type analysis of what psychosis was.
And basically I think that the definition even changed over the last few years: it's like one out of touch with reality as opposed to an earlier definition. It said something like a higher level of consciousness. So you know it was kind of like I wasn't really getting much to help me. I wasn't really getting much to help me ascertain what was going on in, I guess, a mental health practitioners head to judge me in that way. I wasn't getting a lot of insight from just desktop research on that sort of stuff. And I even felt that when I was asking them, I wasn't getting the information that I needed to help me figure it out.
So you mentioned that there wasn't much information back then on the internet, as you know we're producing a website. Was there any information that you were looking for then that you think should be included in a website like ours?
So I think some kind of more friendly language around what the Mental Health Act means. So, you know, I think when someone's suffering ill health, the last thing I think they need is the black and white textbook type answers, or the legalistic terms. Yes, we all need to be apparent, like we need to be aware of those. But I think it needs to be meaningful, you know, and yeah I'm the first to say like, mental health doesn't discriminate against education type. But you know it's kind of very legalistic terms.
So I think your other options need to be available as well. So what options are available within the region that I'm in, or what do the different organisational groups do. So, you know, I think Beyondblue from memory, just refer you on to a psychologist, I don't even know whether they've got a link to the CAT team or anything like that.
> Experience of receiving a diagnosis - The first time Alice knew about her diagnosis was when she was discharged from hospital and saw it written on the discharge sheet.
And that was the diagnosis itself? When did you receive it and how was it given to you in the mental health unit?
So, again I don't recall ever formally being given like a diagnosis other than, to me, a lot of what was happening was being advised to my family, not directly to me. But that's what I felt anyway, I don't know, having you know at the time. So I don't feel like anything technical was ever being described to me, other than you know, this happens to a lot of people. It's like breaking an arm, you need time for it to heal. Yeah, kind of lots of analogies, lots of sort of graphs in terms of everybody has you know the other graph that I remember being shown to me, with my family present. Was you know everyone has a breaking point, put enough on to them and we'll end up in this kind of, you know, unrealistic based in real, you know, based in unreality.
So I don't remember any sort of formal, like until I probably got a discharge statement, that's when I think it had a kind of first episode psychosis on it
When you read that on the discharge sheet, what did you think and how did you feel?
So initially I think I was kind of very angry at the services. So I didn't, I still look back feeling that yes, I will absolutely admit that there was an element of my thoughts and that inhibited my behaviour that was out of touch with reality. I will admit that. But there was a lot of me that was grounded in reality at the same time. So I still feel that it was a very kind of - what's the word I'm trying to say. I'm very like it was a very kind of intense approach to what I think was probably maybe at most, you know, even throwing maybe 20 per cent of me was being inhibited by.
> Experiences with mental health practitioners: Psychiatrists, counsellors and others - Despite feeling 'more in tune' with herself, Alice found it difficult to speak to her doctor.
And that's how I've always felt with psychiatrists, is that I'm always debating them. I've always felt like I'm more in a debate about legalities and what they academically think. Rather than being seen on an individual level from a coaching perspective, there's always - even with the one that I stuck to for a while - there was this level of superiority as to where they sit in the system, you know. Maybe that's something that I value to an extent. Is that we're all human beings regardless of what experience we've got, what education we've got, and we can all learn from one another. You know, some need to lead and others be influential and all that sort of stuff. I get that. But yeah, I guess I never felt like I wasn't in tune with myself enough to make an informed decision for myself. And sort of always felt like that was being taken away from me, so why do I even bother entering into, expending the energy to enter into a debate that I'm not going to win.
> Experiences with mental health practitioners: Psychiatrists, counsellors and others - Alice described mental health practitioners as 'risk averse' and said this made her feel like there wasn't 'a lot of hope'.
But it kind of was always with this kind of 'We'll dip your toe in, we'll see how you go,' and you know. It was kind of very risk adverse, so it didn't, for me it didn't feel like there was a lot of hope. And I just felt like it kind of crushed my spirit to an extent, in terms of what you can and can't achieve. So yeah, so I do feel like at times I got listened to, particularly with that therapist that I had for three years that they kind of recognised that I was so angry at like the whole mental health system, that I was just ready, well, had no optimistic thought of where that was going.
> Family and friends - Alice's father 'walked out in tears' after seeing her 'talking gibberish' when she was heavily medicated during her first voluntary mental health unit admission.
So my family came in, so actually when I say my family, it wasn't all my family from memory. It was my mother, a good friend of mine and my sister. We were all in a room together at one point and I think it must have been around lunchtime... The conversation came up around food and the canteen in the hospital or whatever, and then I kind of remember asking my mum to go get me some food. I don't know whether I was hungry or whether I didn't want to eat what they gave me or whatever. And she did...
But by the time I was medicated, I can't remember whether it was that night or the next night. I'm sure it would have been that night because my father wouldn't have waited 24 hours to come see me. He came in. By then I was talking gibberish. So that's how the medication affected me. I don't think that was, I don't think I would have ever ended up in a state of, so when I say gibberish I don't even think I was coherent when he saw me. My father walked out of there in tears, freaking out at the state I was in by that night.
> Experiences of work - Alice confided to her boss that she had had a compulsory admission. Later, a situation arose in which she felt 'judged' by her boss because of her disclosure.
The little bit that I guess I did disclose in my current work environment, I did at times feel that I was judged, not necessarily when I was in the vulnerable moment of disclosing, but later on. I disclosed that I'd had an admission, again it wasn't in the writing, so it wasn't in the upfront documentation. But I felt that I'd developed enough rapport with the person to disclose that.
And then how did that later on come to be something that you felt you were being held up against?
So it kind of came about by you know, I mean I'm the type of person that has lots of balls juggling all the time anyway. And you know depending on what happens with those balls, or putting to one side or one dropping or whatever. You know, I'd like to think I'm quite dynamic but you know, yeah. But look there was a significant shift in that I'd decided to stop taking my medication. So to me I felt a lot more centred with who I was before all this happened, since that has happened. So there's been several months now.
And again I'm managing that tightly in terms of who I'm telling. So I kind of had felt, look I probably jumped the gun a little bit to advise that at the time. But I kind of felt that my changes in the workplace, in terms of my behaviour, probably as a result of that, were being seen negatively when I felt that they were more positive. Because to me I was becoming more you know assertive, not that I wasn't assertive before. But definitely compared to how I was prior to any of this happening, I definitely was a lot more, not toeing of the line, but a lot more, held back a lot more you know.
So I was kind of like asserting myself, expressing my opinion, showing my initiative, getting things done. And was kind of almost in a zone again with work, which I hadn't felt in a long time. And yeah so I kind of ended up being pulled up on that a little bit, which I found quite bizarre. Because you know I ended up managing that process by saying that I felt that the change was nothing but positive. And if anyone felt otherwise then come talk to me. You know, yes there was a change and that's fine.
But I guess working in a smaller environment of not you know thousands of people that it's probably easier to pick up those changes in people. But life I think in our modern day world has become so busy, that you know people will, I don't know. I guess I don't look for consistencies in people's behaviours. So, do you know what I mean? Like I don't, I just feel that we need to be dynamic to get stuff done in the modern world. We can't, yeah I can't be doing something on a real monotone element.
> Finances and housing - Alice talked about the impact of being diagnosed with 'reactive psychosis' on her finances and 'lifestyle'.
I don't dine out nearly as much as I did then. But I'll still dine out probably at least once a week these days. And you know, I kind of... so I don't feel like my lifestyle has hugely altered. But probably that's the luxury of not having dependents and, you know, being in a supportive family arrangement as well. I think again being put in the frame of a mental health practitioner, they all say well you're still batting above the average, you know. But from my perspective, I guess that financial, it wasn't necessarily stability, but that financial continuity that I had with work, put me in a way in which I felt that it gave me the ability and the choice to be able to do things that I wanted to in life. So it gave me that sense of freedom, you know even though technically I was tied to an employer. But it kind of, I haven't, you know, I haven't really had since this happened, I haven't had that continuity in salary for a long time.
> Personal recovery - Alice feels different now and thinks maybe her mental health problem was a 'wake up call' to make her more resilient.
Oh I definitely feel very different to what I would have been back then, but you know I guess looking five years prior, I guess I would have felt different. I guess to me it's just something that I took for granted, like your mental health, it kind of yeah... It sort of opened up a sense of vulnerability in me and that we're all...
Again you know, I'm not naive enough to think it's just me. I think we're all vulnerable to an extent, so you know maybe I needed that so called wake up call. To kind of get me resilient to what the rest of life has to offer. It's can you really go through life you know by taking your mental health for granted, or your emotional health for granted to that extreme.
> Advice to others: Health, mental health and allied health professionals - Alice advises health and mental health professionals to recognise their 'model' may not work for everyone.
I think that a mental health practitioner also needs to be humble enough to say, "Well we can't, I can't help everybody. And my style might not be the best style to help this person", and I think you know if they can see that quickly. If they can be self-aware enough of themselves and see that quickly and refer the person on to somebody else. I think that's a very big positive. I think that that's human nature. I don't think that's a reflection that they didn't study hard enough or anything like that. I think that you know, different people will suit at different times.
I think they need to be open enough to recognise their own flaws, which I think a majority of them will say that they do that. Because obviously they have to get to that level and I think from memory they have to have their own therapy to get there. But so one of the ones is listening, listening skills would be huge - empathy, listening, empathy, relatability. So I guess, you know, to open up that therapeutic relationship. And look, you know, I'm also humble enough to admit this could be my experience.
Like, so I'm sure some people have some very positive experiences with them, but the level of openness I think that they need, in that you know, that their own model isn't necessarily what works for everybody. And to give that empowerment back to the patient, provided it's not what, you know, to the detriment of one's self, provided it's not to the detriment of another. You know, if somebody chooses to kind of lose their marbles, you know, all right fine. If they're going to be a burden on the system so to speak, then maybe we could step in.
But, you know, I don't know, see to me that's a catch 22. I don't know, I sort of sit there and think you know, we're not going to prevent every suicide in the world. So at what point do we sort of say well, "That's a person's choice, do we try to save them?" Yeah, I don't know, I guess that's a fairly blurred line at the moment for me. I just don't think we need to be prescribing drugs to everybody that we feel has you know a self-harm thought. Because it could be just testament to what's going on in their lives, it doesn't mean they're going to flow through with it.
More about Alice
Alice enjoyed working in a 'large global' organisation throughout her 20s. It came as a surprise to her when, in her early 30s, she began to feel tearful and 'struggled' to get out of bed in the morning.
Alice went to see her GP who suggested she was experiencing 'stress' from her job. She chose not to take time off work or try antidepressants because she was not convinced that her condition was work-related. Alice was also experiencing difficulties in her eight-year relationship, which had 'turned nasty.' Following an argument during which Alice said her partner threatened to harm her and her family, Alice moved out of their jointly-owned home.
About six weeks later, Alice became 'consumed' by 'paranoid' thoughts that her ex-partner was going to hurt her and her family. Alice voluntarily admitted herself to a mental health unit. The following morning, she said she was taken without advance notice to meet the unit's Mental Health Review Board*. Alice said she did not feel comfortable speaking openly during that meeting and did not reveal her ex-partner's threat. She described the hospital environment as intimidating and 'not peaceful.' Alice said that this could have contributed to her 'paranoia' during her meeting with the board, which admitted her under compulsory status for a few weeks. Alice was given a diagnosis of 'reactive psychosis' on her discharge statement, but she said this diagnosis was never verbally communicated to her.
During her stay in the mental health unit, Alice said she felt her 'liberties' were 'restricted,' and she said she was not allowed to personally contact her employer. When she returned to work after two months, she did not feel adequately 'prepared' to talk about her absence, which influenced her decision to take leave of absence after just one day. While she was on leave, Alice's doctor prescribed medication that made her feel tired and 'out of touch' with herself. She recalled questioning then whether it was an 'early 30s lifestyle' to be awake for only 'a few hours' each day. About three years ago, Alice felt well enough to start a new career in the community sector.
Over the past few years, Alice's psychiatrist prescribed 'very different' medications. When she told her psychiatrist about side effects she was experiencing, she said she felt that he implied it was 'all in her head.' She made the decision about six months ago to stop taking medication. As a result, Alice said her 'energy levels' are back, she can think 'more clearly' and feels 'more in tune' with herself.
Alice described feeling 'caught' and 'disempowered' in the mental health 'system.' She thinks a 'medical model' was applied to her treatment, and that she was not 'respected' to make her own choices about her mental wellbeing. Alice thinks mental health practitioners should exercise 'empathy' and 'curiosity' to gain a better understanding of their clients' past and present situation.
Alice feels 'more centred' now and is undertaking further study with her sights set on a change of career.
* Now called the Mental Health Tribunal.