Preface by J. Rosberg, Ph.D.

The following is written by a Finnish man who agreed to volunteer for a day in a mental hospital.  I had the opportunity of meeting him in Finland and believe what he has to say is relevant and is not really different than the experience one might have in many countries, including the USA. 

Wouldn’t it be good if people in the bureaucracy would volunteer as he did!  Maybe then things might improve.

A DAY IN MENTAL HOSPITAL, ITS ISOLATION WARD

The closed institutional care used in mental treatment is suffering from extremely negative attitudes. The exercise of power in those wards is partially distorted, reminding of the abasement of mental illness compared with other diseases.

Everything told as tales seems to be nightmare when being told by a patient. Perhaps the stories about straitjackets, segregation cells and violence in isolation wards are drowned out by continuous killing, aggression and violence seen on television.


As a substitute for a day

The members of the board of North Carelian nursing district with reference to the sector of mental health had been challenged to work in mental hospital for a day, as substitutes. I regarded this as an interesting challenge because a mental hospital was familiar to me as an experience, the afterimage of which doesn’t disappear though it had happened 15 years before. After having agreed a date for the work with the matron of the hospital I thought I’ll experience something positive.

In the morning at 7 I walked to the ward, I got the key and I walked along a corridor, the walls of which brought to mind the turning points in my life, the deepest crises of a mental disease. A white coat and pants were found in a wardrobe. I was nurse.

The closed chronic ward of women woke. The nurses sat in a glass cabin of their own. The patients got gradually together for breakfast and distribution of medicine. Some of them didn’t agree to rise without persuasion. That one, who had been confined in a straitjacket, got a complete service. She was out of the medicinal preparation she had used because the medicine was no more made. The situation worsened and the restlessness increased as far as using straitjacket. The blessing and curse of medicine came to my mind. Who would say in this case if it’s a question of difficult withdrawal symptoms or signs of disease? They seem to resemble each other.


Contacts with the patients

“Speak you English? Who are you?” Unexpectedly clear questions in English were put to me. I sat down beside her and in a while we talked in Finnish. We suddenly discovered that we were previously familiar to each other. She remembered an occurrence happened 15 years before when I had smuggled cigarettes to her. We were on the same wave length.

She was a typical rebel against the hierarchy of institutions and the rules which could be even really stupid but you had to observe them in mental hospital. This absurdity seems to cause bitterness, rebellion and mood against the treatment. Her face told about a deep suffering. If you didn’t come back from your free walk it was regarded as a serious crime. The prohibition against smoking hurt both physically and mentally. Also this sanction is regarded as a cure.

In the music room I met a silent artist. She took me to her room and showed her pieces of work. On the wall she kept also some ten letters in which the treatment of the ward was criticized. I thought myself those letters further hardly exemption from the isolation ward. To her the art was all in all but she lacked only those who understand it.
A young maiden from the eastern border district represented a sensitive, frail and childish patient, ill-used by the hard world. Most of all the patients just she was that one, who would have belonged to some other place. In the room of a group on a table there were some modest things. A little soft teddy reflected her inmost stayed in her childhood. She had been aggressive hitting her patient companion; one of the few signs of health when being stoned.

An elderly woman seemed restless but also rather clear if someone had listened to her. The side effects of the medicine were distinctive. She told her story of life with animation. We saw we had common acquaintances.


A report and a doctor

Sometimes I had hoped to get to hear a sitting dealing with the report of the nursing staff. Now I had this opportunity. It became also a moment of disappointment. In mental hospitals there seems to be used the point system of Ojanen & Sariola, applied at least, based on the dog experiments of psychologist Pavlov. Roughly speaking you’ll get minus points as a result of bad acts and plus points of good acts.

It felt bad that only symptoms were taken into consideration and it felt absolutely senseless that the behaviour of a patient was anticipated like this: “I wonder what she’ll do now when looking out so restless.” This is called ‘provoking’.

For that day no doctor of the hospital was used there but one had been borrowed from the health centre. He met two patients under spontaneous medical treatment. They were those girls I had met before. I think they came out with flying colors of a situation at times like a third degree cross-examination.

I became sad when meeting a young maiden. Her way to the hospital probably was endless and it had gone through smelling at glue. The damage of brain cells was irrevocable.

During the rest of the working day we were sitting with the patients in a large lounge, conversing there. The atmosphere was oppressive. Freedom was behind the door. For getting there a patient had to yield to the norms, sometimes very absurd, of the hospital.

I said goodbye to the people of the ward. The atmosphere was dispirited. During the last 15 years no development had happened for improving the treatment of patients of the isolation ward.

When hanging the white clothes of nurse to the wardrobe I thought like this: “I wonder where the organization Greenpeace for the protection of a human being is staying; the organization which would chain itself to the doorways or the walls of a mental hospital, on behalf of patients.”

RAIMO MATIKAINEN