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People have always fascinated me – how they think, what they think, how they feel, what they feel, what they do and why. I wanted to study Psychology at University but my family told me I should stick with English so I could write about it instead. Up until this year I had never delved into the depths of my psychological intrigue, but when I was presented with the opportunity to pry into the privacy of the mental health care system in Dunedin, I embraced it.

My initial interest into this started when I read in the Otago Daily Times, back in March, an outline of a proposal made by the Southern District Health Board to a particular mental health care hospital in Dunedin. The SDHB proposed the cut of 24 beds to 12 as part of the Board’s new “Raise Hope” mental health strategy for 2012-15, which aims to create “better health outcomes by preventing mental illness and addiction, intervening early when it occurs, and by providing targeted, effective health care availability for people who need it in the community.”

The SDHB claims to rely on different recovery approaches for different people, but says that some “approaches” to reducing the distress of mental health problems are “effective across all groups.” For instance, the principles of the recovery approach currently emphasises “the importance of good relationships, education, employment and purpose,” which indeed can apply to all age groups. The SDHB suggests that promoting access to such social support structures of those experiencing mental health problems, and those at risk of developing mental illness, is an important part of recovery and prevention. In March this year, however, Labour Party’s mental health spokesperson said that the SDHB’s proposal to “halve beds in a sub-acute ward” is “indicative of the reduced priority of mental health nationally,” and that some long-term mental health patients face an “uncertain future in the community, which does not appear equipped to care for them” when they are discharged.

Although patients may have an uncertain future in the community, which does not appear “equipped to care for them,” is this not fuelled by their isolation and total detachment from society? How is an individual ever suppose to learn things about themselves, and society, to grow and develop and understand things personally and socially, if they are stuck in some tiny room at some insignificant concrete institution that is completely detached from any sense of normal reality? That is not “equipping someone to be in a community,” that is just allowing someone to disintegrate and fall off the radar completely.

Having considered the SDHB’s “Raise Hope” plan, which focuses on integrating the individual into society rather than isolating them in institutional mental health care, against the opposing concern of the patients not being “equipped” to live favourably in the community, I decided (as an individual who can observe both places: the hospital and community) to take measures into my own hands. I went to a local psychiatric hospital to gain insight into the “recovery environment” of those individuals who are removed from the community for various reasons regarding their “mental health problems.”

I was tired of reading articles regarding mental health care that sympathise only with the doctors, nurses, and other regiments involved in this system and therefore failed to empathise with those who play the key part in the whole thing – those who are actually suffering from mental health problems. Instead, I wanted to get their perspective, and so I did.

Naturally my friend was sceptical when I asked him if he would come with me to the psychiatric ward. He tried to talk me out of it. But, once he realised my persistence, his scepticism eventually subsided and we drove up to the hospital. After stopping at Burger King on the way, we drove through the hospital’s gates and parked the car. I was anxious. For ten minutes I couldn’t really breathe. There were barbed wire fences all around the carpark and hostile concrete buildings surrounded us. But I ate my burger, calmed down and we established a plan.

We left the car and headed towards the map displayed on a nearby sign. The map showed us where each wing of the hospital was located. In stressful situations, at least being able to read a map is relieving. I also took a quick photo on my iPhone for memorabilia. Without enough time to visit every wing, we chose to visit the two places that we felt were most appropriate for our purpose – the acute mental health wing for inpatients (where beds were removed) and the rehabilitation centre.

We walked across the grass towards the road, which would later lead us to our other two destinations. I exchanged a nervous “hello, are you an inpatient here?” to a person we saw on the way. The person clearly did not wish to engage in further conversation, responding blankly, “yeah,” before returning to what looked like his flat next to the administration building. We saw another older man sitting outside too. He was in a wheelchair, dribbling all over the ground. Disturbed, I wondered where a nurse was with a cloth.

My initial anxiety returned. On top of the place being encaged by barbed wire, it was incredibly eerie and sprawled out across desolate land. Being on the fringes of the city there was no sense of community. The entire place created a looming feeling of absence. At a place like that, I began to wonder how the hell people are supposed to “get better,” especially when within minutes of being there, my anxiety was already out of control and I felt more nervous and distressed than I had in a long time. Despite this, we continued to make our way up to the inpatient ward.

Along the way, we came across a huge fenced garden where all the roses had died – the austerity resembled one of my favourite contemporary American abstract artists Donald Sulton’s infected flower paintings. After taking several photos, we went over to the abandoned concrete wing where there are rooms that remain decorated as if a patient could still move in. The bedside tables sit with vases on them. Next to them are metal beds that have undone ankle and wrist straps that dangle from each corner. There are piles of towels folded on shelves. Despite this, the windows are all dusty and broken and barred up. The doors are locked and there are old documents scattered all over the floor. It’s Saw meets Girl, Interrupted – I wish I could have gone inside to read the scattered documents and snooped around the bedrooms to see more, but I probably would have been arrested. Instead we took some photos, contemplated the whole ordeal for a moment and then proceeded to the rehabilitation centre.

Rehabilitation is obviously supposed to be where people rehabilitate and reform themselves. You would therefore assume that the place would be serene and comfortable, but it isn’t. Once we got inside I found it increasingly difficult to understand how one could possibly “rehabilitate” in such a disturbing environment.

The rooms are tiny – all they have in them is a bed and a lamp (that is inbuilt into the wall) and a cupboard where I assume the patients would put a small amount of personal belongings they brought in with them. The hallways are long and dark with playing cards stuck randomly on the walls. It was menacing. Throughout the rehabilitation centre were storage rooms and offices that were mostly unoccupied, aside from the occasional nurse who would be sitting at a desk in an ill fitted white uniform. They all looked the same.

The patients are separated in the wards by clinical curtains and the bedrooms vaguely smell of urine. There is no privacy. There was a communal bathroom with this heavy metal door – it was empty, concrete and cold. All that is inside the bathroom is a metal bath with leather ankle and wrist straps. Again, I wondered how that could be helpful to anyone’s mental health, not to mention the gumboots I saw, which I assume is the footwear the staff wear when they shower their patients.

Inside the centre I spoke to a man. I asked him what it was like to stay there – he just stared at me and told me that “sometimes it was fine but sometimes it was lonely.” When I asked him why he was there and how long he would be there for he didn’t reply, so I left. I wondered why he thought, if he was supposed to be rehabilitating, why would someone leave him to feel alone? Surely he would have a greater chance at “recovering” if he didn’t feel so alone?

Our next stop, the inpatient ward, was particularly overwhelming. When we approached the wing I was unsure how to get in, so we knocked on a few doors, all of which were locked. We spoke to a nurse and I introduced myself and told her what I was investigating, and asked her if I could go in and talk to a patient. As expected, she declined my request and told me, “the confidentiality of our patients is very strict and we don’t really want people in here for information that patients are not in a position to give.”

We turned to Plan B. We got to a clear entrance with sliding doors and a “welcome visitors” sign – cleverly decoding the sign, I came to the understand that indeed I am visiting, therefore I am welcome, and so we proceeded to walk in. I crept through the metal door that is the entrance into the acute inpatient ward, went inside and sat on the couch. From the couch, I watched six patients walking aimlessly around the common room, while others sat alone in random spots staring at the wall, or the ceiling, or outside, or at one another.

What struck me about the whole situation was that the severity of patients who were in there was of such a high variation, yet they were all just thrown into the room together. It was like an orgy of addiction, depression and suicide and the energy was anxious and horrifying.

One girl was sitting on a couch opposite the lady who had “smoked too many joints and had a bit of memory loss.” She told me that there was another girl who was in there and had been for almost a year, and she would sing: “I’m h-a-p-p-y, h-a-p-p-y-” repetitively, while wandering aimlessly around the common room. Then she proceeded to tell me that the only visitor this girl gets is “just as fucking nuts,” “neither of them are happy” and that is the main reason they can’t get out. I felt fortunate that I didn’t have to see this girl, but couldn’t help wondering if the whole thing would be quite scarring to experience.

Another girl who I sat next to told me that she wanted to die and that no one visits her and that her family gave up on her and she had no idea what to do with her life. I wondered why she had no friends or family that cared. The nurse interrupted our engagement when she called out her name and told her to go and take her medicine (they all line up at the reception desk to take their medication). After that I didn’t see her again. The other lady who I talked to told me she had been in and out of psychiatric care because she had “smoked too much weed” and they “couldn’t find the reason why.” Sounding too much like my own life I decided to end my experience at the hospital.

Before I could write about this experience I had to take some time to dwell over the thoughts and feelings it raised within me. The place was awful and the people there all seemed lost – looking for guidance, but to me, at the wrong place. The hospital was hostile, cold, and regimented, and had an inherently temporary feeling to it that was both unnerving and upsetting.

I began to rethink about the comments in the Otago Daily Times made by the Labour Healthcare Spokesperson (I won’t embellish him by mentioning his name), surrounding the removal of beds in the hospital. How could anyone want there to be more beds kept there and how could anyone want people to actually stay there? How could anyone even think that by staying there these individuals will all of a sudden “get better?”

Mental health is about understanding, empathy and unity between individuals. I realised that the SDHB’s strategic “Raise Hope” plan seems like a more effective and interactive way to relieve issues regarding mental health, as it gives people the chance to be socially involved and active rather than being socially detached and therefore inactive as a member in the community, simply because they are coloured with different shades.

Perhaps institutions are helpful in some aspects – the nurses seemed like they were doing their job, as in, they provided showers and medication for their patients and provide “support systems,” but I feel like all these patients really need is something to make them happy – some purposeful part in society in which they can feel motivated to be part of, rather than just being secluded and rejected.

In saying that, the horror of the place and the sadness of the situation haven’t left me, and despite the nurses and doctors who seemed to “care” for these patients, I cannot stress anymore the sense of detachment and isolation one feels by simply being present there. I am excited to see the progress of the “Raise Hope” plans, which focuses on a more integrated approach to mental health care, and I am hopeful of its implementation in Dunedin in coming years.