working in mental health
By Clara Autumn

The walk up to the building felt like I was hiking up the side of a mountain and had to look flawless at the finish line.  I was just about to attend an interview for the first job I actually wanted.  I hadn’t exactly resigned myself to McDonalds previously, and had a small string of respectable yet fucking boring jobs.  But as I reached the doors to the old hospital, a mixture of terror and anticipation filled me.

Life experience

The building was old and beautiful, however, if you have ever seen the film ‘House on Haunted Hill’, it was undeniably perfect in looks for the industry it contained.  The job advertised was for a support worker in a low secure private hospital for adults with mental illnesses.  I applied, not really expecting a response as I was just turned 19.  But fuck, by that age I think if life experience was transferable to the professional arena I should have at least been considered for the role of hospital manager.

The airlock doors were a familiar security, only this time the smiling receptionist gave me a visitors badge and wished me good luck.  In the lift up to where the interview was going to take place I readjusted my poorly fitting cheap suit and checked my teeth for any unattractive debris.  Trying to look more competent and adult than I felt being in such an imposing building.

I was a patient

If I’m honest with you, all through the interview I was conscious of three things.  Firstly, how much of a fraud I felt like considering I was a patient in a hospital like this previously.  I felt like the interviewers saw through me in an instant.  Perhaps mental health nurses could smell crazy?  If they could then I fucking stank out that conference room.  Secondly, I was trying to discreetly re adjust my cheap suit so the arms of it were covering the more obvious signs of my quirks.  I sensed that the ‘ideal candidate’ wouldn’t quite look like they had just been in a fight with the entire contents of the lady shave factory.  Finally, it actually looked like they were taking me seriously.  Either I was making full use of my B grade in GCSE drama, or they actually saw something employable.

I got the job

“Dear Miss Edgecombe,

We would like to thank you for taking the time to attend an interview with us on 23/03/08 for the post of Support Worker.  We would like to offer you a full time contract to start with a two week induction starting on 24/06/08.  Please respond to this offer within 7 days if you intend on formally accepting the post.  We look forward to working with you soon.”

With a rush of endorphin more effective than any overpriced class A I was absolutely on top of the world.  Maybe this would be my chance to pay the cosmos back for the help this kind of place provided me when I was on my ass.

Working in Mental Health With a Mental Illness – My first shift

My first shift was a night shift on a PICU ward (psychiatric intensive care unit).  I was shitting myself.  I had never done a full night shift let alone one in a place like this.  My objective was to stay awake, not make a dick of myself, and try not to piss any of the patients off.  Simple?

The first thing that hit me like a wall as soon as I entered the ward was the smell.  It was like walking into a teenage boy’s room who has pissed everywhere.  I walked down the corridor, one hand slightly hovering by my attack alarm and keys.  And into the office.

If I had known now that I would be walking that and other floors leading to fishbowl like offices for almost 10 years, would I had taken that first shift?

Of course I bloody would have, I’d had been crazy to pass up a career like this…wait….

Over the following years working in this environment something became very apparent.  The patients were a delight compared to the staff.  Politics are rife in health care regardless of the setting, maybe it’s the 12 hour shifts, maybe it’s the stressful environment, and maybe it’s the fact that everyone is shagging everyone.  And no, I am not a stranger to the latter.  But slightly wiser after 10 years!

Meeting my ex-husband on shift

I was the responder (person who runs to the violent incidents) on my ward and as I ran down the corridor to manage whatever triggered the alarm our eyes met over the smell of piss and violence. I really should have known that it possibly wasn’t going to be one of my finer life choices from the start. And after a more than rocky first couple of years into the relationship, I was using work like a sanctuary (when you have to use a psych hospital as solace, you need a new relationship folks).  I ended up having a thing with someone else from work.  I know, talk about shitting on your own doorstep.  But anything that gave me an out from feeling like something someone had just scraped off their boot was a welcome intermission.

However it wasn’t something I could keep to myself, and from disclosing my indiscretions to my then fiancé life took a drastic turn for the worse.  He began a campaign of personal annihilation against me, and thinking I deserved nothing less I allowed it to happen.  For four years and two months.  But that, my friends, is an entirely different chapter for another night’s listening.

It felt like I was fracturing into a million pieces

At that point I knew that there was something going very wrong.  Not just at home, but in my head too.  It felt like I was fracturing into a million pieces.  And none of those pieces knew how to find their way back together.  I went with my fiancé to the local community outreach centre after my GP referred me, and said what had been happening in my life, how I felt utterly out of control.  And I mentioned that my father and grandmother both had diagnosis of ‘manic depression’.

After assessment I received a letter summarising the outcome of the meeting.  I had been diagnosed with bi polar ‘rapid cycling’.  The first diagnosis I had had since my first presentation to services at the age of 12.  I was then 23.  I let my fiancé think that the illness must had been a cause of my recent lapse of underwear.  The truth was, I would have told him that chicken had teeth, if thinking that would have stopped him getting fucked up, hitting me and calling me all the names under the sun.

Managing my illness

Over subsequent years I managed my illness, my tumultuous home life and my medication regime all while working with many who had the same diagnosis as me.  And it was liberating.  Somehow that label gave me permission to get more comfortable and self-assured.  I stopped wearing long sleeved t shirts, sick of being hot and uncomfortable in the summer at work.  And I pushed myself harder professionally.

But while my confidence grew, so came those assholes that always want to put a self-harming, bipolar support worker back in her box.

I responded up to the female ward one day to manage an incident that was occurring.  I walked onto the ward to find a very distressed woman who had self-harmed rather badly.  She had left bits of her insides outside on the floor.  The staff nurse and I helped her to the clinic room.  When there was another staff member to stay with her I went to go clean up the aftermath.  I didn’t want this poor woman to come back to her room to see the remnants of her trauma on the floor.  No one needs reminders like that.  So I dutifully collected a hazardous substances clean up kit, and got to scrubbing chunks of her off the floor.

Managing an incident

By this point in my career I wasn’t just a support worker.  I had graduated to lead MVA (management of violence & aggression) tutor.  I felt it part of my duty to go see the staff in the office and offer them a debrief to make sure they were ok.  After all, staff are the same as any other person.  Although you become conditioned to some pretty extreme shit, you still need to talk it out.  I made sure that all involved felt it was managed ok.  By this point a male support worker had started crying due to what he had witnessed.  He went off with a manager after I had made him a cuppa and given him a hug.


That asshole only reported me.  He felt that with my ‘history as a self-harmer’ it was inappropriate for me to be interacting with that kind of client group.  I was dumbfounded.  I’d held a woman’s arm back together, cleaned clumps of her off the floor with nothing but the smell of copper in my nostrils THEN gone and made sure everyone else was ok.

I made sure everyone was ok

And I was in the wrong?  What this ill-informed bottom crawling fucktard didn’t realise was that I left work that night and cried for most of the night.  I hadn’t debriefed …as I was the one doing it.  In addition to this, a few weeks later this man was politely informed that he would have his career ripped from underneath him if he wished to bring my statemented mental health issues into question again.  Woops.

Now while working in mental health with a mental illness isn’t always easy, it is something I wouldn’t give up for the world.  It humbles me almost every shift to see those in adverse circumstances and some still strive to get out.  I work with some amazing professionals who still work tirelessly in an effort to better someone’s quality of life, despite the abuse from some patients (but mainly management).  I am no longer employed in the big white house on the hill (no, I didn’t get sacked you pessimistic bastards).  But that place taught me a lot about working in mental health with mental illness.  I’ll write you a little list now I’ve bored you with my ramblings.  This is the real meat on the bones you need.

My advice

  1. Stay out of politics.  The people who push it don’t care about you or your mental stare.
  2. Avoid work socials. People with no life love gossip.  And if you get drunk and cop off, you will provide this in abundance for years to come.
  3. Yes, you may be on more meds than your patients.  But that doesn’t mean you aren’t fucking fabulous at your job.
  4. Disclose your illness to your employer.  It will cover you if you need a mental health day or 2..or 28.
  5. Do not, under any circumstances date in work.  You may be lucky and not get a c*nt.  However, you need something more than just mental health in your lives.
  6. Yes your patients will probably clock that there’s something a bit ‘different about you’. It’s ok, as long as you stay suitably vague about your personal life and don’t disclose, then it can give you more credibility.
  7. Know your limitations, don’t allow people to use you for every task.  It’s OK to say no sometimes.
  8. Yes, you will probably have flashes back to Your Own treatment.  If they are unmanageable then it’s probably too soon to be working in this industry.  You will always need a good distance of separation.
  9. You have a unique insight that most wouldn’t have into mental health.  This makes you a very highly sought commodity.  Remember that.

I now work in another hospital, bigger, more secure, fuck loads more responsibility.  And I have worked hard to be known as a valued professional.  From the days in ‘the unit’ to now I think I have earnt the pay rise.  I am a professional patient nowadays.  The only difference between me and my patients is my pay check and a set of keys.


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