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Horror and hope on the wards

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I will never understand people who think mental health service users are suitable Halloween entertainment.

I was raised with Michael Myers and Hannibal Lecter as much as you were, but let me reassure you that those characters don’t represent the true horrors of disturbed mental health.

”89% of homicide convictions were people without a mental health condition”

According to the most recent National Confidential Inquiry into Suicide and Safety in Mental Health, 11% of homicide convictions were people with mental health conditions. That’s around 71 people.

That might sound scary, but consider this perspective: 89% of homicide convictions were people without a mental health condition.

And consider that homicides by people in mental distress are rare without substance misuse – a coping mechanism many employ.

When we experience trauma, we each react differently. In one case, trying to cope through deliberate self-harm might earn us the label of personality disorder.

In another, the persistent voice of the person who inflicted that trauma ringing in our ears might mean we’re prescribed antipsychotics to help with our schizophrenia. Ultimately, we’re all trying to live with the horrors we have experienced.

On placement, I have sat with a kind older lady who gently explained to me all the ways in which she was evil and deserved to die. I have taken a ligature from a distressed woman’s neck and then held her as she cried. And, in my own experience, I have watched my parents’ world fall apart when their only child announced she had overdosed on painkillers because the voices told her to.

This is horror. The blank gaze, the agonised scream, the deep cuts. This is not entertainment.

“Who has the right to decide that one person’s suffering is less valid than another’s?”

Imagine if, instead of mental health, we still stigmatised cancer. Oncology has moved a long way from ‘the Big C’, but imagine a world where blockbuster films were filled with shining scalps, retching and the slow drip of cytotoxic chemicals. This is no less horrific, but somehow not as palatable to Hollywood.

Who has the right to decide that one person’s suffering is less valid than another’s? If a teenager has schizophrenia, why is her horror more marketable than that of a teenager with leukaemia?

Stigma becomes internalised in the minds of those in mental distress and destroys our greatest weapon in the fight against horror: hope.

In the movies, Michael and Hannibal don’t recover. There is no hope for them. And when people with mental health diagnoses internalise these messages, it extinguishes their hope.

The same goes for ‘nuthouse’ and ‘loony bin’. They create visions of being locked away, damned for eternity, cast out by society. The images conjured by these words offer no hope and, without hope, there is only horror.

As student nurses, we are in a good position to lead the change in attitudes towards mental health service users. With our branch-specific training and siloed ways of working, we can struggle to be holistic.

If you notice unhealthy attitudes while on placement, perhaps you can try gently challenging some these.

That ‘happy slasher’ who’s appeared in ED for the 20th time this month is someone’s mum. When you see the psychiatric liaison nurses and tell them you’ve got ‘one of yours’, that’s someone’s brother. They’re not monsters, they’re you and me if we’d been through what they’ve been through.

We are the future of nursing, and the future of nursing is stigma-free. An easy way to start is by role modelling appropriate language.

Nobody is expected to know it all, but making an effort will result in you and those around you dropping some of that prejudice. It will help you appear as a safe person to speak to when working with someone who’s distressed.

Openness, integrity and unconditional positive regard gives hope to those you work with. And wards full of hope sounds like somewhere we’d all prefer to be.

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Readers' comments (1)

  • Excellent article and very true.

    As a more mature nursing student it sometimes feels difficult to challenge terminology and practice that doesn’t ‘sit right’ as your often seen as ‘old school’ and won’t go against the grain.
    Your article gently reminds me that all nursing students have a part to play.

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