Tuesday 28 January 2014

The Open Window - Simulated Mental Health Ward

The blues screens arrived over night, slicing the room into claustrophobic cubicles of tense and nervous energy. The chilling light that passed through the screen's opaque skin made you feel as though you were trapped underwater, breathless in a mental health fish tank. Here was a Simulated Ward with experienced facilitators acting as the safety net, the students darted in out of cubicles while the trapped mental health patients roamed their minds in search of answers.

Two days of preparation can never quite ready you for the plunge you are about to take. You can read books, talk to your lecturers, health professionals and even the actors who 'play' the role of mental health patients but this is a 'live' ward situation were the unexpected can happen. Patients react with each other, student nurse's failures and successes impact upon their fellow participants in this mental health dance.

'Sandra and Karen'
The first moments on the simulated ward are quiet and tense, the patients are already in the starting stalls, their minds whirring with back stories, emotions brimming in the imaginations. I am lucky enough to be an observer and sketcher so I placed myself in my favourite patient's cubicle. Jeffrey was sitting nonchalantly beside an open window, and his muse Sandra sat at his feet, love it seems had blossomed on the ward, another permutation in an already complicated mental health story for the nurse's hoping to make a difference here today. Out of the blue Jeffrey announces

"I did it with Joan Collins many years ago!"
We all do a double take as the nurse puts his body between Jeffrey and the open window. Danger averted for a moment but it feels like the nurse has just shut us in the cage with the tiger.
Jeffrey - "Midsummer Night's Dream that is dear boy, Sandra and I were just running through the introduction."
Nurse - "I don't want you to fall out of the window"
Jeffrey - "Joan is delightful. Do you know Faustus?"

Julia Pelle
It seems you need to be a thespian as well as a therapist in this line of work. Bringing Jeffrey back into this world to discuss his problems isn't going to be an easy task. Student Graeme does a jocular and calming job, never shutting the metaphorical window on Jeffrey's humour or hopes. After all the open window represents both the danger and freedom for us all.

Most of us know what it is like to visit or be in hospital and a mental health ward is no different in many ways. Your physical privacy is just a thin veil, shouts and expletives roll through the blue wipe-clean curtains. I can hear Sandra and see Peter confronting a new face on the ward, Tim. The ward explodes with movement. Peter hasn't been taking his medication because it was stopping the important messages hot-wiring in his head. Ward manager Ben tries to help nurse Carmen but it has become too much for her, and tears spring forth. This is the where the simulated environment is so versatile because Facilitator Julia Pelle calls a timeout. She carefully dissects the last volatile minutes, divulging her experience and helping everyone including myself learn from the experience.

You would think that this 'Stop Start' scenario would disrupt the actors rhythm but their characters flow deeply through their consciousness. 'Out of role' I talk to 'Leo' who is John in the real world. He takes these potentially toxic characters home with him over the course of the simulations. "Sometimes I sit at home and I can't get Leo out of my head".
When in character he can often can be heard saying  "This is like a prison in here!" You can not help but contrast the actors who are temporarily trapped in these painful personas and the patients who cannot escape them.

Laurie who plays 'Frances' is an accomplished actress in her own right, with many years of experience with the Teddington Theatre Club and YAT. Her performances always have to be understated when inhabiting the world of 'Frances'. Less is more and she often lures the student nurses into the trap of an over compensating babble on their part.

When Lyndsay plays the role of 'Sandra' she goes to the well of personal experience rather than professional acting expertise. Her performances are never short of intensity and power, with tears and a raw emotion that is virtually petrifying for an observer like myself. Lyndsay finds the whole experience therapeutic and feels a natural affinity with her character. She was never physically abused like Sandra but certainly feels the emotional bruises from her youth.

She has been known to be so caught up in her role, that she once ripped a students t-shirt in a frenzy of Sandra's paranoia. Today she flares up once more but fortunately student Karen competently guides her to calmer shores.

Martin McIntyre
Like all good Lecturers or Facilitators in a teaching role the team on the simulated mental health ward possess an overwhelming nurturing propensity with a wicked streak of course. For the final roleplay of the day they threw a spanner in the works, a Care Quality Commission Inspector arrives in the form of Martin McIntyre.

Student Snowdon
Luckily the students don't have to deal with the real paperwork associated with a mental health ward, lets face it they've probably got enough on their plates in their 3rd year at University, but this CQC Inspector revealed some of the draining resources on their future energies and possibly sanity.

David Tracey
A CQC Inspector arrives unannounced and spends their time directly observing care and talking to patients or people on the ward and their families or carers, as well as staff. I can't imagine the tolerance it must take to balance all these scenarios and practicalities. It is probably why many of the Facilitators at Kingston University have a Zen like aura. None more so than David Tracey who gently rocks back and forth, with eyes closed, a softly spoken mantra on his lips.

Harjinder Sehmi
The final speech of the day went to the perpetually mobile Harjinder Sehmi who had rattled round the ward all day like one of the minions in the popular film 'Despicable Me'. With legs for once planted firmly on the floor, he looked pensively at the students gathered around him. They stared back, a mixture of exhaustion and relief relaxing the muscles but one still had the strength to speak out, "I faced myself in there".

We were all impressed by the students commitment to the Simulated mental health ward but Sehmi had one last pearl of wisdom,

"Within the next few months someone may be giving you the keys to the ward and say....here you go, you are in charge."

In time I know that these students will be keeping the windows locked for the safety of their patients but having the confidence to open them when the time is right for hope and freedom.


1 comment:

  1. Mental health assessment play an important role for the people suffering from mental illness. There are different mental and heath related issue which are cured in the mental aid training. You must go for it at right time.

    UK Health and Safety Training.