The Mental Health Condition Made Them Do It

I was chatting on the phone to a former colleague last night and during our long conversation he briefly mentioned training he sometimes delivers, on aspects of mental health, that reminded me of my final year as a Metropolitan Police Cadet. Mental health seems to be rarely out of the news these days and is often cited as mitigation for tragic incidents. The following is an account of part of my training during my time at Deptford police station:

Unlike my fully trained police mentors, I would get the occasional break from the 24/7 downs, and downs, of dirty Deptford, for which I was truly grateful. The work was relentless and at times almost overwhelming. One such break turned out to be one of those transforming experiences that would resonate throughout my service. When I first heard what I was about to do, it caused me to wonder what could possibly be gained from sending me to work with the NHS as an auxiliary in either a secure psychiatric unit or a nursing home for the disabled? As it turned out, I gained a great deal and It was due to our remarkable Cadet Corps commandant, Colonel Andrew Croft, and his vision to broaden our outlook in order to enhance our effectiveness in the wider community.  

There were two such establishments; St Francis Hospital, Camberwell and Crab Hill House, Redhill, Surrey. St. Francis was a very old hospital, having opened in 1895 as the ‘Constance Road Workhouse’ before becoming the ‘Constance Road Institution for unmarried mothers, the handicapped, the elderly and the mentally ill’ - quite a variety of ‘eggs in one basket’. What effect that label had on those sent there I can only imagine, as just one look at the building was sufficient to send a shiver down the spine. By1930 the Public Health Department of London County Council took it over and under their management it catered for people with chronic mental illness and also had a so-called 'special mental observation ward'. I guess that was where I was headed in October 1970, by which time St. Francis was part of the Kings College Hospital group.

Sister Murphy was kind and compassionate; her build and bearing was formidable. Starched blue dress, white apron, frilly hat and a handshake that felt like a padded vice. She was responsible for a unit of the hospital that was looking after people who were diagnosed with various types of mental illness. I was issued with a short, white, starched jacket which had faded yellow bars on the epaulettes which apparently identified me as ‘unqualified dogsbody’. Apart from that I was allowed to wear my own clothes. Everywhere smelled of floor polish and something I couldn’t quite identify but assumed was disinfectant. There was also a background odour of boiled cabbage. It’s funny how public sector buildings all have their own distinctive smell. The floors were worn but shiny and clean. There was a communal area with tables and chairs for meals and therapeutic activities as well as soft chairs around the perimeter which I assumed were for relaxing and reading, although today it just seemed to be patients ‘sitting and staring’, mostly at me. My first hour consisted mainly of being introduced to everyone. There were very few nursing staff, maybe four in total, two of whom were male, one of whom I initially took to be a patient; I was told he definitely wasn’t, but after a full shift with him I still wasn’t convinced.

There was one patient Sister Murphy took extra care to brief me about. Apparently, Damien believed he was Jesus Christ and was still undergoing assessment. He’d been there for a couple of weeks and by all accounts was a very disturbed young man, having once tried to walk across the Thames at Greenwich. There are no bridges at Greenwich. Over the next few days, I got to chat with the patients, some of whom were happy to talk to me. There were quite a few ladies, most of whom I guessed were in their sixties. They were all considered a risk to others as well as themselves, although in most cases you wouldn’t know it.

I was issued with several large keys on a chain as there were certain rooms that had to be secured, something described as a ‘lock and key regime’. I didn’t appreciate quite how important this was until one afternoon when I was assisting a nurse to administer drugs to a male patient. On a previous occasion he had assaulted her, nearly knocking her out. As I locked the door behind us the man stood up and backed himself into a corner. Although he was a slightly smaller build than myself, his body language did not bode well, and I found my mind quickly running through a few of the restraint holds I’d been taught over the previous 18 months. The nurse spoke very matter-of-factly to him, and he complied with her instructions to the letter. His injection was administered, he gave a big smile, and everybody seemed happy. We left the room, alert for any sudden movements and I locked the door. I mentioned to her that he seemed fine and asked what his situation was. She told me that if he didn’t respond to his treatment there was only one option for him and that was Broadmoor. I was shocked. There I was holding the key that held the man whose next stop would be Broadmoor Hospital, ‘if he didn’t respond to his treatment’ - Broadmoor, where most of the nursing staff are members of the Prison Officers Association and where the surrounding villages have ‘inmate escaped’ sirens. Broadmoor sounded like the ultimate challenge for the staff and come to think of it, the local estate agents as well. It took a while for this to sink in, but it had by the time I saw Damien for his injection the next day. I said, ‘good morning’, but I wasn’t sure he agreed with me.

Another young male patient, who I got on with really well, was something of an enigma. Highly intelligent (Oxford graduate) he had some expensive looking clothes, always wore a freshly laundered shirt with smart casual jacket and trousers. He seemed very popular with the staff, but Damien (Jesus) didn’t like him. He would chat to me about matters scientific or natural history and then suddenly stop mid-sentence and begin lightly hopping from one foot to another, sometimes so quickly it was as if he was tap dancing. He would always apologise and repeat the word, Stelazine several times. He told me it gave him itchy feet and hands. Stelazine was the brand name of a first-generation anti-psychotic drug prescribed for schizophrenia.  

On my last day at the unit, on what had been a fascinating and eye-opening attachment, I was thinking how relatively peaceful everything had been during my time there. Sister Murphy was a pillar of calm authority and the rest of the staff, from the nurses to the cleaners, were all compassionate and caring towards the patients. In my short time I had been privileged to take the briefest peek into their hitherto secret world, although I never saw any doctors – although in such company it can be difficult to tell.

My final duty of the morning was to set the tables for lunch and help serve it up; something I’d done several times before. Everything was routine; patients sat in their usual places as the food trolley was wheeled in. A nurse and I began to serve the food and I noticed that Damien had stood up and was muttering a prayer. He then picked up a glass of water, dipped his fingers in it and started flicking water over his roast beef and Yorkshire pudding. Sister Murphy appeared from her office and watched. The nurse whispered to me that Damien sometimes blessed and anointed his food. He sat down and I moved to serve the person next to him, placing my free hand gently on Damien’s shoulder. Bad move. He leapt out of his seat, spun round and pushed me, his arms flailing wildly as he headed for the corridor, determined to leave the building. Sister Murphy shouted feckin’ get him Geoff and I took off after Damien, halfway down the corridor heading for goodness knows where. I rugby-tackled him above the knees and we hit the deck, my arms clamped tight around his legs. As we slid to a stop, I noticed I was staring at his buttocks, his trousers having come down just past his waist. He struggled like crazy, forcing me to increase my grip and then someone thumped down next to me. It was sister Murphy. Her next words of command were equally brief, “hold him still” at which point the biggest hypodermic syringe I’ve ever seen appeared an inch from my nose and was jabbed straight into his backside. Having emptied the barrel, she left the needle in situ and screwed a fresh dose onto it and pumped a second dose in. I felt his muscles and his fight quickly subside. It was game over. He was quickly taken elsewhere to recover. Sister Murphy congratulated me on a good tackle and explained that when Damien snaps, he snaps big time. She’d forgotten to tell me that he didn’t like being touched; a simple oversight, she was a very busy woman.

My time at the sharp end of NHS mental health care was over. Who would’ve predicted that the finale to a fascinating week would be a rugby tackle on a bloke making a break for it, who thought he was Jesus? There were no tearful goodbyes, there was no time, although I did get invited to the single nurses' quarters regular dance evening that became a most popular venue for me and my mates. It was a remarkable week for me but merely business as usual for Sister Murphy; or should that be Sister ‘Mercy’? From the perspective of value, that week punched way above its weight. I had been told the day I arrived that the people I would meet as patients of St. Francis were exactly like the ones I would be meeting on a regular basis on the streets of London, in fact anywhere up and down the country. The following extract is from the foreword to a report by Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Services entitled, “Policing and Mental Health - Picking up the pieces”:

“In our inspection, we found that the police approach to people with mental health problems is generally supportive, considerate and compassionate. But we believe there is only so much the police can do to improve the overall picture. This is because, in our view, too many aspects of the broader mental health system are broken; the police are left to pick up the pieces. The fact that almost every police force now has its own mental health triage team indicates that there isn’t nearly enough emphasis on early intervention and primary care to prevent the need for a crisis response. This is letting down people with mental health problems, as well as placing an intolerable burden on police officers and staff. It is a national crisis which should not be allowed to continue; there needs to be a fundamental rethink and urgent action”.

The fact that this report was published in November 2018, forty-eight years after I first reported for duty at St Francis Hospital, speaks volumes, not only of the vision of Colonel Croft who identified the need for our awareness of the mentally ill, but also how this ‘national crisis’ has hardly caught us unawares.