‘Humiliated and degraded’ in the name of treatment

James Wooldridge probably knows more than most about the compulsory
mental health treatment the government appears keen to
extend.

The 39 year old from Devon admits that the number of times he has
been sectioned is “well into double figures”.

His first taste of forced treatment was at the age of 18 while he
was undergoing military training at Sandhurst academy. He became
ill after his parents’ “nasty divorce” and was locked in a
guardroom without food or water while he waited for his parents to
pick him up.

Wooldridge admits he behaved “riotously” after arriving home and
within 24 hours he was sectioned. He remembers a group of strangers
entering the house, pinning him down on his bed and forcibly
injecting him before taking him to a “grim” hospital ward.

He tried to flee, believing that his experiences were still part of
army training and a new nerve agent was being tested on him, but he
was eventually surrounded by 15 staff.

“I felt like a cornered rat, very scared,” he says. “The only kind
face I saw as I was being injected with two or three people on
every limb was a student nurse who just smiled.”

Although he has worked all his adult life, including eight years as
a retained firefighter and time as a mental health awareness
worker, Wooldridge admits he damaged property and threatened people
while he was ill, but says he has never been violent.

Diagnosed with bipolar schizoaffective disorder, he has had long
periods of stability but powerful memories of forced treatment
during some of the relapses.

He recalls being pinned down on the floor as a nurse forcibly
injected him twice in the same place on his buttocks. “I remember
taking a door wedge and almost biting through it with pain,” he
says.

He felt so much discomfort he could not sleep or sit for days but
was offered no pain relief. “I wonder how some of the government
officials would cope with such an event happening in their lives,”
he asks.

The government says its proposals to extend compulsion in the draft
Mental Health Bill are needed to protect the public. It plans to
allow compulsory treatment for people with a mental disorder, if it
is necessary to stop them harming themselves or to protect others,
even if there is no therapeutic benefit. It also proposes removing
the requirement that a person’s condition is serious enough to need
hospital treatment, allowing compulsory treatment in the
community.

Mind says more than 45,000 people were detained under the Mental
Health Act 1983 in England last year, equivalent to 88 in every
100,000 of the population.

Although the number has remained steady in recent years, Jane
Harris, campaigns officer at charity Rethink, says it has been kept
down by the lack of in-patient beds. If people can be compulsorily
treated in the community, she argues, that could lead to a huge
increase in the number of people being sectioned.

Harris says implementation of compulsory treatment varies between
areas, with use of restraint and seclusion left to guidance rather
than law, and not monitored.

She says many people in England do not receive treatment until they
are sectioned. In Scotland people have a right to services and can
access preventive treatment earlier.

Yet Wooldridge, despite all his experiences, still believes there
is a place for compulsion. “Yes, I can see it’s necessary at times
and I can see it’s necessary for me because it could be deemed I
was a danger to me or others if I was left in the community,” he
says.

But he believes the guidelines on how compulsion is used need to be
considered carefully. “People seeking help for the first time need
to be reassured it will only be used once certain criteria are
reached,” he says. “If there’s the risk that they might be
compulsorily treated or sectioned purely after asking for help it
may well put people off getting help.”

David Crepaz-Keay, senior policy adviser on patient and public
involvement at the Mental Health Foundation, also has personal
experience of compulsory treatment, having been sectioned
twice.

“It’s a humiliating and degrading process, which is consistent with
a lot of the treatment that goes on after that,” he says.

Crepaz-Keay believes there is a strong case for intervening if
someone is an immediate threat to their own safety or to others.
But it is what follows the immediate intervention, a response that
can go on for long periods, that is problematic.

And the situation will be made worse by the government’s plans to
remove the requirement for there to be a therapeutic benefit, he
says.

Susan Jones,* 60, believes she was wrongly sectioned two years ago
and presented no danger to anyone.

She fell into a deep depression after a traumatic family episode
and her condition worsened over six months until, while staying in
France, she suffered a breakdown and was taken to a local
hospital.

Jones praises the hospital and says she felt well enough after five
weeks to return with her husband to Britain, where she checked into
a private clinic. But once there she was given anti-psychotic
drugs, without her knowledge, and became ill.

Her husband had her put back on mood-stabilising drugs and she
started to feel better and expected to go home. But a psychiatrist
decided she needed tranquillisers and when she refused he had her
sectioned.

Jones says: “I said ‘you can’t do this to me’. He said ‘well I’ve
done it’. I tried to leave the hospital but they forcibly put me
back in my room, putting a nurse at my door. I was furious but
there was nothing I could do about it.”

Jones managed to escape the clinic and was about to board a flight
back to France when she was arrested, handcuffed and returned to
the hospital. She says the tribunal appeal to lift her section was
refused on the grounds that she would try to go back to France,
justification Jones finds difficult to understand.

When her private funding ran out she was transferred to a mixed NHS
ward, where she says she was sexually assaulted by other patients
and had all her belongings stolen. After two months she was
discharged and returned home. But then she had a row with her
husband, in which she says she was assaulted. He told police she
had threatened to kill him and burn down the house.

Jones was sectioned for a second time and was kept in hospital,
this time for six months. She says she was given no treatment in
hospital, only drugs to placate her. “I used to watch people
walking in the street and was so jealous. You have no voice, no-one
listens to you.”

Jones accessed her case notes after she left hospital and found a
psychiatrist’s report that she had post-traumatic stress disorder
and there was no benefit in continuing to incarcerate her. But she
says the report was not used in her tribunal hearings or shown to
her family.

“I endured hell, absolute hell, there are no other words to
describe it,” she says. “Compulsory treatment has a place but
compulsory treatment must be very carefully acted upon by
experts.

“Surely compulsory treatment is only necessary if somebody presents
a danger. I was sectioned on my husband’s word, I had no
examination. How dare they?”

* Not her real name