A friend on the autism spectrum who deals with mental health issues asked me if I’ve ever suffered the Mental Health system myself.  It was a great question and really the answer depends on what the contrast is.

I was diagnosed in a 3 day hospital observation at the age of 2 as psychotic. In 1965 that would have been a social death knell.  The abuse, degredation, being hidden, paraded etc, the sense I was only temporary and ultimately pegged for an institution… was that suffering due to the mental health system?

7 yrs of the primary school having me observed by Psych and Guidance, studied, evading, being labeled disturbed for my inability to comply, participate, communicate with all the associated 2nd class citizenship that entails in a mainstream.  The teachers going through the motions at best, mostly left alone or stood out in the corridor, later stood in the rubbish bin by the teacher who threw chalk at me to the amusement of the students… is that due to the mental health system?

Being 9 and medicated, sedated, then abused whilst sedated leaving me with even more trauma, dissociation, confusion to recover from but which was all deemed part of ‘being disturbed’, was that part of the mental health system? Being in psychiatry by 16 for attempted suicide and sent back out to the streets, sexploitation and abuse instead of to a social worker, was that abuse in the mental health system? In therapy with a child psychiatrist from 17-18 and medicated but not told of the side effects, and given her to disclose to with none of the tools with which to disclose and all the while returning home to the man who’d been abusing me since 16 instead of to a social worker… was that suffering in the mental health system?

Being 18 before the psychiatrist finally ran out of tricks and decided maybe I’m not ‘just’ crazy and just might be less crazy if I could read, write, add, subtract, get out of long term unemployment and off the streets so THEN she got a social worker to get me into education – was that suffering in the mental health system?

Being in college but so abused the psychiatrist recommended I’d be better off walking the streets, instead of getting a Social Worker back on my case to help me, was that suffering in the mental health system?

What I can say that for good or bad (and there was both) the child psychiatrist I had from 17-18 was the closest thing to family I had known.  She was my first positive role model and inspired me to want to have education like her, be professional and respected like her, be a citizen of community.  But on reflection there was so much she could have done differently but didn’t, simple things like sending me to the right professional for the job – a Social Worker – or at least liasing with one, and an OT for significant information processing and receptive language problems… but in those days they didn’t know a verbal adult with autism if they fell over one so if you were in a mess you were either backward, disturbed or crazy.   She’d talk of me as her ‘star patient’ as if my success (which was also due to the Social Worker getting me into school) was a reflection on her alone.

I always felt uncomfortable being a ‘star patient’.  I was a star.  I had got off the streets, escaped sexploitation, gained an education, had a chance at equality.  Being HER star PATIENT defined me as HER achievement, not my own, and reminded me of my role, I had achieved – AS A PATIENT.  Sort of saying ‘not bad for a nutter’.  But at the time, given the horrors I’d come from I thought her warm, kind, I was so grateful for a safe shrink’s office because everything else was so awful.  But in time, no, I feel she lacked humility, she didn’t share the load with a wider professional team as she should have, she reinforced my lesser social status indirectly (reinforcing her higher one too) and it could have been healthier than it was.

I had good experiences with Lawrie Bartak, an Educational Psychologist who diagnosed me with autism.  He helped me understand and come to terms with my information processing disorders.  He helped me navigate social basics and learn self protection skills.  He was an egalitarian and not at all the Clinical Psychologist type. I felt I was in the room with a human being.  Not a scientist.

I had good experiences with a mental health OT in Wales when struggling with loss, agoraphobia, on the edge of breakdown.  The OT got me back into my skills, the community, into life.

I had good experiences with Sheila Kittrick, a psychiatric social worker when I lived in England who did dreamwork hypnotherapy and worked with PTSD.  She was wonderful, innovative, empowering, practical, humanising, egalitarian and has the professionalism and boundaries I aim for an autism consultant. There was no them and us stuff but good clear boundaries (on both sides).  That’s good work.

A psychiatrist in the UK helped me onto low dose Risperdal (with the support of my psychiatric social worker) which probably continued to save my health (I have immune deficiencies so it improved my health) and my life.  In Australia I saw a reviewing psychiatrist who adapted that to low dose Seroquel.  It was a walk in walk out service.  I had no desire nor faith in having my head shrunk and the psychiatrist felt sort of like Freud, a kind of social gulf dividing the very expensive room, a strong ever present feeling of formal hierarchy in this doctor-patient setting.

I’m doing positive work with the psychiatric social worker I’m now seeing in Melbourne.  With qualifications in social work and psychology he’s got at least 5 years study behind him as well as practice and is more equipped to help me manage my stuff than the average 3-4 year graduate of clinical psychology who has no social work or OT to help me holistically with my issues.

A medication review this year with a new psychiatrist in a one off appointment found me diagnosed with DID (in addition to my autism) and the diagnosis probably helped although I was already working through the issues with the psychiatric social worker.

So how have I found psychiatry? More useful than suicide, useful for (potentially life saving) low dose medication if necessary, but fairly piss poor by contrast with what Social Work and OT can do for my mental health issues in the context of disability (a service the federal government is in the process of cutting funding to)  Did psychiatric medication help me?  I’ve been abused on it, abused by it, and saved because of it.  Medication is like a knife.  It can be used helpfully or dangerously.  What I do know is that medication and psychiatry alone, nor clinical psychology alone, could have helped me holistically to address the complexities of where mental health, disability and life long history of trauma are combined.  Fact is, my mental health issues ain’t all some pathology, conveniently removable from society, from community, from marginalisation and in that sense my mental health issues ain’t all IN MY HEAD.
Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.

http://www.myspace.com/nobodynowherethefilm
http://www.donnawilliams.net
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