What Does It Do To You, Growing Up With Mental Health Services?

Julie has now turned nineteen.  She has been continuously involved with psychiatric services for about four and a half years.  In this time she has had roughly two years of inpatient admissions, including one continuous twelve month stint.  She has been in the care of five different psychiatrists, had about a dozen keyworkers, care coordinators and outreach workers, and seen countless duty psychiatrists, psychologists, A&E specialists, dieticians, social workers and peer support workers.  At school she is accompanied everywhere by teaching assistants.

I am curious how this experience has affected Julie's view of the world and her place in it.  It has been a far from normal teenage.  Her brother Duncan, about two years younger than Julie, is having a much more typical experience.  His life is one perpetual experiment: he tries a new hat on every day.  He might be Jean Paul Sartre one day, Mr Bean the next, and Ice-T the next.   He makes mistakes, and sometimes experiences humiliation and disappointment, but these feelings are usually private and they rarely last very long.  A few days later he will have forgotten the bad experience, though not the lesson he learnt from it: that hat didn't suit him after all, he says cheerfully.  He is enjoying the luxury of youth: while nobody is paying much attention to you, you can get on with the business of growing up and figuring yourself out in peace.

Julie, on the other hand, is constantly scrutinised by professionals. Often she has a great deal more interaction with adults than with other teenagers, and the sole foundation for her relationship with most of these adults is that she is ill.  They would not be involved with Julie unless she were ill.  If her behaviour starts to become normal, and she stops reporting alarming experiences, most of these adults melt away.  As her behaviour worsens, they come flooding back, along with a host of new characters.

Julie's teenage experiments are observed and sometimes commented on by her Greek chorus of attendant professionals: it is good to be an exercise bunny; it is bad to lie in bed all morning and be a couch potato; blue hair is amusing.  What is it like for Julie, conducting these experiments in growing up under the bright lights of this detached and adult scrutiny?

Many of the professionals play a more active role than simply providing a commentary.  What impact do their actions have on the way that Julie thinks?  They insist that Julie takes quantities of mind-altering drugs.  At certain key moments in a crisis they lock her up on a hospital ward.  They inform her that she belongs to a certain category of persons, denying her the freedom to decide for herself what sort of person she might be.

When Julie talks about her illness, she describes it quite dispassionately.  She has become so used to talking about it with professionals that she regards it as something entirely outside herself, outside her control.  And there is no limit to what the illness can do.  The illness prevents her from going to school.  The illness makes her shy in a crowd of strangers.  The illness makes it hard for her to sleep.  As you can see, the illness has begun to annex things that do not belong to it: things that are part of normal experience, and finding the solution to which are normal parts of growing up.