Wednesday, February 20, 2008

mad about the fen

Cycling back to the draughty old fen one night, I found myself hotly pursued by a giant flying Weetabix. Being manic-depressive (bipolar), I didn't start to realise until soon afterwards that my perceptions of the event and reality might differ.

I am in good company. For example, one doctoral dissertation asserted that Ravel's repetitious masterpiece Bolero, the soundtrack of Torville and Dean's victory at the 1984 Winter Olympics, signified incipient manic depression. Winston Churchill found building walls a great mood-stabiliser, albeit one that could not exorcise his "black dog"; like Spike Milligan, I have taken that dog for walkies many times. The jury's out as to whether Nietsche's obscure aphorisms were due to manic-depression or syphilis, or a combination thereof.

One sure thing is that a routine, desirable in the best of times, is indispensable in the worst. When in the grip of mental illness, any routine is vastly preferable to none. However, a complaint of ostensibly progressive mental health commissioners was that occupational therapy consisted of demeaning drudgery like putting sticking-plasters in packets or weaving baskets.

I could say many things about this (for example that during my occupational therapy I learned how to write HTML code), but will satisfy myself with commenting that had they tasted madness for any extended period, they would have realised that it doesn't matter what you do, just that you do it. That you come to an allotted place to do it, and when there you do it for the prescribed period, interacting with peers, managers and the public, and in the break indulge in the deliciously sane pastime of slagging off your bosses. With grumbles, gripes and the odd personality conflict, it was an ideal preparation to re-enter the world of work - and though it didn't cure hallucinations, delusions etc, having to engage with the world outside your mind gave reality a fighting chance inside your mind, no matter how many cornflakes had your name on them.

With recent ward closures in Cantabrigia, places are prioritised for the most severely ill, therefore in-patients miss their peers' journeys toward wellness. There is a growing group in the community who are not yet well enough to work, but are not judged "ill" enough to merit a Community Psychiatric Nurse (CPN). This group was well served by the closure of the Cantabrigia Clubhouse, which was a centre of excellence when it came to catering for individuals who fell into the cracks between other services, and also Vocational Services, which took occupational therapy to another dimension.

Case in point: recently in a café in Cantabrigia, I met a former Clubhousee, who hails from an even draughtier old fen than I. she cannot sustain a job or voluntary work so, in the absence of other engagement, sits in her house and deteriorates so she can save her money for her one voyage into the city a week, to sit alone at a table and deteriorate in an altogether classier environment. Since she is not ill enough for a CPN (ie not about to kill anybody), she is technically a victory for the mental health system hereabouts.

The local spokesman stated in the article in the Nuntii Cantabrigenses that the mental health service, having removed £3 million from its budget in 2007, now had the "appropriate number of beds according to advice from the Sainsbury Centre for Mental Health" - this latter organisation commented in 2003 that the NHS was receiving more funding than ever, but mental health services received an ever-dwindling share. This is somewhat Lovecraftian arithmetic, methinks, and it'll take a procrastination of managers the appropriate amount of time to appoint a tea-party of commissioners to hire a column of accountants to sort it all out.

Not everybody with mental health problems will be able to sustain a job. But with the appropriate support, many who are presently languishing in the rather drab no-man's land between pity and prejudice, like my friend, eventually could.

And if anybody sees that damned flying Weetabix, tell it I've marked its card.

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