David & Narelle

This is not McDonald’s mate.

A reflection on a visit to a mental health unit in Brisbane in 2002

I knew this wasn’t McDonald’s fast food where you get in a line and you will be serviced…but in my wildest dreams I never imagined waiting seven and a half hours!

So said David, one of the most easy-going guys you would ever meet. Just read this story and you will see what I mean. David’s job brings him into regular contact with distressed young people who need mental health support. On many occasions he has taken a person (out of work time) to his nearest mental health unit and waited up to four or five hours.

On the occasion in question he took a distressed young woman to the clinic and waited from 5pm until 12:30am for treatment. Narelle had sought David’s company as she knew she would need someone with her to cope with the excruciatingly long wait in confined quarters with other fragile people.

All types of people came into the waiting room while they were there. Some were brought in handcuffed by police. Some were intoxicated and some needed detox. “Waiting in a room four metres by three metres with a loud TV and a noisy water cooler it’s just like the back room of the hospital…Sitting there everyone was looking at one another…really inappropriate for people who are agitated…The situation was pretty tense”

This particular night the ward was one doctor short. Only one doctor was present to do the one hour assessment for each person. If there were six people in front of you, you knew you were in for a long wait!

Fortunately David was prepared. What did this experienced youth worker do to cope? He employed a few simple strategies – he played ball, he went for walks, he got people singing and he got people talking!

Firstly, he had made sure he brought a tennis ball. Finding a strip of concrete outside he took Narelle and bounced the ball for a while “trying to divert attention from what she was focusing on”.

For another while they stood in a corridor singing Beatles songs and any other tunes that they knew. This went well until a security guard wrestled someone to the ground in front of them. This upset Narelle as it brought back traumatic memories, so they stopped the sing-along.

Then for some of the time they were sitting in the waiting room David tried interacting with people there. Once they went outside for a smoke and a walk but another fellow came walking along with security after him and about four or five people jumped on him and bundled him off. “I don’t know what happened to him as we didn’t sight where he went.”

David struck up conversations with others. “We started a conversation about their experiences. There was camaraderie. Really rich to listen to them describing what it is like to be helpless, when they’re tied down and shackled, and had some type of sedative pumped into them…They were willing to admit that they did need medication and did need some time to calm down – but it is the way it is delivered that is the problem.”

Narelle looked after herself too. She recognised someone else at one stage and they consoled each other. As time went on Narelle needed to lie down, so David asked one of the staff if she could lie on a trolley in the corridor. She was not allowed to do this as people had to be admitted first before they could use a trolley, he was told.

Is the staff the problem? Not according to David. “I think the staff actually love Narelle and they know her quite well…They know what she is like. The nurses were good but they had a job to do. The security guards were friendly too, unless a confrontation arises when they’re going to be more aggressive.”

How can we do better? How can our high tech, sophisticated, expensive, professionalised, institutionalised, medical responses we have established encounter people in a more helpful way? More space, better communication about waiting times, mattresses or couches to lie on, attentive and calm people to talk with (as we have when we donate blood), not mixing inebriated, intoxicated and fragile people waiting for long periods in the same confined space, are all points that immediately come to mind.

Obviously there are micro issues that this story raises – about how this particular waiting room could become a place of solace, calm, recuperation and support rather than an agitated, uptight, constricted and volatile place. However this story also raises big picture systemic issues. It reminds us of the failure of most of our large service systems as they seek to respond to the needs of large numbers of people – particularly devalued and marginalised people. More funding will help, but the keys are more fundamental and central than dollars. It is about the heart of the response. Whether the system can nurture love and hope.

The story of David and Narelle contains seeds and pointers to where the way forward might be. David is a symbol of a more human and less institutional response. As a committed and compassionate ally of Narelle, David employed quite simple and inexpensive strategies to enable her and the others in that waiting room that night to avoid an explosive and volatile situation escalating. Playing ball, singing songs, chatting and walking together are all ordinary human activities. He demonstrated what a compassionate individual with time to share can do.

This story is a symbol of our options as we respond to people with mental health challenges. It is a reminder that we need to acknowledge that we are in a mess. However it also shows us a way forward – in more connected, careful, compassionate and ordinary community responses. David has waited with people in this waiting room many times with distressed people for “four to seven hours on average”. His closing comment says it all, “My mind goes out to anyone who hasn’t got anyone to talk to”.

NOTE: A formal complaint was made to this mental health unit about the evening described here. We are sending this discussion paper to the Minister for Health.

© A Place to Belong: An Anglicare Mental Health Network