Overcoming institutionalisation

I did a calculation earlier this year about the amount of time I have spent in the psychiatric ward in my 46 years. It was just over three years, not counting residential programs which weren’t hospital – that is about an additional 18 months. Then I spent over three years in prison in my early twenties (long story – refer to chapters 6-8 of my autobiography, ‘Finding a Different Kind of Normal.’) So I have spent eight years of my life in one institution or another. Institutions are a big part of my life.

For many years I was what may be termed institutionalised, especially in prison. Being in a place where I had absolutely no control became quite attractive. I would be released from jail and then not cope in the oh so big and scary outside world so I would commit a crime in order to go back to prison. I was not alone in this. Many of my fellow inmates were also serial recidivists who found the outside would too big and scary. Several of these people would I think have gained an autism diagnosis had such a thing been available to them. The odd thing was that I was in far much more danger in jail than out and I absolutely hated it. But there was an alluring attraction to the place. I am pretty sure that it was because I liked to be contained and to have no power or control – or responsibility.

Even after I left prison for the final time I struggled with these issues. I had to make lists of reasons why I was better off in the outside world. Thank fully I overcame my recidivist tendencies but I still struggled with the institution. I became quite independent and was proud of myself for this but I have a nasty mental illness that periodically enters my life and tries to destroy everything I have worked for. In 2001 I had a hospital admission which was a pivotal moment. I had become unwell after having extreme stress related to a part-time job I had at the time. In the past, hospital would have triggered the need I thought I had for institutional care. In past admissions I had done everything I could to go to hospital and be cared for. However in this instance that was not the case. I was delighted to be discharged. What’s more I didn’t want to go back to hospital. Maybe I was cured of my need for the institution?

Many years passed with no hospital admissions. I got myself a masters degree, wrote a book and started a professional job. I also bought an apartment. Basically I was as far removed from the serial recidivist I had been in the past. I had ‘arrived.’ Sadly my mental illness didn’t agree and in 2010 I became extremely unwell. My accommodation was causing me stress and I didn’t want to live there. I ended up in hospital and found myself in and out of hospitals for the next three years. That need for the institution returned but I had so much to lose. I had created for myself a near-perfect life and I wasn’t about to throw that away for the sake of being cared for. There was a war raging within me. I ended up meeting my saviour – the very beautiful and highly therapeutic black cat known to all as Mr Kitty. I was institution free for another six years. As time has passed I have become further and further removed from the institution. I am currently in the middle of a period of illness which so far has lasted 18 months and I am absolutely free of the wish to be in hospital. I genuinely want to avoid the place. I think I have finally won this particular and very long-standing battle.

Some thoughts on institutions are:

• Institutions tend to breed the need for institutions. The longer you spend there the more you feel the need to remain or return
• Some things can trigger the wish for institutional care. I avoid watching  hospital themed shows when I am unwell as I tend to find myself wanting to go there if I see hospital on TV or in movies 
• Institutions perform a role and are not always bad. I accept that there are times when I do need to be in hospital and it can be beneficial
• Institutions – especially places like psychiatric wards, aged care facilities  and prisons – can have staff who are hostile and cruel. Sadly there places tend to be ‘out of sight, out of mind.’ Society needs to care more for people in institutional care. 

My former psychiatrist, who sadly passed away last year, told me something which illustrates the points in the piece. I reflected to him that had I been born thirty years earlier, as a person with schizophrenia, I would have been in a long term institution. My psychiatrist looked at me and said ‘Yes. You would have been working in the kitchen because you are reliable.’ That was a chilling moment and made me extremely grateful that we live in a world where I can do all the good things I do.