For the past four years I have been working in various mental health projects in London, Coventry and Liverpool. This past year I have worked in two London based projects. The first was easier for me to work in as I was a locum worker and it was not expected that I become that close to the "residents" as they were never sure when they would see me again. Looking back it was difficult because someone would be quite open with me and then I would not see them for ages and I saw that as quite harmful for the individual. You could say that is how it is like in real life but usually if someone goes off we often know when we will see them again but in a hostel it is hard to plan exactly which locum is working when. One was much smaller than the other, four people instead of fourteen, and I had much more responsibility working as a key-worker. In this project it was interesting to see how staff dealt with situations.

Quite often the "residents" were treated like children, not given respect and basically bossed about. I understand the many stresses staff have but many do not recognise their own needs and their only way of coping is by having a rather patronising relationship with people or totally distancing themselves. Staff in general thought counselling and therapy were a waste of time for most people; medication and occupational therapy were often seen as the only way forward. People complained about their medication but this was usually interpreted as an attempt to resist the power of those running the hostels. It is still not clear what psychiatric drugs actually do (see Peter Breggin's Toxic Psychiatry) but despite people complaining about side effects, a support worker's priority is to get the person to take the drug. At one place I worked in one member of staff who had been there ten years continually gave patients medication not specifically for them. I could not continue working in a job where people were being used as "guinea pigs."

In relation to Care In the Community, different people had different stories. Some liked hospital and the security of the environment, while others found life on the ward thoroughly distressing. I sometimes felt I was working in a "ward in the community." What differences were there? People had to do their own shopping with assistance, cook, clean and become involved in outside activities. Often, under such a strict regime, the programme breaks down for the person once they go and live on their own. Do people do what is expected because they want to or to get the staff off their back? For people suffering from mental health problems cleaning the floor may be less important than trying to cope with how one is feeling.

The frustration of staff perhaps not experiencing a great deal of communication with clients and the fact that they had to have the place clean for the next staff on duty (possibly the manager) often meant that the individual's problems were not considered. Once one makes a career out of "helping others" one must continue to question one's motives for doing so. Do I work for money? For the respect it gives me? For the appeasement of my conscience? Because someone has got to do it and I am good at it? There are a multitude of factors. Many care professionals are merely caretakers, looking after a home or an institution and protecting the rights of those in charge not those in need. But who is in need? If mental health was not seen as a matter of cured/uncured, worker/client, sane/insane then we would feel less inhibited in asking for help. In many places I worked in the managers were on the verge of going through nervous breakdowns, unable to ask for help.

When we see someone in the street who looks distressed and is yelling "fuck off!" to what seems like nothing, are they just echoing our own thoughts about them? It is difficult to know where the boundaries are as one can never be a real friend if one is being paid to be there. This is not in the job description. The job description is to support someone but this could imply that the person supporting knows the right way to be. I learnt a lot from all the people I worked with and I am not saying that people should just be left to fend for themselves on the streets, but no one has the right to tell another person what to think or feel.

Perhaps if I am screaming "fuck off!" I have a very sound reason for this. No one should be paid to encourage me to take my medication and get "well", when well means more passive and more manageable within the system. If I hear antagonistic voices I might not want to listen to them so a pill could do the trick but what are those voices of? Perhaps they are memories and reminders of what is being said at this moment today, that is, don't be like that, be like this and then we all can be happy. Perhaps if we saw sadness as not being wrong, happiness would be less elusive.

Anon