(Intro by Croakey)
Hamilton Kennedy has spent about three months in total as a patient in psychiatric hospitals, where he witnessed and experienced seclusion, forced medication, restraint and humiliation, including being crash-tackled to the floor by security and strapped into a wheelchair.
He now works as a consumer peer support worker in a youth psychiatric inpatient hospital in Melbourne, where he often has to relive his experiences of being an involuntary patient.
Seeing others in pain and distress has triggered significant re-trauma for him, and he told the recent Victorian Mental Illness Awareness Council (VMIAC) conference that for a while he thought he might have to shut down his emotions to cope or find a new job.
Kennedy’s standout presentation sparked quiet tears and deep discussions about how mental health consumers can channel the hurt and anger they feel in peer work – and that they often feel forced to disguise in order to present as “professional” – in a mental health system that uses practices like seclusion and restraint that he says are “tantamount to torture”.
Read an edited version of Kennedy’s presentation below, and watch his video interview with Croakey, in which he says:
We need more consumers in the workforce to create systemic change… I don’t think the Director of VicHealth is going to suddenly change everything.
I think it’s going to be the ‘lowly’ consumers who are going to cause a ruckus, rattle the cages, or be mad or sad in the workplace that’s going to create a culture of change.”
Hamilton Kennedy writes:
I’m a 23-year-old dual diagnosis, consumer peer support worker in a youth psychiatric inpatient hospital.
I have a hell of a time at work, essentially reliving what it was like to be an involuntary mental health patient. I have spent approximately three months in and out of psychiatric hospitals. An experience where every day was almost the same. An experience where I was witness to and experienced seclusion, forced medication, restraint, and humiliation.
Today, I go to work and see it all over again.
Working in an inpatient unit is hard. Clinicians and consumers alike are aware of this.
Clinicians witness the struggles and despair of those who have been admitted and can be targets of frustration and misguided aggression. In fact, I have experienced extreme aggression and threats as a clinician. This is awful, and in no way do I wish to diminish the distress this can cause. But clinicians are positioned to create a certain amount of emotional distance by virtue of their training.
This is different as a peer worker on an inpatient unit. The emotional distance is hopefully and ought to be far less, and we have often been subject to the very same treatment we witness.
I recall, at 18, being strapped to a wheelchair in an inpatient unit, deemed to be at significant risk of absconding or aggression and violence to those who were transporting me. I remember the feel of the leather on my arms. It was humiliating. I don’t enjoy sitting in leather chairs anymore.
I recall being crash-tackled and carried out of the room by two brutes, holding me by each arm. I remember this specifically because, afterward, I felt my mental health significantly deteriorate. I thought I was supposed to be somewhere that helped with my mental health. This sure didn’t.
Something else that sticks in my mind is witnessing a woman, not that much older than me, being thrown to the floor as she screamed and cried about not being able to see her children. I’m not sure why this sticks with me, perhaps because it was so clear that her emotional distress was met with force.
I’ve seen some shit during my admissions.
My work is retraumatising
I work in Victoria, which has the highest use of mechanical and physical restraint in Australia. I also work in a ward which serves people aged 15-25, which, excluding forensic inpatient wards, have the highest rates of physical and mechanical restraint. I’ve seen some shit here too. More, in fact.
I watched a 17-year-old girl, who I cared about deeply, have six people pin her to the ground. The more attention that the situation drew, the more she tried to get out of it.
For some serendipitous reason, a childhood friend of mine from Sydney ended up at the ward I work in. I watched her dragged off by staff to a secluded area as she wailed in response to being told she was not to be discharged that day.
I don’t mention these examples for us to merely ogle at them but because they affected me in deep ways, triggering memories, physical sensations and flashbacks. However, dramatic it may be to say, they inspired terror. I was near mute for the rest of the day, playing over what I had just seen in my head. Remembering the entire time that this, in fact, had happened to me. It made me hyper-vigilant, I closed emotionally. I felt untrusting and unsafe around people. I felt re-traumatised.
My work is re-traumatising. It hurts. I see the misery I once felt and still sometimes feel. I see the lack of connection to consensus reality which I too know.
I essentially have a paid position to passively re-experience the darkest times in my life. I frequently have nightmares about being misidentified as a patient and being secluded. I tremble, get tunnel vision and dissociate at the mere presence of hospital security.
Use the trauma
I started to think this would cause me to ‘burn out’, become ineffective in my work or that my mental health would deteriorate. I was nearly convinced that I could not do this work any longer unless I suppressed and ignored the hurt I had experienced as an inpatient.
This was until I reflected upon previous traumas, and my initial experience of inpatient treatment. I thought, ‘Christ, surely there is a better way to treat me and those like me’.
I could not stand for this to be happening, but without the experience of it, I would not be so damn motivated to stand against it.
I decided I was going to utilise my trauma and the re-traumatising experiences I am subject to.
To some extent, I am allowing myself to have post-traumatic stress disorder, to re-experience trauma in a way that does not end. In the unit, people come and go, but largely it remains the same, a prison of those deemed too difficult for the broader community or for those whose emotional distress becomes too extreme.
Here, I occupy the unique position of straddling both sides of the fence.
It is odd to now say that I cherish the trauma I associate with the public mental health system, but in a way I do.
Firstly, it ensures a genuine emotional connection to people. Sometimes having a ‘mental illness’ isn’t sufficient to truly make me a peer to a person, we often have different belief systems, different backgrounds, and values. But one thing that we can relate on is our experience of how scary and strange an inpatient unit can be.
A constructive nuisance
Few clinicians will concede that having an admission sucks. People come up to me and say, ‘I hate it here, it’s a prison, I don’t feel comfortable’, to which I can say, ‘yeah… I know’. Sometimes I can physically see the change when they realise their emotions are being honoured by someone who also knows them. Walls come down and doors open, we lay our hurt bare with each other.
When this is done, the conversations we can have can be truly transformative. I learn of secrets, shame, wrongdoings, achievements and triumphs that clinicians could only dream of learning of.
I don’t want to merely say to people ‘oh yes, hospital is bad’, I want it written on my face, I want to scream and bust down the doors too! My trauma and re-trauma means that I will try my best not to be a part of the medical industrial complex, nor endorse a system that exists for social control.
If I identify the work as re-traumatising, it means it brings up old emotions in me, including anger, which I can use. I always try to learn about the consumer’s wishes for treatment and their future. My work means I can bring this consumer’s voice to the clinical conversations from which they are usually excluded. If someone wants to be discharged, I’ll do my damn best to make sure that it is known.
When I’m present as a consumer representative, I bring my anger, dressed up in a nice shirt and pants. Management needs someone nagging them, criticising them and being a constructive nuisance. As consumers, our voice needs to be heard, and if they aren’t listening, well we’ve got to say it louder.
It was upsetting to see a childhood friend mistreated during their admission. Then it dawned on me. Everyone who is admitted to this ward is someone’s friend or family member. That allowed me to deepen my empathy for those I work with. It exposed new possibilities for my practice. It made me better.
Re-traumatising experiences enable me to have what has been described as ‘post-traumatic growth’, a positive psychological change or higher level of functioning.
I truly believe that both my past and ongoing traumatic experiences benefit my life. This is not to discount the distress I feel, but I am lucky. I have good levels of social support, flexible life arrangements, an understanding of my spirituality, high levels of education and a lack of financial stress. I am privileged and lucky that these things have been afforded to me.
This raises the question though, how can we support other consumer workers who are not so lucky or privileged to grow from difficult experiences in their work?
We bring a unique set of skills
Our labour is emotionally intensive and as result deserves fair pay. Consumer workers ought to be paid at the appropriate award level, not employed under another award structure to minimise costs. It’s obvious but people work better when they are paid better.
And I’m sure as hell not getting out of bed to go expose myself to more difficult experiences for some garbage rate of pay. If I know my life will financially improve by my work, there is more likelihood of me doing it well.
There also needs to be more support for us in the workplace. Far too many consumer workers are not able to access lived experience supervision and many cannot access supervision at all.
Further, workplaces need to allow for and value our emotional expression. We bring a unique set of skills. Clinicians are often taught to minimise their emotional responses, I can understand why they may choose to but this does not mean we have to as well. If anything, I want to be able to let my emotions out more at work.
I am yet to meet a consumer worker who feels fully comfortable expressing their emotional responses to situations in their workplace. Maybe if more did, we would be able to achieve better outcomes for those we serve and develop better services.
This is why I believe we need more consumers employed. We are sensitive to others in a way that clinicians will not or cannot be. Let us use our unique connection to the space we work in to motivate us to be the best that we can.
Instead of you helping us, as has been the tale for so long, let us help you.
It is because I find some of my work upsetting that I am good at it.
It is because the work is triggering that I am able to connect with those I serve.
Because it re-traumatises me, I am good at it.
• Follow on Twitter: @hamyltonkennedy
Watch this interview
Journalist Marie McInerney is covering #VMIACConf17 for the Croakey Conference News Service. Bookmark this link to follow her stories from the conference.