After the Asylum: ‘I like my reality now.'
The destructive voices in Michelle Dalton’s head resulted in her being admitted to hospital as a teenager. She now supports others in distress
Michelle Dalton with her kitten Lisbeth. “Recovery depends on community support: having a network of friends and family.” Photograph: Bryan O’Brien. See www.aftertheasylum.com for more photos and video.
Michelle Dalton: “Psychotherapy has a big role for me, looking at your self and drawing on your inner resources . . . but many people don’t have those choices.” Photograph: Bryan O’Brien. See www.aftertheasylum.com for more photos and video.
Michelle doesn’t remember when she first heard them.
Even as a child the voices always seemed to be in the background. They felt comforting. Reassuring. They were more like imaginary friends, telling her stories or helping to direct her through life.
“I saw them as a childhood thing. In a lot of ways, they kind of protected me,” Michelle Dalton says. They could be be funny, making her laugh out loud, or give a helping hand by alerting her to danger.
But by her early teens the voices had changed. They were turning angry. They seemed to take a hatchet to almost everything she did, criticising her decisions and wrecking her self-esteem. The most destructive of all them all was the voice she called “the butcher”.
“It tried to butcher anything I’ve ever tried to do,” she says. “It would say the most awful things imaginable . . . it would speak very clearly, very directly. This wasn’t my own thoughts or inner voice – this was a distinctly different voice.”
Sometimes the voices were so loud and venomous it felt like being in a room full of angry people roaring abuse from all sides. It led to her first breakdown at the age of about 14.
“I was in a cafe in Bandon. I was with friends, but it was like I couldn’t see or hear anybody outside of me. All I could feel was what was inside me. I was like a volcano erupting,” she says.
“I stormed out, practically lifted the table and threw it on the ground. People were chasing me, trying to calm me down, but my perception was completely abnormal. It was like the most chaotic form of self-destructive energy a person could feel – it drove me to want to smash my head off concrete,” she says.
Gardaí arrived on the scene. Her friend made up a story, saying she had just broken up with her boyfriend. No one knew what had happened.
Michelle felt too ashamed to say anything about voices in her head. “I didn’t want to be called crazy,” she says. “I didn’t want that.”
Establishing your independence, navigating your way through adulthood and making critical life decisions is no easy feat. Almost a third of young people say they have experienced mental distress in one form or another, according to research by the youth mental health group Headstrong.
For some, it’s tougher still: more than a fifth of young adults have engaged in self-harm and 7 per cent reported a suicide attempt. Dr Barbara Dooley, Headstrong’s director of research and senior lecturer at UCD school of psychology, says the figures underline the urgency of providing services to these young people.
“We must see youth mental health as a national priority. There is no health without mental health,” she said at the launch of a recent report.
With mental health and education budgets under strain there is increasing concern at the consequences for child and adolescent support services. The campaign group Mental Heath Reform points to a number of worrying indicators.
Despite significant progress in recent years – such as the development of adolescent inpatient units – waiting times for adolescent mental health services are on the rise.
At the end of 2012, there were 338 children and adolescents waiting for more than a year for their first appointment. The HSE’s target for 2012 had been to bring this waiting list down to zero.
For young people with more severe mental health problems, services are still far from ideal. Last year 106 children and adolescents were admitted to adult psychiatric units, despite concerns expressed by the Mental Health Commission that the practice is “inexcusable and counter-therapeutic”.
Staffing shortfalls also exist within child and adolescent mental health services and are about half the levels recommended in the Government’s official policy. For professionals such as Dr Dooley, there should be no excuse for substandard services given what we know about the importance and effectiveness of early intervention in the lives of children with mental health problems.