After the Asylum: ‘I loved the severe physical pain. It was better than the mental pain'
Rory Doody spent years in and out of psychiatric hospitals and institutions. Today, he helps others in the community
“Last year we saw mental health professionals taken back into acute services from the community and rehabilitation and recovery specialists posts just terminated. Teams are under constant pressure due to cuts, which ultimately affect the quality of support and care patients and their families receive.”
The HSE, however, says it is appointing hundreds of staff this year to staff up community mental teams as part of a €35 million investment. Officials say this reorientation of services faces the challenges of a dwindling in overall staff numbers in the health services and cuts to annual budgets.
‘You can chalk it down to an imaginary friend’
Doody first recalls hearing voices as a youngster. “When I think about it, my parents are mystified over how I could be laughing on my own or talking on my own in the room – you can chalk it down to an imaginary friend, or whatever. It was certainly something that registers in my own mind as more than a little bit odd.”
As he grew older, the pressure inside his head would build up and up. Unable to talk to anyone about it, he’d end up burying himself in drink to numb the pain.
Other times he would bang the wall so hard he cracked bones in his hand. “I know it sounds a bit much, but it was that severe physical pain,” he says. “I loved it. It was better than the mental pain, and I would feel good for a short while. It’s terrible, really.”
He doesn’t remember all that much about the hospitalisations. He recalls more about the struggle to return to community and society. He calls the process “re-entry”.
“Anytime I’ve ever left a hospital or had a breakdown, there’s a point where I’ve come to; where I’ve come back and felt my two feet underneath me again. I come back to the world we live in . . .
“It was something that was always slow for me. I’d struggle with simple things like wanting to shower, wanting to put on fresh socks, wanting to clean my teeth . . . and then trying to answer the phone and hearing the voice on it, knowing it’s a real voice; or getting into the car and driving to town.
“Or calling your parents and telling them how you are. They felt like massive events which were hugely difficult.”
The road to recovery only came into view after a number of crucial turning points.
One of them was when his consultant psychiatrist admitted he didn’t have all the answers. Instead, the consultant admitted, they would need to work together to figure a way out of his distress.
Another was a close friend who would ask Doody: what are you going to do? Through a combination of dealing with issues in his own life and working on his own mental health, he began to make real strides towards recovery.
“My wife Martina likens it to a light-bulb. After five years, she says, someone turned on a light switch; five years later, someone turned up the dimmer,” Doody says. “It was the start of a journey of empowerment . . . I had handed over my life and will to the institutions of doctors, psychiatrists, nurses. I did it willingly . . . But I began to realise there were choices I could make. I didn’t have to leave it up to others.”
‘The concept of recovery is well understood but implementation remains uneven’
Traditionally, Ireland’s response to mental health needs has been almost exclusively medical, with decision-making power focused in the hands of psychiatrists.
The recovery ethos – the idea that mental health services are designed to assist in a person’s recovery rather than simply to “manage” their illness – is central to A Vision for Change. It involves rebalancing decision-making power and ensuring patients play a much greater role in their care.
However, the Mental Health Commission says there are “serious deficiencies” in the development and provision of recovery-oriented mental health services.
“The concept of recovery is now well understood but implementation of it remains uneven,” it found in a recent report. “Such a service requires an additional multi-disciplinary approach involving psychologists, social workers, occupational therapists and others.
“However, service delivery is still largely provided by medical, psychiatric and mental health nursing staff.”