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
Although individual care plans for patients are now a legal requirement, the Inspector for Mental Health Services, Dr Patrick Devitt, recently found that only half of services were complying with their obligations.
“Safe, high-quality care can only be given if there is a clear, individual care plan for each service user, recognising and addressing their individual needs,” according to Devitt.
“It is disappointing that the level of compliance with this requirement fell from 62 per cent in 2011 to 52 per cent in 2012.”
Consultant psychiatrist Dr Pat Bracken says his profession needs to change. He says psychiatrists still have huge powers – and responsibilities – under the terms of the Mental Health Act. A psychiatrist has the power to determine what treatment will be used, how it will be used and its duration.
It is also within the psychiatrist’s power to decide what risks to the patient’s health will be tolerated. They can even order electroconvulsive therapy if the patient or their family refuses it.
“The powers invested in psychiatry are a legacy of the asylum era and can no longer be justified on scientific or moral grounds,” he wrote, recently.
He argues that the ongoing review of the Mental Health Act offers an opportunity to rethink the ways the profession deals with risk.
More and more research points to the fact that people who recover from serious mental health problems place a major emphasis on things such as relationships, meaning, purpose in life – issues that were often forgotten about in our medical model.
Much of the profession is embracing change. Service users are now routinely consulted by authorities.
There are encouraging developments in the form of HSE initiatives aimed at embedding the recovery ethos across mental health services. But patient groups still, by and large, feel frustrated at what they see as a slow pace of change.
‘I have bad days, like anyone else. But it doesn’t have to turn into a psychotic breakdown’
Today Rory Doody is happily married with four children, aged between four and 10, and has a bright, airy home on the outskirts of Bantry in west Cork.
“I’m very comfortable with myself, with my person,” he says. “I can still hear voices. I still have crises with my mental health. I have bad days, like anyone else. But it doesn’t have to turn into a psychotic breakdown . . . Now, I can engage with my mental health as part of the jigsaw that makes up all of me.”
Looking back, he feels some of his issues stem from handing over too much of himself to others.
“I always wanted to be cared for. That need to be wanted . . . that all stemmed from other stuff.
“Now, I’ve learned to love myself. To respect all of me . . . Like that late 20th-century philosopher L’Oreal puts it, ‘because I’m worth it’,” Doody smiles.
He’s also using his experiences to help others. Doody forms part of what’s known as the “home focus team”, an innovative initiative of the National Learning Network and West Cork Mental Health Services. It involves visiting and supporting people with mental health problems in their own homes.
“Traditional services see the need to fix someone, to get them better and back into their lives,” Doody says. “But recovery work is about being there until a person wants to get better, and facilitating that want.”
The project is being reviewed by academics who say it has significant potential as a way of empowering people in recovery and, ultimately, guiding them into training, education or employment.
“Over the last year and a half I have seen people having an awakening,” he says. “This kind of work is genuinely recovery-oriented. In my own case, I found that nothing really mattered until I wanted to get better myself.”
Doody says the trauma he experienced earlier in his life has changed his perspective on the world.
“I have four children. And I just think there’s nothing wrong with any of them, or any aspect of them. If they’re angry, that’s alright. If they’re quirky and do things in odd ways, that’s alright too. That idea of becoming okay with yourself is every important. I’ve accepted myself. I wouldn’t change anything about me.”