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Dublin: 15 °C Saturday 25 May, 2013

Column: My experience in an adult mental health unit

Last year, Ciaran Behan was admitted to a mental health unit. He describes the terror he felt – and what happened over the next two months.

Ciaran Behan

I WAS ADMITTED to hospital in June. I was seen by the psychiatric doctor in the hospital and she carried out her exam on me. She then broke the news to me I was going to be put in to the Adult Mental Health Unit – or in more commonly heard terms, the psych ward or the loony ward. Yes I was going to this place and I was going now.

As we made the walk to the unit, I felt like I was on death row and was about to be put to death. I did not see any light at the end of the tunnel; as far as I thought, I was about to be put to death for having a problem with my head. Now hindsight is a great thing – I now know that I was about to embark on a journey to get my life sorted once and for all.

When we came to the unit we were buzzed in. I was told to take a seat and the doctor would get the duty nurse to come and speak to me. I sat down in this cold and dreary hall; at 8pm in the evening I think. I sat there – it seemed to be hours waiting – and all I did was pick a spot on the wall and stared at it. I was not going to make eye contact with anything or anyone.

People came and tried to speak to me but I was not in the right mind frame to speak to anyone. I kept focusing on my spot on the wall till the nurse came. Deep down inside I was afraid. I wanted to scream “get me out of here”, I wanted to cry and look for a parent to embrace me with a hug and tell me every thing was going to be OK.

‘The fear that was building up became even worse’

The nurse came to speak to me to get my details. This was a 15-minute exchange or so, and then she showed me to my bed in the ward. When I saw that I was going to be in a six-bed ward the fear that was already building up on me became even worse. I said thank you to the nurse and I went into the toilet and let Niagara Falls loose from my eyes and cried till I made myself sick. As all this was going on, I forgot the main thing was I was here to get myself better. The fear was a killer, but I could do nothing bar go to bed and try and go to sleep, and try and sleep off this nightmare.

I came to spend eight weeks in this “unit”; and without sounding like a preacher from an American Baptist church I went on a journey and found out some wonderful things about myself. I say that but also I need you to understand how the unit came into play. It’s a wonderful place to be – you are cut off from the outside world and all the problems that come with being on the outside.

When it was coming to be time to leave, the doctor would first let me leave the unit to go down for a coffee. The first time I did this I went down and turned straight back into the unit. I needed to be back there. I did not want to see anyone. I thought people were looking at me, staring at me and saying ‘Oh look its the guy from the adult mental health unit’.

Over time, I got over this fear and then I had to tackle the fear of going outside the hospital. That was quite a daunting experience because it went from thinking one person was looking at me to thinking everyone walking down the street and driving down the street where looking at me and they all knew my problems.

‘We took everything at a child’s pace’

This was all solved in small steps, and we took everything at a child’s pace. It worked out well and after my eight-week stay I was sent on my way. I was to have access to the day services in my local town on a weekly basis. I had to see my key nurse weekly and my doctor fortnightly which I have done without fail ever since.

For the last nine months I have been on my rocky road to recovery. It has involved lots of swapping and changing between different types and doses of medication- trying to get the best match for me and my body.

Looking back on the whole experience it has been a life-changing one, and probably one that has made me be a better person today because it has given me the strength and understanding to know that the things I did in the past were the result of an illness, unknown to me. Now I know how to deal with this illness. This would not have been possible without the help of my doctor, my key nurse and especially all of the nurses who looked after me for those eight weeks.

So if you are faced with having to go through what I have done, I hope this helps you. Don’t be afraid and don’t be scared, this is a wonderful experience. Quite scary at the start but you will get so much help with all the problems that you may have thought would never be sorted.

As the great Irish man who does comedy, Tommy Tiernan, said: “It’s hard having a head”.

Ciaran Behan writes a blog, Wayfaring Stranger, where this post originally appeared.

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Comments (51 Comments)

  • best of luck in the future! good to see someone talking about mental health.

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  • Well done Ciaran. I believe the key to smashing the stigma around mental illnesses is demystifying peoples experiences and accepting it as a normal and common component of the human condition. I wish you well in your ongoing recovery/ discovery.

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  • Best of luck to you and your future plans. I hope you make a great of ‘things to do’ and may all your positives chase the negatives away!

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  • Cork 13/05/12 #

    So important, and courageously written.

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  • Well done Ciaran. Excellent article and very brave to come out and talk about it all. I hope everything works out for you. Keep up all the excellent work with #sundaycookoff on twitter!

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  • Hi Ciaran well done I have great respect for you. I know someone trying to come to terms with been bipolar and it’s a hard road for her and us her family. Putting that aside I wish you the very best with your life well done.

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  • Ciaran
    I have to say this is one of the best ever articles I have read on the Journal and I read them all!!! It’s reads like I’m sure it actually was, scary but worth it. I wish you the best, confronting your problems , which you have done, is half the battle. Onward and upward! Brilliant.

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  • Heart breaking and so couragrous in speaking out . Good Luck for the future

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  • Great article, it takes courage to write and publish this. I’m very glad you found it a positive experience. Unfortunately not everyone does. I would put it that while the reasons for entering care may be addressed, the being in a care facility puts a person in a very fragile place emotionally and that can open up a lot of doors that lead to frightening places. Institutionalisation is scary to, being in a facility gives a person a sense of belonging in a sealed community but it makes it difficult to a person to see themselves as “healthy”. At the end of the day, the only person that can say you are healthy and functioning is you yourself, no one else.

    But this is only my opinion. No one chooses a mental institution just because they’re acting out, if someone needs professional help, don’t hesitate, just get it. Great article, so thank you.

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  • its great to see something positive. I think this article will be very beneficial to a lot of people whom need mental health care . well done for writing this and the very best of luck for the future!

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  • The Irish Government should be doing a lot more to help people with mental health problems.

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  • Thank you for sharing your story Ciaran. The courage it took to do this and come out the other side is inspiring. Mental health is a taboo issue in this country and its a barrier that needs to be removed so that others dont suffer needlessly. Telling your story like this will help to tear down those barriers and I wish you all the best for the future.

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  • Well done Ciaran. Thanks for a brilliant article. There is still such a stigma surrounding mental health issues in this country. Honest people like you help sufferers and the greater the awareness the better.

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  • Well written article about mental health, also good to hear such positivity regarding this issue.

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  • Very brave and an inspiration..keep going…. :-)

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  • This country needs a lot more people talking about mental health issues and treatment. Thanks for sharing your story with us. Good luck for the future.

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  • i had a few mental problems once upon a time took me many goes to get it right but i must say i loved every min of time getting help because the people in these places deservers rewards for what they do. took me 3rd time lucky to get things rite, but fingers crossed ill stay there.

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  • Im so glad i read this article, well written and positive, thank you for writing it. I talk openly about my experience with post natal depression in the hope it might help someone else. I feel lucky that i sought treatment and it worked. I wish you the very same luck x

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  • Finally, a man with true guts! So many people I know don’t have the guts or the integrity to do something about their issues. You are a great example of manhood, maturity, integrity. You’ll do very well in life.

    From the bottom of my heart, thank you.

    Respect!

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  • I hope this uplifting story will encourage more folk to speak out so positively! Whether it be a simple physical illness or a more complex mental health issue, society needs to now start accepting that the time comes when sometimes one needs healing. We need to work much harder at eliminating the social “stigma” still attached to mental health issues. There is a great deal of help out there, and, this report is proof of the many successes that are taking place!

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  • Colette 14/05/12 #

    Ciaran, you are an amazing person, and have answered a lot of my questions I could not ask of a loved one. Thank you so much for posting this.

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  • Thank you for sharing your story, Ciaran. I wish you health in the coming years and a full and joyful life.

    And I wish to give another message: to any prospective firm or person or institution who might, in future, decide to penalise a capable and intelligent man like Ciaran, or discriminate against him for his honesty, or deny him employment for a treatable condition, or shame him in society, because of this necessary episode – please be assured that many thousands of Irish people are watching you and we have had enough of your kind. Enough. Do not stigmatise our tribe any more. Your behaviour shall not be tolerated. And I sign this comment with my own name.

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  • Such an inspiration Ciaranfor people struggling with mental health issues. I am in awe as always and someday hope to have your courage.

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  • Great to see someone that has the guts to talk about this thank you

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  • Thank you for your candour and honesty in writing this article. The more people talk about mental health issues in such an open manner, the better for everyone. I’m tired of the attitudes of ‘shush’, ‘sure what do you have to be sad about’ or ‘cheer up’ when it comes to talking about depression and I’m sure discussions on other mental illnesses can be the same. As many have mentioned here, the removal of that stigma is the first and most important thing towards helping people who suffer from mental illness and more articles like this will advance such a cause!

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  • All the thumbs up pressed on this site should just go to this..

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  • Congratulations on your recovery and for your honesty. I think it’s important to say not everyone has positive experiences in these institutions. There is a very limited approach taken and patients are not encouraged to be active participants in their recovery. By all means get help but Hospitalisation should be an absolutely last resort. I hope your recovery continues and thank you for getting poeple talking about mental health.

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  • So good ( and so unusual) to hear somebody had a good experience in a hospital in Ireland I wish you well in the future well done.

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    • It really isn’t that unusual to hear of patients having good experiences of hospital in Ireland, the bad experiences are usually found people in trying to access the services. This is a point worth clarifying and I don’t work in the Irish health system to give balance to the response.

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    • Irish hostipals have a long way to to go. Their primary focus is medication. There is no other treatment available before medication is given.

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  • Ciaran. Well done on ahving the courage to speak out about your experience of mental illness and I’m delighted you had a positive experience of the mental health system. If it’s not too intrusive a question, I’m wondering if you were treated in a private or a HSE facility?
    Unfortunately I have to add my own voice to that of Thomas Roddy and Robin Boots. I had some terrible experiences in the mental health system. I recieved several diagnoses, was detained against my will on many occasions and was put on various medications including anti-depressants, anto-psychotics, tranquillizers and sleeping pills. I was told I was just like a diabetic and would need to be on some form of medication for the rest of my life.
    Eventually, after years of the same revolving door, I was admitted to a private psychiatric hospital in Dublin. After a week my consultant came in and told me I wasn’t mentally ill as far as he could make out. That was around eight years ago.
    From my own experience I’d guess that over-diagnosis of mental illness is a huge problem in Ireland. Many people have had their lives transformed by psychiatry and find the medication really useful, as this story attests. I don’t belive in good drugs or bad drugs, only in good or bad prescribing. Over-prescribing is bad prescribing. I often hear the statistic “one in four will experience mental health problems” and it drives me nuts. Tiis made-up statistic has the twin effect of pathologising feelings of distress or behavioural problems and simultaneously decreasing empathy for those whose problems are genuinely medical.

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    • Ciaran 14/05/12 #

      Jone, I was treated in a public HSE facility and was a voluntary patient.

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    • Thanks for answering Ciaran. Hopefully things have moved on from when I was a patient. I too started out as a voluntary patient but I think it’s a bit of a misnomer. It can be very, very hard to leave if they don’t want you to leave andon one occasion I became an involuntary patient when my 72 hours notice was up. On another a nurse tore up the piece of paper.

      Many people here are criticising hospitalisation but I’d say over-medication is a bigger problem. At the time I went into hospital I needed somewhere to go and home was too stressful. I was completely exhausted to the point I was having problems communicating. Looking back though I really think the doctors jumped the gun in diagnosing me as psychotic. Whitikar’s book “Anatomy of an Epidemic” explains this really well when he says some countries have massively cut their drugs bill, and also their long-term disability bill, by holding off on medicating young people who are presenting to a psychiatric unit for the first time. In many cases a couple of days of rest, a safe environment and sleep (even with sleeping pills) brings them closer to normality so a more accurate assessment can be made. Of course, even then, medication will be the way to go but nothing will have been lost while waiting to be sure.

      Some-one commented earlier that the way to take the stigma off mental illness is to normalise it. I disagree profoundly. We don’t need to see a condition as “normal” to feel compassion for those affected. Look at how generously people donate to funds for children with rare diseases. Through my time in hospital I met many fine people whose problems were not easily solved, who could not function without the “lift” of anti-depressants or who were glad of the relief medication gave them from distressing hallucinations. At the time there was no psychotherapy but having had a lot of that as well I think, while it helps, it’s not the panacea it’s touted as.

      Serious mental illness isn’t normal. the majority of the population won’t ever see the inside of a psychiatric ward, at least not as a patient. But those affected by mental illness are normal people, as I think this article shows.

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  • Nice to hear a positive story , great insight into the world of mental health issues. Best of luck and thank you for sharing

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  • Ciaran,
    Well done on writing of your experiences of being admitted to a psychiatric hospital. It reminds me so much of when I was admitted to psychiatric hospital at the age of 20 with severe depression. I was terrified anyone that knew me would recognise me. I remember thinking when I first went in I wouldn’t tell anyone my name but within a minute of going in I met a man who originally came from my home village but who had spent around 30 years in the hospital at this stage and was given certain responsibilities there like a member of staff eventhough he was technically still a patient. He asked me my name, I told him, he said he knew my father. My secret was out.
    You seem to have benefitted from the medication you were given. However I disagree with the medical model that psychiatrists operate under. In my opinion the majority, if not all, psychiatric illnesses have their roots in emotional problems. In my own case I was diagnosed as suffering from manic depression having spent a second period in hospital after my first admission. During both periods no effort was made to look at any other difficulties I was experiencing at the time – and there were many.

    In the psychiatrist’s viewpoint, I suffered from depression, there was a chemical imbalance in my mind and I needed medication to correct this chemical imbalance. In my late 20s, after moving to a new area of the country when my depression got out of control and the medication wasn’t helping, I made contact with Professor Ivor browne, then chief psychiatrist in the Eastern Health Board who felt, as I did, that there was a reason for my depression; and I commenced psychotherapy.

    It’s nearly 19 years since I came off the lithium which I was told at the age of 20 I would be on for the rest of my life. In my view the medical model of treating mental illnesses is a fallacy. It may alleviate some of the symptoms. In some people like me it doesn’t and can even make certain conditions worse. It deadens the person and numbs their feelings. It’s only in the process of psychotherapy I regained a sense of myself and was able to deal with the issues that were behind my depression.

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  • Gutsy, honest article, good luck to you, hope you remain healthy, seems like you are on the right track.
    Well done.

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  • Glad you had a positive experience of the “mental health system” but not everyone has such a positive experience. For some it can be a nightmare. Especially if you are locked away in some backwater hospital, even though you have not been a danger to yourself or others. I was actually on an “anti-depressant” when I developed symptoms of Bipolar disorder/Manic Depression. I recently listened to a podcast/slides by Professor of Psychiatry David Healy who highlights the truth about these psychoactive drugs/”anti-depressants”. He gave a lecture at Trinity at the beginning of the month. Big Pharma hides some of the negative trials on these drugs. They can increase the risk of suicide and if a woman is pregnant or gets pregnant, there is an increased risk of miscarriage or damage to the baby. Never stop medication without consulting a doctor as there could be withdrawal symptoms. Dr Peter Breggin has also written a paper that claims “anti-depressants”/SSRIs increase the risk of suicide, violence and mania. The last part “mania” resonates with me. There were probably a number of factors but I do believe an “anti-depressant” was part of it.

    There are also drugs that called “anti-psychotics” which are in fact tranquillizers (or at least have a tranquilising effect, if you do not like to hear that). There are even law_suits against some of these drugs so always do your research, as doctors or Psychiatrists will not tell you these things. Some of these drugs will leave you sleeping well into the afternoon, which is hardly a “cure”. Rapid weight gain is something I experienced. And some of them can also cause diabetes.

    While some of these drugs can be helpful in a crisis, I believe the answer lies in a Psychosocial approach. Psychotherapy can help. Even though I spent 2 months in hospital, I never got one minute of Psychotherapy, which says a lot about our mental health system, where the emphasis is drugs. Meditation and Yoga can help when done regularly. Omega-3 can help with Depression. Diet and exercise is important. I try to take a good multi-vitamin sometimes. One that does not have Copper in it. The WRAP programme by Mary Ellen Copeland is something that can help. Its about Wellness and Recovery. If out of work a person needs a structure. Use a diary to plan the week. Try some voluntary work until you get a job. Keep busy and active.

    There are a few doctors I listen to when dealing with my mental health. No one told me the truth at the beginning about the fact that an anti-depressant could have been part of the problem (I was in my late 30s). So I am quite sceptical about most of them. I have been called “non-compliant” but I will not be intimidated. Professor Ivor Browne is probably one of the few Psychiatrists in Ireland that I would listen to or trust. He has over 50 years experience in the field.

    In this era I do not believe locking someone up is of any benefit to the patient unless is exceptional circumstances. With the help of someone independent, ie a Mental Health Advocate, who I was on the phone to at the time, I would have gone voluntarily to a private hospital. Instead of some backwater hospital that made me feel like a criminal, even though I had done nothing wrong. But advocacy is one of the areas which is been cut which is a shame. It will only end up costing in the long term. There is no “magic pill”. And answer lies within the person. We have a certain amount of control over our own biochemistry. If you are “Bipolar”, and I do believe there is an over diagnosis of the condition, try not to be seduced by the “high”.

    Dr. Terry Lynch also does a lot of great work in the area of mental health. He is a GP in Limerick who is now a Psychotherapist and has written a number of books.

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    • Search on “Healy” to find the podcast and slides from Professor of Psychiatry David Healy’s lecture in Trinity. http://www.nursing-midwifery.tcd.ie/events-conferences/events-schedule/index.php

      And by the way I was an involuntary admission. So I should have had a solicitor appointed and a tribunal after 3 weeks. The Mental Health Commission should also have been informed of my admission. But due to the manipulative way in which Psychiatry operates I was changed to “voluntary” and never got my basic rights. Psychiatry has taken the word voluntary and reinvented it for their own purposes. It means nothing in the Psychiatric system. I could keep going and highlight a lot more but I will bite my fingers!

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    • People don’t realise once in hospital you have no rights and can’t leave if you’re not happy with your treatment.

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  • Hi Ciaran,
    Congrats on publishing your story. It will give comfort to others like you who will go through this experience.
    However let me assure you as a (poorly paid!)health professional not strapped to the psychiatric disease agenda, that the points raised by Tommy here, albeit after a period of treatment, are increasingly gaining weight amongst those like him, realising that they do not have to abandon their emotional intelligence to the medicalising /institutionalising lobby., and can not only recover from their breakdown, but go on to discover a new more integrated drug free consciousness. To rather paraphrase Tommy T..’ Its tough having a head not attached to a body!’

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  • Ciaran, I`m glad you had a positive experience in our dreadful mental health system ! it’s a pity this is not the experience many service users report after exiting these dreadful places !!! We now have a ill for every pill where Recovery is never mentioned and we are led to believe we will need to be maintained by these drugs for the rest of our lives !! Pills are not the only solution to life’s problems !!! I wish you well on your road to recovery .xx

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  • Well done Ciaran for such an honest, insightful article. The stigma surrounding mental health issues is shameful and won’t change until people openly discuss their experiences.

    Wish you all the best in the future.

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  • Great inner strength to be able to recount your experience. It may be the ray of light that will motivate someone suffering in silence to seek help.
    Maith an fear.

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  • Great piece buddy :) your a legend

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  • while the writers recovery and wellbeing are to be commended there is a dangerous message in the article that medication and recovery are synonomous. The article seems only to strengthen the argument that only medication-based treatments are being offered to those in care. While the man’s wellbeing is indeed great, the ideological implications of the article are anything but

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    • Cork 14/05/12 #

      I don’t believe the focus is on medication in this article . I know that there is a mention of adjusting meds but weekly or daily visits to day centres are for occupational therapy . Which can be painting .exercise .music or any of life’s pleasures . Ciaran is a brave man .who deserves the best in life and it is great to see the people who work in Mental health with minimum funding commended. I don’t know Ciarán or work in the HSE

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    • I agree with Dylan in that there is a sub text to the article in that the author places a lot of emphasis in receiving the right medication for him. However if he feels it works for him well and good. However this is not the case with many people and for the majority of people who enter the psychiatric services with major issues such as severe depression, psychosis, scitzophrenia etc. medication is the primary method of treatement and for the majority of these people they are caught in the revolving door system of the psychiatric system for the rest of their lives. See my separate post.

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    • Ciaran 14/05/12 #

      Dylan, I have to disagree with you here. My focus when writing this article was not on medication. If you look back, you will see I only mentioned it in one sentence in the whole article. I mentioned it and rightly so, because it has been a part of my experience, and that is all I will ever write about – my personal experiences.
      However, I do understand your point and agree to some extent, there was a limit to the types of treatments I received while in hospital and now as I recover. While in hospital, I was encouraged to attend daily classes, be it yoga, art, music or I could attend talks with different organisations on mental health issues (I remember aware and grow in particular). While in hospital, I was told I would benefit from Cognitive Behaviour Therapy but unfortunately 9 months later, I am still on a waiting list to see the one therapist in Connaught.
      To clarify, my experience with the HSE has not been 100% perfect but I have benefited and used the services available to me to my advantage and am a better person for it.

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