Two Types of Patient

As found often in life, mental health reveals a distinct dichotomy when categorising patients. The dividing line falls between voluntary patients (who constitute the vast majority of the world’s mental health patients) and compulsorily treated patients. The difference between the two is significant. I like to think of the distinction in terms of pornography There is a great variety of porn on offer in today’s world and it can neatly be placed in two major categories: Softcore porn might be viewed post-watershed on Channel 4 or be made by a loving couple at home on their Nokia Camera Phone; Hardcore Porn although a lot rarer, can emcompass anything an although not a particular porn aficionado myself, I understand from friends that seeing lesbian dwarves being impaled by horses is not uncommon.  There is a gulf of difference in acceptability and the way in which these two types are viewed. It is a lot easier to take up softcore porn and get back out of it into a normal life, yet on the other hand you can slip deeper into the murky world by joining in and end up being drawn into the niche area of hardcore porn. Very rarely indeed do people move in the other direction. There is no turning back.

The housewife who gets a bit overexcited around Christmas time and needs some valium prescribed from the GP to beat away the January blues is a fair way from, for example, Peter Sutcliffe or Charles Bronson, who while away their days in the confines of Broadmoor. What defines the boundary between patient categories? It comes down to law. In Britain we have the Mental Health Act which attempts to define mental illness in terms of the law. Mental Health Law is very very shady. It allows for psychiatrists to pass legislation based on their medical examination of a patient which  can mean that he or she can be ‘sectionned under the Mental Health Act. If a doctor decides this then, as a patient, you lose your rights to decide on treatment and your (self) appointed doctor is able to treat you without your consent. The rights and wrongs of this fundamental principle of Mental Health is a subject which I really want to delve deeply into as the End Of Terror blog develops. It opens a whole massive can of worms of medical ethics and human right. Not all psychiatric’ patients see the inside of a mental hospital and indeed not all mental hospital patients are ‘detained‘ patients (a sectioned patient also loses his fundamental right to liberty in addition to enforced treatment). Many inpatients are ‘voluntary‘ patients who are deemed sufficiently within their capacity of mind to choose what treatment they receive, although this can also be bit of an illusion as a voluntary patient who chooses not to agree to a doctor’s recommendation of medication can easily slip into the ‘hardcore’ world.

Like hardcore porn stars, many sectionned patients are victims and merciless to what life has thrown upon them. They never wittingly chose this lifestyle and once in, as much as they long to leave the dark world, they cannot get out. At the same time there are one or two real purists who just simply love to test the boundaries and see just how dirty they can go in the quest for hell. They revel in the unnatural world, their goal is to push out the boat in terms of what evil humanity can really achieve. These purists, however, might not always be on film. In hardcore porn there are one or two cameramen and producers or directors who never appear in the footage. They may reveal themselves in the end credits as ‘Dick Dastardly’ or ‘Pervy Peter’ but they are critical to this world and keep it all flowing. they are the ones who coin it in, who recruit, keep people involved in the hardcore world, and ultimately decide what trainwreck results in the end product. Back in the healthcare system ‘Pervy Peter’ is likely to have a title of Doctor or Consultant before his name, or maybe ‘Dick Dastardly’ is a simple Nursing Assistant who gets his kicks while plugging people into the mains for E.C.T. treatment. These people are the unknown quantities. Their stories are rarely told. They are adept at occluding themselves from society but could it be possible that the odd shrink or nurse are as inherently evil as the most notorious of our mental patients?

My first involvement with mental health came not through volition in any way. At the age of  19 I was thrown right in at the deep end. Sink or swim, it was straight into the danger zone. Horse penis or not, it has been an unpleasant journey but the interesting thing is that I have maintained sanity throughout (in my own opinion). It’s as though they are filming me shagging with all my clothes still on… It’s weird staring at the film crew all day  every day and wondering what they are actually achieving in this purgatory or getting paid for, but a job’s a job, and if society needs them to record every detail then so be it. Maybe there needs to be a change in market appetites for a new vice to emerge and the evils of porn could be wiped from the face of the Earth.

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