Comment: A day in the mental-health holding cell

Every patient with a mental illness dreams of a direct admission to Eric Martin Pavilion. I hope to arrive on the ward with my bags and find a bed waiting.

Ninety-nine per cent of the time this does not happen and I am forced to enter EMP through the psychiatric emergency room, otherwise known as the Archie Courtnall Centre or PES, for psychiatric emergency services.

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PES is nothing short of a nightmare. It is a holding cell for people at rock bottom, waiting for a transfer to the in-patient unit. It is a small room, overseen by a glassed-off nursing station, that at some points holds over a dozen people.

Claustrophobia sets in the minute I walk through the secured doors and if I'm not on edge to begin with, I most certainly am bordering on psychosis when the door shuts and I am confined at the mercy of an overburdened health-care system.

My personal items are examined with a fine-tooth comb and promptly locked away until further notice. I am allowed to keep a journal and a book. I want to cry when they take away my cellphone, my last connection to the outside world apart from the public phone they provide, which is always in use. The items on my person must be guarded at all times as theft is rampant in PES. Blink and my stuff would be gone, likely to be sold for cigarettes.

I try to create a niche for myself away from the other patients, but because the space is so small, I am only afforded a three-to four-foot personal bubble radius. In PES, I miss my privacy profoundly. Usually, within the first half-hour, a nurse who has been assigned to my care will take me into a small interview room and provide a litany of questions as to what brought me here and how I have been coping overall.

This is the first of several interviews - later on, the psychiatrist and usually a medical student will ask me the same questions but expect more detail. By the end of my interrogation, my brain is fried and I am exhausted. I head back out into the common room and do what everyone does in PES - wait for a bed on one of the wards.

There is a small courtyard covered with bars and I usually step out there and pace until I am exhausted enough that I am too tired to be anxious. If I expend enough energy, I can allow myself to sit and relax for an hour and read (provided no one is screaming or bashing up the isolation rooms. The shrieking makes me feel like I am in a forensic asylum).

People in PES are in varying states of despair. Most just sit and blankly stare at the TV mounted high in the corner. Others pace in front of the nursing station until they are told to calm down, take an Ativan and sit. Some get so agitated with the monotony that they escalate to the point of needing solitary confinement, all because they are so frantic for something to distract them from the very thoughts that landed them there in the first place.

PES also takes in people waiting for detox. These cases are the worst because there is no reasoning with the intoxicated or strung-out. I keep my distance so that I don't get puked on or groped. If I am lucky enough and my doctor is in a forgiving mode, I can leave every few hours to inhale a much-needed cigarette.

The only real structure in PES is the arrival of meals. Guaranteed, at 8 a.m.. 12: 30 p.m. and 5: 30 p.m., we are fed something that purposes to be edible but is really bland and cooked to within an inch of its life. I am usually too anxious and distressed to eat anything and end up living on coffee and cigarettes until I get onto the ward. If I am lucky and the dietitian comes by, I am afforded special status because of my eating disorder and provided with vegan meals, which are frozen and imported from Ontario. They are five-star dining compared to the crap that is fed to everyone else. Sock it up to the privatepublic partnership for hospital funding.

Based on the unrecognizable entrées the general population is provided, apart from the greasy sheen that glazes the dish, it is no wonder patients complain that they have gained 10 or 15 pounds during the course of their stay. Where is Jamie Oliver when we need him?

By 5 p.m., the doctors have left for the day and we are left to amuse ourselves until we are given night-time meds, which I hope will induce a coma so I don't have to think about how closely I will be sleeping next to a complete stranger.

There are about 10 recliner chairs that double up as beds when the sun goes down. It is a scramble to secure a spot because if I don't act fast enough, I will end up on a cot on the floor, or worse, in a dining room chair. The state my body is in right now makes it painful to sleep on a recliner and I pray that my nurse is feeling generous enough to give me one of the cots if I am on my best behaviour.

Lights out are at around 9 p.m. and shortly after the TV is turned off (thank God - it is cacophonous and the mindless programs we watch agitate me even more). I don hospital pyjamas because it is too much trouble to nail down a nurse to find my belongings and by now I can barely keep my eyes open because of the potent meds they give me. They are supposed to calm me down but really just render me a zombie. I am lucky if I only get up a few times in the night, usually jolted awake by the screamer in isolation. Twelve hours go by and the whole process begins anew in the morning.

One, two, upwards of 10 days can go by without any word about getting a bed. As each hour passes, I lose hope of ever being free and my motivation to get healthy starts to crumble. I feel I am being slowly broken down and, by the time I actually do get a bed, I will be a shell of my former self, every ounce of me sucked away in an effort to survive this nightmare.

It takes me a few days to recover when I finally do reach the ward. I am almost shellshocked when I see the vast common area and open nursing station. It's like I've died and gone to psych heaven. I almost feel like a war veteran - I stuck it out in the trenches and I am now being rewarded with an extended leave. I realize that if I can survive PES, I can most certainly survive the weeks ahead.

Tara Levis has lived with anorexia and bipolar disorder for 15 years. She is currently living in Victoria and works part-time both as a librarian at the Eric Martin Pavilion and at a popular used bookstore downtown. She blogs at bibliotherapy.blogspot.com.

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