If you are homeless and placed in emergency or temporary accommodation, there is a chance that the place you get will be completely empty.
When I was housed in emergency accommodation, the flat had a dirty old carpet and some blinds, but NOTHING else.
There was no furniture – no bed, no table, no chairs. There was no cooker, no fridge or freezer, no microwave, no washing machine, or any other kitchen appliance. Not even a kettle or toaster.
I had nothing, apart from a small bag of clothes and toiletries and, luckily, a sleeping bag I had brought with me.
For weeks I slept on the hard, cold floor because there was no furniture of any sort.
I had hardly any money and no way of cooking food for myself.
I was lucky enough to be given an old plug-in electric kettle by one of the other residents who was moving out. It was a lifesaver because it meant I could eat some hot food – though I had to be creative about it.
Hot food you can make with an electric kettle
I could only cook foods that could be made using hot water, and that I didn’t need to keep in a fridge.
Remember, you will need probably need to top up the electric meter in your new place, but a kettle doesn’t use much electricity, so £5 should be enough to at least feed yourself for a bit.
Food I made included:
Pot Noodles – these are great because they give you a pot that you can wash and reuse for other food or drinks
Porridge Pots – instant porridge pots where you just add boiled water – good if you don’t have a cup or bowl
Instant Soup/Cup A Soup (or miso soup sachets) – good if you do have a cup or bowl to mix them with hot water
Smash/Instant Mashed Potato – you can buy sachets of instant mashed potato and mix hot water with it in a cup or bowl. (If you want some flavour, you could get gravy granules and make gravy to go with it.)
Couscous – just pour some in a bowl or pot and add hot water to cover it and then a bit more on top, then put something over it to hold the steam in for a few minutes and its ready. You don’t need a lot because it expands. You can get sachets of flavoured ones or bigger bags of plain. It’s usually near the pasta in supermarkets.
You can get tea or coffee and if you don’t like it black, get some powdered milk too. Also, instant hot chocolate often has powdered milk already included in it. You can make hot drinks in the Pot Noodle cup if you need to.
You can also hard boil eggs in the kettle. Some people prefer to keep eggs in the fridge, but they will be ok if they are not refrigerated. Put one in the kettle with the cold water and bring it to boil. Let it sit in the hot water for about 5 mins and then re-boil – then repeat. Let it cool (you can hold it under the cold tap to speed it up) and then peel the shell off. If it’s not hard enough, next time try re-boiling it once or twice more.
Bear in mind, eating like this is not healthy in the long-term and you certainly won’t be eating a balanced diet. This is just about feeding yourself in the short-term to keep warm and survive, while you sort out getting a fridge and a microwave, at the very least.
My biggest tip
My biggest tip is to buy a Pot Noodle first because once you’ve eaten it, you can wash up the pot and use it to make some of the other food mentioned above in, or cups of tea/coffee (if you don’t have a mug or bowl).
If you don’t have washing up liquid, use soap or shampoo if you have it, or just rinse it really well in boiled water.
More tips for getting and storing food
Browse the supermarket for food that you can eat without cooking but that doesn’t need to be stored in the fridge. If you do buy something that does need to go in a fridge, then just buy what you need for one meal and eat it all in one go. Supermarkets tend to be cheaper than local shops, so it is worth going further to get to a supermarket, if you can. B&M, Asda, Aldi, & Lidl are some of the cheaper supermarkets.
If you live near enough a supermarket, or even a smaller convenience store like the Co-op, it is worth going in a few hours before closing time and looking in their fresh food reduced section for stuff. You can get some cold meats, bread, fruit and veg etc. that need eating right away, for really cheap.
Remember, if you buy any tins, make sure they have the ring-pull tops & don’t need a tin opener to open them.
One of the cheapest foods available that doesn’t need cooking is carrots. They don’t need to be in a fridge, they are literally only a few pence, you can eat them raw, and they are at least some kind of vegetable if you are craving something healthier. I used to snack on them to keep myself from feeling too hungry throughout the day.
If it is winter, you may be able to get away with buying some refrigerated items and putting them on your windowsill. Lean them against the window, as the glass tends to stay quite cold. You could maybe put them outside too, as long as they are somewhere they won’t be stolen. They won’t last as long as if they were refrigerated and will probably go off before their expiry date, though, so check the milk isn’t off before you pour it in your tea!
Basic items and how to get them
If you do find yourself housed with nothing, if you can, try to at least get the following:
– a kettle (electric one you plug in)
– a cup or mug (though a pot noodle pot will do in the meantime)
You might find it in store if you’re not able to order online.
In terms of the other smaller items, you could try charity shops that sell household items – here they will be extremely cheap. I went to a charity shop that sold household stuff and got myself a mug, plate, and a knife, fork, and spoon for just under £1.
If not, you can use paper or a chip shop box as a plate (buy yourself some wrapped chips from a chip shop – they are usually only around £1 – and keep the wrapping). You can grab some chip shop forks while you’re there, and it’s always good to have some napkins and spare sachets of salt too (makes plain couscous taste better!), if you find some.
Stirrers from coffee shops are good for mixing up Cup A Soups or tea/coffee.
Sometimes instant noodle pots have little plastic forks in that you can reuse.
Help from charities & organisations
There are some charities that help people in this situation by donating furniture and appliances, but sometimes it takes time to organise those things.
Your priority items are a fridge and a microwave, and also a bed or something to sleep on that isn’t the floor.
If you want to find out about what is available locally to you, you could start contacting your local Citizens Advice office. You can find out where that is by typing your postcode under ‘Find your local Citizens Advice’ on this page: https://www.citizensadvice.org.uk/
They should also be able to help you find out about any food banks nearby that you could use, or food parcels you can get, though remember to pick food (if you’re allowed to choose) that you can eat without cooking facilities, plus tins you don’t need openers for, until you get something sorted out.
I have written this article not just to help other people who find themselves in this position, but to raise awareness of the lack of facilities emergency or temporary accommodation for homeless people can have. You have a roof over your head, which means you are safer and (slightly) warmer, but it really is only one step up from sleeping on the street if you are provided with nothing. I do think that accommodation should include the essentials for someone to feed themselves, which for me is a fridge and a microwave (or at the very least a kettle!).
If you are placed in this kind of accommodation, you likely have very little money, and maybe have a vulnerability that makes you less able to be resourceful and organise things for yourself. You may have been through some traumatic or stressful experiences, making it much harder to gather the strength to figure out what you need and go out and get it.
If you are in this situation, I do encourage you to speak to your local Citizens Advice office, or a support worker if you have one. They should be able to point you in the direction of local organisations who can help you at least get some basic items together to help you survive in your temporary accommodation.
It takes time to build up the essentials and slowly make yourself more comfortable, and sometimes you will have to be creative to survive, but you will get there.
I know it is hard, but I did it, and you can too – I believe in you!
Shame is a normal human emotion that most people feel in varying degrees.
It becomes problematic when it starts to negatively affect our thoughts, emotions and behaviour, and so also our mental health, our self-esteem, and how we function.
I only recently discovered the extent to which shame has affected me. I realised it had fuelled my actions, emotions, and thoughts for a vast chunk of my life, and was most likely what kept me in cycles of self-destruction and pain.
Learning how to recognise and take control of this powerful but elusive human emotion has made a huge difference to my self-esteem, how I deal with anxiety-producing situations, and how able I am to engage with other people and feel confident to reach for the things I want in life.
It can be painful to learn about at first, but I think it is important that more people are aware of shame and how it affects them, and that we talk about it more. If I had learned about shame years ago, I might have been released from cycles of pain long ago.
What is it?
I realised recently that I didn’t actually know what shame was and how important it can be. I had always equated it with embarrassment and self-consciousness. It is similar, but much more powerful and potentially damaging to your self-esteem and mental health.
Feeling shame is feeling really bad about your worth and adequacy as a person, and often incredibly self-conscious about it at the same time. It is a disabling and debilitating emotion that can lead to us feeling that we are intrinsically flawed, bad, and unworthy of love or inclusion by others.
Feeling shame doesn’t mean you have done something bad. If you are feeling bad about something you have done, that is more likely to be guilt. Guilt can be easier to deal with because it tends to be due to something specific that has happened, and we are more likely feel an urge to talk about it with others and perhaps try to make amends in some way.
Shame is more often felt when you haven’t done anything wrong, for example feeling it due to how you look or for who you feel you are as a person. We are much less able to talk about shame because it is so tied up with our feelings of the bad or flawed person that we might feel we are inside.
Shame makes us want to hide away or hide parts of ourselves, because it is such a deep and painful emotion that makes us feel incredibly vulnerable.
It is important to know that shame is not about blame. It is not because of something you have done. We can feel bad about ourselves due to strict standards we hold ourselves to, but shame more often starts due to how we are treated by others or due to difficult situations we have found ourselves in, which go on to affect how we see and feel about ourselves.
If you feel deep shame, it could be due to having been mistreated, put down, made to feel small, or like you are in some way unacceptable, undesirable, unworthy, or defective. If this was particularly painful for you, shame can become internalised and it can stay with you for years, even a lifetime.
Shame is such a powerful emotion that it can cause us to react in strong ways in order to cope with how painful it feels inside us.
The Compass of Shame
These strong reactions are best explained using a model called The Compass of Shame (Nathanson (1992)).
This is one of the most useful concepts I have ever come across and I was able to recognise myself in it instantly.
It shows four ways that people tend to react when feeling shame. You may find you do any number of these in any combination and also may react using different ones at different times.
Withdrawal – wanting to isolate yourself, avoiding relationships, people and situations
Attack Self – negative self-talk, self-destructive behaviour, self-hate and self-loathing
Attack Others – blaming others, lashing out at others
We all feel shame but when we have internalised shame over a long period of time it can have a much bigger hold on us and our reactions on the compass are more likely to have become ingrained coping mechanisms.
I immediately related to the ‘attack self’ and ‘withdrawal’ compass points, and even the ‘avoidance’ one.
All that time, I hadn’t consciously known what it was I was avoiding, what I was withdrawing from, or what I was attacking myself over. All I knew was that I was in pain and that I felt really bad about myself and felt compelled to think and act these ways.
Understanding what has been going on all these years has made such a difference to how I am able to function today, and how I treat myself.
How to spot shame in yourself.
I had varying degrees of social anxiety for over 20 years before I discovered the shame compass, but I hadn’t realised that shame was actually the major driving force behind it.
It was a personal revelation.
The thing about shame is that it is sneaky and that it likes to keep a low profile. It hides underneath other emotions such as anger and anxiety. It stays powerful by staying hidden.
It was only when I learned about shame from a psychologist that I found out how to spot it.
This is what I discovered shame looked like for me:
When I was around others, whether they were strangers or good friends, I would begin to feel really bad about myself and my inadequacies as a person. I would have loads of negative self-talk going around my head, criticising me and telling me what a worthless person I was, beating myself up for the things I had said and making me feel like crap.
Sometimes I would feel physically sick with self-disgust and self-loathing so intense that I couldn’t even look people in the eye. I would desperately want to leave the situation, not out of fear I realise now, but out of feelings of such deep inadequacy and unworthiness to exist, let alone be around others.
I used to think this was all just part of my anxiety, but after looking at The Compass of Shame, I realised that it was deep-seated shame that was leading me to ‘attack self’ and ‘withdraw’.
Noticing that was the beginning of a process of slowly removing and releasing the shame I had internalised and had been feeling for so long.
I still get anxiety. It still makes me feel hot and shaky; my heart beats fast, and my mouth goes dry. I feel awkward and uncomfortable, but it is much more bearable than it used to be. This is because now it is largely a physiological reaction and not an emotional one.
Separating shame from anxiety has radically changed how I am affected by social situations.
Are you able to recognise any of the actions and reactions in the Compass of Shame as underpinning your emotions?
If yes, you may be carrying internalised shame.
How I began to release internalised shame.
Name it and acknowledge you’re feeling it.
Learning to spot shame was the first thing. Next, I began to label it as such and acknowledge that I was feeling it.
Whenever the negative self-talk would start up in the middle of a situation, or feelings of self-loathing, I would note it and then say and repeat to myself: “I am feeling shame”.
Acknowledging the fact that you are feeling shame in the moment immediately takes power away from it.
This is because shame works though opinions, such as ‘I’m a worthless person’. If you reject opinions in favour of a fact ‘I am feeling shame’, the opinions lose their power.
It also puts it into context: I am not thinking/feeling this stuff because I am a bad, unworthy person, I am thinking/feeling it because I am feeling shame.
And remember, feeling shame is normal and human and is not your fault. It doesn’t mean anything is wrong with you.
Shame thrives on being unseen and as soon as you start to notice and point at it, it weakens. It also thrives on opinions, so when you start to challenge them, they don’t tend to hold their own for long.
Challenge the ‘shame scripts’.
I made a list of all the things that my negative self-talk (also known as my ‘shame scripts’) was saying. It included:
“You’re weird and no one will ever like you”, “you’re a joke”, “no one cares what you have to say”, “you don’t deserve to be here”, “you’re nothing” … etc.
When I looked at what I had written in front of me, I noticed that all these phrases were things that I had been told or made to feel when I was a child and teenager. Decades later, I was still being plagued it.
It made me realise how long I had carried all this stuff, which was never mine to begin with, and how it had continued to affect me most of my life. It had been with me so long, constantly battering away at me, that I just assumed it must all be true. I had never sat down to analyse it or challenge it. It was something that I had simply got used to as a part of me.
Now, I took time to pick apart each phrase to see if it was fact or just an opinion. I also looked at whether it was helpful to me or my mental health – and then I argued with it.
Example 1:“You don’t deserve to be here”.
Is this a fact?
No, it’s not a fact, it’s an opinion, because there is actually no proof to back this up. I also think if you ask people who know me, they would disagree.
Is it helpful?
No, it’s definitely not helpful, in fact it is actually a really horrible thing to say to someone.
In fact, why don’t I deserve to be here, in this social situation? I feel like everyone else deserves to be here. I’m a good person with things to offer, so why the hell can’t I be here with everyone else?!
Example 2:“You’re weird, and no one likes you”.
Is this a fact?
Actually, no, it isn’t a fact at all because people on the whole don’t dislike me. I tend to get on well with most people. I’m friendly and kind and compassionate and I have friends who definitely do like me.
I have a unique look with tattoos, piercings, and purple hair, but that doesn’t make me weird. I’m sensitive, and sometimes I sense things others can’t, but that doesn’t make me weird either.
Is it helpful?
Definitely not – it is a nasty thing said to me by people decades ago and I refuse to believe it anymore!
I found that getting annoyed with the words and phrases and telling them how much I refused to believe them actually helped me fully reject them, but you could do it in any way you like really: whatever works best for you.
You could even write them out on paper and rip each one up after you challenge it. This way you are truly saying goodbye and good riddance!
Keep at it.
Now when I’m feeling anxious and uncomfortable and I start noticing the ‘attack self’ scripts starting up again, I tell them to go away and that I don’t believe them anymore (though usually phrased as ‘piss off, you know that’s bullsh*t’).
It does take practice, and you have to expose yourself to some uncomfortable situations that might cause you to feel a bit of shame, in order to do the practice (go gently at first) but I have found it really does work.
I began to notice shame popping up here and there, such as when I was walking around in public and when I went into shops, and every time it did, I reflected and challenged it.
I had always felt really self-conscious, but now I could see it was shame making me feel that way because the script was telling me I looked weird, and that people were all judging me and hating me.
I began to understand that emotional abuse and bullying I suffered when I was young was the cause of me always feeling so uncomfortable around other people.
Combat it with something you know is true about yourself.
This is something I find works really well for me.
Sometimes I repeat things to myself inside my head to double-down on keeping the shame away. I do it when I’m sitting in meetings feeling anxious or even just walking along the street feeling self-conscious.
I repeat to myself:
“I am a good, kind person with a lot to offer other people”.
I want nothing more than to be kind to people and help them – that is who I am deep down. This is a fact, not an opinion. This is my fact about myself.
Remember, facts always crush opinions because they are much, much stronger.
Reminding myself of my intrinsic good qualities always makes me feel instantly more at ease.
If the self-talk is saying I’m ugly, or weird, or I don’t deserve to be somewhere, I basically argue back and say that even if those things were true (which they are not), I am a good, kind person with lots to offer other people, and that is what really matters.
You will have to find a phrase that works best for you.
It could be ‘I am kind and loving to animals’, ‘I am a good parent’, ‘I always try my very best to do the right thing’ etc. Search deep inside for one thing that you know is good and true about yourself – you don’t have to share it with anyone, so it doesn’t matter what other people would think or say about it. It is a fact about you thatyou know is true, so search deep inside yourself – you will know it when you find it.
I still find some social situations uncomfortable and anxiety-producing, but on the whole my work to combat my shame has completely transformed by life.
Now I mostly only have anxiety itself to deal with (the body reactions of thumping heart, dry mouth, feeling shaky). It isn’t pleasant, but it is manageable now, compared to when there was deep shame attached to it, where I sometimes felt in severe emotional distress, wanting to cry and run away.
I still feel shame, too, in areas of my life, and everyone does to some extent. I have managed to tackle the shame that was disabling me the most however – the shame I felt in social situations. As I notice shame pop up in other situations, I use the skills I have learned. I spot it, and acknowledge it and later I write down what it is saying and analyse it.
None of this has been easy, but it has definitely made a big difference in my life.
The reason I decided to write this is because I think it is so important to share with others. It has been like a magical healing potion for me!
We need to talk about shame more, even if that can feel hard to do.
Why is it so hard to talk and think about shame?
Talking and thinking about shame can make us feel extremely vulnerable. It can make us feel more ashamed.
It is an emotion tied up with very personal thoughts and beliefs about being unacceptable and unworthy and so we automatically feel we need to keep it to ourselves and not share it with others, in order to protect ourselves. That is a natural way to feel.
The very first time I learned about shame, I felt withdrawn for quite a few days afterwards as I needed to process the fact that I felt it at all. I realised it had been there my whole life, ruling me in so many situations, affecting my mental health, and yet I had not even known it was there. It was difficult to accept at first.
I recently read ‘The Gifts of Imperfection’ by Brené Brown (2010), and in it she says that shame has the most power when it is in the dark. To make it less powerful, the best thing you can do is drag it out into the light.
You can do that by doing what I have described in this article, but Brené says it is also useful to talk about it with someone who you can trust to listen and not judge.
After a week of reflecting on the whole situation, I was talking on the phone to a friend and began to tell her about what I’d learned about shame. I said something like this:
“Last week I learned about shame – it’s actually not what I thought it was at all. You know those times when you feel bad really about yourself, that you’re not good enough? That’s actually shame talking. I’ve started to realise all those times when I’ve felt bad about myself in front of others, I was feeling shame. I realise that it was shame making me attack myself with all the negative self-talk, making me do so many self-destructive things, and also why I’ve found it so hard to be around people so much. Do you think you’ve felt it sometimes too?”
It was the beginning of a really frank and open conversation between the two of us.
I know not everyone has someone they can trust to talk to about their deep feelings. If you have a psychologist or therapist, perhaps you could ask them to look at it with you.
If not, just having conversations about shame in general, even without giving details about your own personal experiences, helps to raise awareness of this emotion. I think this is a topic that should be more acceptable for people to think and talk about because it could lead to better understanding what really lies behind our strong, often painful emotions. Perhaps it could help more people heal more quickly.
Spotting it, naming it, and talking about it gets it out of the shadows where it prefers to be and helps reduce the power it can have over us and how much it can rule our lives.
Even once we release internalised shame that has been there a long time, shame can still come along here and there through ongoing experiences. Learning to notice when we are feeling new shame and to recognise it for what it is and release it, as it happens, can make it much less likely to become internalised again and to have such a hold on our lives as in the past.
Please remember – shame isnot your fault.
You have no need to feel ashamed if you recognise shame in your emotions or in your life. It could mean that you have not been treated very well at times in your life.
Shame can become overwhelming and can really affect people’s lives, but it is a normal human emotion that everybody feels to some extent.
Nothing is wrong with you for feeling shame.
I recommend reading anything by Brene Brown. Her work on vulnerability, courage, and shame, researched and written as both a professional and as someone who has intensely felt both, is incredibly heart-warming and honest and I have gained so much from reading her books.
If you can’t afford them, ask in your local library to see if they have or can order you anything by her.
A couple of years ago I was asked as an ex-patient to be involved in a participation project with mental health staff called ‘Reducing Restrictive Interventions’.
We split into separate groups (one of staff and one of service users), each with a facilitator, to brainstorm. One member of staff misunderstood the instructions and joined our group. None of us said anything, assuming there was an unspoken reason for her joining. She wasn’t meant to be there, but it turned out to be a really helpful mistake!
We talked about restrictive practices on the ward and their effect, from small things like not being allowed to congregate and chat in the corridor, to more difficult things such as restraint and seclusion. The staff member listened intently to what we said and acknowledged our experiences, saying it was very helpful to hear. She then tentatively told us about how imposing restrictions upon us sometimes made her feel, and we listened in return.
It hadn’t been planned. Out of nowhere a safe space materialised where testimony was heard and acknowledged on both sides. For that 20-minute slot, we were no longer staff and service users – we were human beings, equal to one other, listening and acknowledging with empathy and compassion.
The whole group agreed that it had been an enlightening experience, including the member of staff. I thought about how incredibly helpful it would be to have opportunities like this occur more often. It wasn’t until I recently came across a piece written in in the British Medical Journal by Dr Sarah Markham, that I realised what had emerged that day was the kind of space and situation that restorative practice (also restorative justice/approaches) works to create.
What is restorative practice?
Restorative practice can take many different forms, and for more comprehensive explanations, please see the links at the end of this piece.
The way I understand it is as a coming together of people who have been involved in a conflict, difficult experience, or trauma, in order to share the impact it has had upon them.
It can be used to repair specific relationships or harms that have occurred, or it can be a more general expression of thoughts, feelings, and needs in a mediated safe space where everyone is listened to without interruption or judgement. The idea is to create empathy, enable mutual understanding, and to then work towards a satisfactory resolution for the benefit of all.
Restorative practice and approaches are already used in various forms in a number of sectors, such as criminal justice, community mediation, and in schools.
Why might we need restorative approaches in mental health?
Restorative approaches could help by:
Reducing the impact and level of trauma felt by those using or working in mental health services.
Improving staff/patient relationships.
Improving mental health outcomes and quality of life for all.
Despite it being a contentious issue that not all like to accept, harm occurs regularly within mental health services and on psychiatric wards.
Many are harmed by the most obvious major practices, such as Mental Health Act detention, coercion, restraint, forced seclusion and sedation (which is another article in itself!) but harm also occurs in smaller, more insidious ways.
These include verbal abuse, gaslighting, neglect, withholding care, not telling the truth, making decisions without the patient, breaking trust, not listening, ignoring, being dismissive, and acting without care or compassion.
When cumulative, these ‘little’ hurts can become more painful than the bigger harms. They are thousands of papercuts that never heal.
It is these cumulative harms that I would like to focus on in this article, because it is these that I feel are most unacceptable because they are the most avoidable, and could be most easily tackled by restorative approaches.
Of course, mental health staff are also harmed by what they experience at work. This could be directly through violence and abuse from unwell patients, high-stress work environments, or by being implicit in restrictive and coercive interventions or practices that they do not feel comfortable with.
Staff themselves are not subject to those coercive and restrictive practices, and they implicitly have more power than a service user even at the lower end of their pay grades, but they are certainly still vulnerable to stress and trauma.
Psychiatric wards are trauma machines: harm is cycled and passed from person to person in an enclosed space within the rigid, heavily bureaucratic, emotionless system that is NHS mental health services – a model unfit to deal with the complexity that is humanity and human emotion, let alone that of mental distress.
Relationships between staff and service users are often strained. Each views the other as an oppositional unit which they should be wary of and therefore protect themselves from. This creates huge rifts that undermine the therapeutic benefit of services.
Mistrust stops people reaching out for help in the future. If someone does so and is met with a dispassionate, unkind response, they will think twice about doing so again. This increases loneliness, fear, and risk of self-harm or suicide.
A lack of trust also adds to service users’ issues with healthy relationships in general: feeling suspicious or afraid of others can lead to further isolation from peers and greater society and worsening of the original mental illness.
Of course, there will always be those who find their interactions with mental health services supportive and helpful. This must be acknowledged, and I am happy that those people certainly do exist.
Where trauma is felt, however, patients are often dealt an extra burden to recover from in addition to the illness or condition that brought them to services in the first place.
In this way, mental health services can actually perpetuate mental illness and distress.
In particular, those deemed to have a personality disorder (a contentious label at the best of times) or complex needs, have often been on long journeys through services, experiencing exclusion, gross misunderstanding of needs, verbal abuse, threats, coercion, prejudice, not being believed, and a stark lack of compassion.
All of this mirrors and reinforces traumaalready experienced in personal lives outside of mental health services.
Like a snowball rolling down a mountain, trauma and pain and their associated difficulties stick to the original, core problem, making people so heavy with pain that they become formidable, dangerous, and impossible to treat in the eyes of those who helped make them this way.
Those who have spent years in services can find it impossible to detangle the trauma that existed originally, from that gained since.
It doesn’t make sense to be healing and hurting people at the same time, particularly if you want them to thrive and get free of the revolving door of repeated discharge and re-admission.
Are restorative approaches feasible in mental health?
In a dreamworld, everyone who has been cruel and neglectful to me in a healthcare setting would come and sit with me and we’d use restorative approaches to work it through. We’d have conversations about how it affected me, and they would listen. I would ask the ‘why?’ questions I’ve always wanted to ask and listen to them in return, hopefully they’d apologise or at least reflect, and we’d repair things and find a way through that felt better.
This is an unlikely situation for service users.
There is rarely a single ‘perpetrator’. We often hurt from many actions from many different people, that have chipped away at us sometimes over decades of damaging interactions with mental health services, when we were already at our lowest and most vulnerable: those papercuts.
We have no chance of facing all of those who hurt us. Would they even remember the nasty comment they made years ago? Would they remember a single situation even months ago, during yet another busy, understaffed double shift?
(Most likely not but, rest assured, we definitely do.)
They might not even see what they did as wrong or negligent, or may not want to admit it.
One of the underpinning principles of restorative practice is that it must be voluntary – everyone has to consent to join in and so there needs to be a willingness to engage.
Services and staff may feel that restorative practice will involve some admittance of mistakes or of neglect and abuse, and it is unlikely they will be happy (or able) to do that.
Due to this, I feel that more formal restorative approaches like those used in criminal justice, with an obvious victim and offender, are most likely not feasible in mental health services.
Spandler and McKeown (2017) suggest that grassroots truth and reconciliation initiatives might indeed be what is needed, particularly in the absence of the interest or enthusiasm of services and psychiatry.
They describe instances of grassroots and service user led mental health organisations in the USA that have made use of community-based models and healing circles to hear testimony from those harmed, whether staff or patient, and also to hear from those who did not feel harmed – all viewpoints being equally welcome and compassionately acknowledged.
Perhaps something like this could be helpful.
I know from the experience I described earlier that if you can turn a room of service users and staff into a room of human beings, even for a short while, amazing things can happen.
There would need to be a level playing field offered, and a space of safety for all to be able to speak and listen, wearing no official ‘hat’ of service user or staff member.
There would need to be no repercussions for sharing, and it would need to take place in a neutral space, so not in a hospital meeting room.
There already exist initiatives amongst service user only communities where testimony is heard in safe and non-judgemental spaces, providing those who have been hurt a forum in which to express pain and anger, and for that to be acknowledged.
I am currently involved in project ‘For The Record’ with the grassroots service user group #MadCovid, where experiences are shared via closed-group presentations of writing and creative pieces on the theme of iatrogenic harm.
Supporting each other in this way is helpful, and for some it is the only forum in which they feel safe enough to truly express their feelings. However, it is no surprise for us to hear the trauma of our fellow service users. We know it only too well.
There is absolutely a place for this work, but for true restoration I feel that those with other viewpoints, perspectives, and experiences need to be included and need to listen, or we risk remaining in a well-meaning echo-chamber, with no real movement towards remedying the situation.
I like to think that there are staff and patients who would genuinely want to take part in informal initiatives that aim for better understanding for those on all sides.
Service-user led initiatives may not be impartial enough for this specific task. We need projects formed by both ‘people who work as staff’ (a distinction from ‘staff’, which is their official capacity whilst at work) and service users, and/or by allies who are completely impartial.
As it would be a voluntary activity engaged in outside of work time, that could be off-putting to staff who already work long hours, but if touted as an exercise that could enrich them personally, rather than a work-related box-ticking exercise, it could perhaps be more attractive. There will always be those who are not at all interested, but I believe there will always be those who are.
Meetings or circles should be trumpeted as positive, welcoming, healing spaces that are not about apportioning blame. The idea is to enrich understanding and empathy on all sides, which could go some way to better relationships within services and hopefully to change opinions and behaviour towards those previously seen as an oppositional group.
They would need to be closely guided by restorative principles, impartially managed, and only joined by those distinctly wanting to work towards restorative ends.
An important question at this point is: do we need to come together with specific people who were involved in our own individual experiences, or is hearing testimony from anyone, even people we don’t know, still helpful? In an informal meeting like this there would be no guarantees about who might attend.
As I said earlier, we may wish for the opportunity to face those who wronged us, so we can ask specific questions, understand particular instances, maybe even share apologies, but the chances of this are low.
Hearing from others who have been in similar situations (on either side) might not give us that, but it could still help expand empathy for and understanding of each other, break down oppositional barriers, and help us see each other as human beings, all with capacity to hurt and be hurt.
Will restorative approaches actually make any differencein terms of harm?
Despite me advocating for restorative practices, there is a voice of cynicism deep inside me, one which most long-term service users will know well. It says that nothing will ever be enough to make up for the pain that has been inflicted.
I’m trying not to listen to that voice, because I want to be more hopeful than that, but I acknowledge that there are many who have been hurt so badly that these drops in the ocean will seem nowhere near good enough, and I fully respect that.
There will be many people who won’t like these ideas. They won’t want to relive their traumas or remember certain times of their lives. Some understandably won’t feel able to be vulnerable around the ‘opposite team’ who has caused them so much harm. Many will be afraid of repercussions and further victimisation.
We need to acknowledge and be mindful of this.
I do think, however, that proactive restorative approaches could go some way to lessen the cumulative harm that occurs within mental health services.
If we deal with each papercut as it occurs, we can help to stop it building up into trauma.
I remember a difficult interaction that occurred once between myself and a professional within services. She made a mistake that broke trust and at the time it really upset me. Trust of healthcare staff was already something I found difficult.
When we were next in touch, she set aside a good 15 minutes of our appointment to talk about it. She apologised and completely owned the mistake. She didn’t make excuses and she listened to me explain why it hurt me so much. We talked through it. She did not rush me or minimise my emotions or reaction.
The fact that she had the courage and integrity to initiate this conversation made a huge impression on me.
It may seem obvious that someone would do this, but it is not common.
She was so demonstrably honest and compassionate that we quickly repaired the relationship and the hurt I felt disappeared. I also apologised to her for how I had reacted when it happened, and we were both able to agree to move on.
Just a single restorative interaction like this can give a service user hope and a renewed faith in services in general. It creates a welcome contradiction against the idea that ‘all staff are bad’, or ‘I need to protect myself from staff’.
The more examples we are shown of compassion and kindness, the more that serves to challenge ingrained views of staff and services as a homogenous group of unkind, uncaring people.
This experience helped me believe it is possible to have the restoration we seek with those who have directly hurt us if it happens as soon as possible after the incident.
Apologies are probably best left to occur in organic and spontaneous ways in order to protect their sincerity, however proactive restorative approaches could be part of a new way of working. Examples include improved communication styles and time set aside for restorative and reflective catch-ups with service users, as the need arises.
Restorative approaches in schools often include the use of restorative communication. Staff and pupils are encouraged to make ‘affective statements’, where they communicate to each other how they have been affected by the actions of the other, both positively and negatively. They also use ‘affective questions’ to explore things that have happened and how they could be best resolved as they arise, avoiding the use of blame or accusation.
Time is taken out to have restorative talks, as needed, which could just be a couple of minutes or longer if needed.
Something like this might be really helpful if it was embedded within mental health services, for both staff and service users to make use of.
It might be viewed as more work for already under-resourced staff teams, but I genuinely think it would be worth it in terms of improved relationships and outcomes for all involved.
It could also help improve communication skills, assertiveness, and skills for dealing with confrontation on both sides.
I acknowledge that issues of mental capacity, distress, and illness are factors to consider that aren’t as relevant in the school environment, but ways in which proactive restorative approaches could improve the mental health environment are definitely worth exploring further.
In believe that informal restorative approaches, utilised as we go, may be the best format for mitigating cumulative harm within mental health services. These have certainly made the most difference to me personally.
In addition, there could be grassroots initiatives that bring people who work as staff and people who are service users together voluntarily and on equal grounds, in order to learn more about each other’s experiences.
Restorative approaches may seem too meagre to make a dent in the impact of harm caused by mental health services. There is no doubt that social action aimed at general reform of mental health services and legislation is desperately needed in addition to any restorative work.
Bloom & Farragher (2010) call for organisations to be “trauma-informed systems” run to be more like living organisms, “capable of all the same emotions, processes, learning, disease and change that any other organism experiences”, instead of cold machines.
I think restorative approaches, especially proactive communicative ones, should be a key part of that vision.
I don’t have all the answers, but I know that ignoring the fact that trauma occurs within our services isn’t working and is a ticking mental health timebomb.
I also know that the interactions I have had with staff on a human level have made the biggest impact on my ability to heal and have faith in people, more than any psychology session or medication ever has.
Those interactions have expanded my own capacity for empathy with those who care for me and have most of all allowed me to feel hope that things can change.
I do think it is important to bring restorative approaches to mental health services, even if the efforts at first seem small. More opportunities, spaces, and interactions like those I have described – informal, voluntary, human – would contradict negative experiences, foster better relationships between staff and service users, and make small but solid steps towards repairing harm.
To achieve this, big work desperately needs to be done, but I personally believe enough small, reticent stones cast out in hope could cause enough ripples to rock the boat.
Bloom, S. and Farragher, B. (2010), Destroying Sanctuary: The Crisis in Human Service Delivery Systems, Oxford University Press, New York, NY.
Emergency housing is accommodation provided to people who are homeless and seen as in being priority need (in the UK). The idea is to house you for a temporary period whilst you wait for more permanent housing to become available.
You can read more about how emergency housing is allocated here.
I spent nearly two years in emergency housing.
The first couple of months was in what was called a bed and breakfast (B’n’B), though it was really a bedsit in a converted, disused pub (definitely no breakfast!). The rest of the time, I was in a studio flat in a large, old, damp Victorian house converted into flats. Both were in different towns at least 40 minutes drive from anywhere I was familiar with, and I didn’t know anyone at all in those towns.
If you are being housed in emergency accommodation, you are probably vulnerable, even if you do not think of yourself that way. You can easily become the target of coercion, abuse, or even violence.
You are meant to be safe from harm in this type of accommodation, but this is unfortunately not always the reality, due to a number of unstable and/or distressed people being housed in one place.
I am writing this in the hope it might help someone falling into some of the many traps that can present themselves.
I don’t want to make anyone feel overly afraid or paranoid: I simply want to encourage healthy vigilance and awareness so you can stay as safe as possible while you wait for more permanent housing.
– Be careful about who you make friends with
Everyone has their own reasons for being housed in emergency accommodation.
There were a mix of people in my building: single mothers with young children, people with mental health difficulties, and people with drug and alcohol issues, and often a combination of these.
Most people seen as being in priority need are vulnerable and that can create a hotbed of issues and emotions in one building, particularly when drugs and/or alcohol are also a factor.
I found the best way to act around my fellow residents was to be friendly when I bumped into them in the hallway or in the town, but to not stop and chat. I was never rude: I was always pleasant, but I made it obvious I wanted to keep myself to myself. If you’re polite when you do see people, they do tend to accept that’s just how you are.
After some time, I got to learn who it was okay to stop and talk to a little more. Eventually I made friends with one of the single mums, and we would go for walks into town together.
You may feel you want to get friendly with the other people who live there, particularly if you don’t know anyone else in the area. I would recommend that you get to know people what the people are like slowly over a period of months before you do this, and sometimes it might be best avoided altogether.
You don’t want to end up in a situation where you feel coerced to do things for people, where you are harassed and not left alone, where you feel unsafe, or where you will come to the negative attention of the housing association. If you get into a sticky situation with people where you live, you can’t get away from them without forfeiting your right to accommodation, so this is really important.
Being discerning can be tough when you are vulnerable, but it is important to safeguard yourself from getting drawn into other people’s issues or into volatile situations, particularly around drugs or alcohol.
– Be selective about what you tell others
It is best to avoid giving out any personal information, or details about your personal circumstances. Definitely do not give away any information about possessions you have that might be valuable, or anything to do with money, which benefits you get, how much you have, when you are going to get some etc. If people ask, just play dumb and say you can’t remember.
You may also want to be careful about sharing where you live with people who don’t live there either. Your address may be known in the area as somewhere vulnerable people live.
– Keep your door locked
Even if you are just going out to the bin and will be minutes: lock it behind you. Don’t leave anything you care about in the communal areas.
– Don’t lend or give out possessions
If you lend things, there is a chance they may not be returned. Also be wary of giving out things like cigarettes, unless you are sure you can trust the person not to hound you for more from then on! A neighbour of mine would drunkenly bang on certain people’s doors in the middle of the night demanding tobacco.
Don’t allow yourself to be indebted to anyone.
– Don’t invite other residents into your flat
There are some people who will be very interested to see what you have in there. Keep valuables away from windows, and keep the curtains drawn in rooms where you can easily see in.
– Always lock your door at night
I used to keep my door locked even during the day when I was in there. Always make sure your keys are nearby though of course, in case of a fire or emergency.
– Avoid answering the main door unless you are expecting someone
Our front doorbell would ring all the time, and because I was in the front ground floor flat, I ended up opening it all the time.
I opened the door on two separate occasions to some men wanting to find people who lived here due to drug debts or thefts in the town. I just played dumb and said I didn’t know these people because I didn’t want to be involved. I was lucky that no one forced their way past me, as they easily could have if they wanted to.
If you’re not expecting someone, you don’t have to answer the door.
– Don’t leave your own door propped open when you are inside your flat
Try not to let visitors see inside your flat, even just a quick glance. Visitors are complete unknowns because the housing association will not even know who they are, and they may see you as an easy target.
– If there is an incident, keep your involvement to the minimum (where you can)
Incidents can happen a lot in this kind of accommodation: drunken fights, anti-social behaviour, criminal damage, domestic abuse, thefts, overdoses etc.
You may have to make judgement calls about whether to intervene if an incident occurs in the communal areas. I’d say that most of the time it is best not to get involved in anything and to stay in your room with the door locked. You may decide to call the police, and by all means do. It might be best to do this discretely, if possible.
One evening, a female neighbour was being attacked in the hallway by one of her male visitors. She was banging on my door screaming to be let into my room so she could escape him. It was a really scary situation.
I had already called the police, but then had to decide whether to let her into my flat to safety and risk him coming into my room too, or to keep my door locked and let him keep attacking her. I eventually let her in. Luckily, he didn’t follow her in, and I locked the door behind her. The police arrived minutes later and arrested him. It is the only time I let someone into my room.
I can’t tell you what to do if something like this happens, as every situation is different, and it is up to you to make judgements in the moment. I exposed myself to violence when I opened the door for her, and although I feel now that I made the right decision in that particular moment, it could easily have played out very differently and I could have been hurt too.
Remember, if you are ever seriously afraid for your safety because of someone’s aggressive behaviour, you can call 999.
Be aware of people who come into your flat to perform maintenance or work duties, even if they are from an official company or service. Most will be friendly and professional and there will be no issue, but they will know that you are vulnerable because of where you live.
If any maintenance person uses your contact details to send you private messages, they have crossed a line, and you should report them to the company they work for, if you feel safe enough to do that. At the very least, they are breaking data confidentiality if they are using your name or number to add you on Facebook/Snapchat/any other social media, or to text or call you.
Block them. Don’t let them flatter you into engaging with them. Anyone who solicits you, knowing that you are living somewhere for vulnerable people, is not the sort of person you want to respond to or meet up with.
This includes the police. I am sad to have to say this, but my friend in the accommodation was contacted by a police officer who made a series of advances towards her, after he had attended an incident there. She complained and it was taken to a tribunal, which she found a very distressing experience.
That this happens at all is so wrong and incredibly inappropriate, but it can happen. Please be aware of everyone who is in your space, no matter who they are.
Keep any texts or messages and make written notes of anything not stored or recorded by your phone, whether you are planning to complain or not – you may change your mind down the line and decide you want to. If you have a support worker or professional who works with you, it may be a good idea to mention to them anything untoward that happens, if you feel able to trust them.
Sadly, I was bullied by individual members of housing services staff in both of the homelessness accommodations I lived at. When I stood up for myself, they used their position of power over me by threatening me with the loss of my accommodation.
Threats to have you ‘thrown out’ if you do not comply are NOT ACCEPTABLE. I’m not talking about official warnings from the housing organisation if you are breaking rules. I’m talking about individual staff members making off the record threats in order to wield their own personal power over you when you try to stand up for yourself.
This is abuse and it sadly happens more than you think.
I have been spoken to very badly over the phone by housing officers, too, as was my one friend in there. The general impression was that they automatically saw everyone who lived in this type of housing as potential troublemakers and low-lifes who should be treated accordingly.
This is not acceptable!
Please do not think that because you are in emergency housing that you do not deserve to be treated with humanity and dignity.
You are not a second-class citizen. You have the same rights to fair treatment as everybody else.
Of course there are helpful and compassionate staff as well – hopefully you will be luckier than me!
– Keep notes
You can do this on paper or in a notepad app on your phone. Keep records of any interactions where you are not treated unfairly or badly. Include dates, times, and details of what was said both by you and them. If it keeps happening, having a timeline and ongoing record of the incidences will really help if you decide to report it.
I understand if you don’t want to report anything while you live there, but if you collect notes, you can complain about them once you leave. Even if it is too late by then for the complaint to benefit you, if every person these people bullied made an official complaint about them, a pattern would emerge that their organisation/the council wouldn’t be able to ignore.
If you have a social worker, care co-ordinator, community nurse, or any other supportive person who works with you who is not part of the council or housing association, it can be a good idea to share with them about any bullying or abuse that is happening, particularly if you trust them.
– Try to stay as calm and assertiveas you can
Try not to get abusive back, no matter how upset or angry you are. Your true power isn’t in answering back in the moment, but in making a record of how you are being treated, and then getting support to challenge them on their behaviour later.
Don’t stoop to their level – you are better than that, and you are more likely to get somewhere by taking the higher ground, getting support, and going through official channels.
I have included contact details of some really helpful charities at the bottom of this article.
The services that run the emergency housing, such as the council and the housing association, have a lot of power over you, and they are not always fair. This relative position of powerlessness that you are in is another way that you are vulnerable.
There are a couple of really important tips I want to share to help you retain your power as much as possible.
– Make a photographic record immediately after getting the keys
Despite me leaving the flat cleaner than when I went in, and the woman I handed the key back to saying verbally that it was all fine, I was sent an invoice a year down the line saying I had not cleaned properly and demanding hundreds of pounds in compensation.
Luckily, I had proof, and they had no choice but to waive the invoice in the end. I still have no idea why this happened suddenly a year after I had left – no explanation was ever given to me by them, despite me requesting one.
When you move into your room or flat, the first thing you should do is take photos or video of the whole place – floors, ceilings, walls, all appliances, all the bathroom and kitchen amenities like the toilet, bath, sinks, cupboards. The more you photograph the better. Make sure you include any already-damaged areas or items (a common one is kick/punch holes in internal doors).
You want there to be a record of how the flat looked when you moved in, so they cannot charge you later for damage that was there before you arrived.
Save these photos/video – your phone should automatically record the date of your moving-in day on them. Do it as soon as you get the keys and ideally before you’ve moved any of your things in.
Do exactly the same when you move out, on the actual day you move out, after you have cleaned and emptied the place of your stuff, and ideally just before you hand the keys back. Your phone should record your moving-out date on the photos.
When you move out, the important thing is to show how clean you have left it. Clean it well, and then get close up evidence of how clean it is!
Keep all of these photos and videos for up to a couple of years after you move out. As I say above, I was challenged on how I left things a YEAR after I had moved out, so it is best to hold onto those pictures as long as you can. If you need them off your phone, email them to yourself, or download them onto a memory stick or a laptop etc, if you have access to one, or perhaps to a friend’s one.
You might even ask the person who is collecting the keys from you to put in writing that the flat was fine when you left it, rather than just giving a verbal okay. They might refuse if it isn’t their policy, but it could be worth asking.
– Stick to the rules!
Avoid bringing drama or issues to the accommodation, because those in charge of it have a lot of power over you and can make your life very difficult. They can keep you there longer by temporarily removing your option to move into more permanent housing, and they can evict you. If you are evicted, it can make it harder for you to be housed again in future and you could end up on the streets.
You definitely don’t need any extra stress to worry about! Protect yourself from this by playing by the rules of the accommodation as much as possible.
Remember, your situation is temporary (even if it feels like forever) and eventually you will be housed in a place of your own, where you will feel much safer and more stable, and you won’t need to follow as many rules.
Where to go for help and support
If you need help with any of what I have discussed here, I recommend you:
Speak to your support worker, social worker, or any impartial professional who knows you and who you feel you can trust.
Speak to the housing association or the council, depending on what the situation is. Be careful as they may close ranks – it might be best to get the support of one of the below organisations first.
Here are some very good, impartial organisations you can go to for advice and support:
They have a free national helpline you can call to speak to an adviser, or you can find information on their website that may be of help.
Both are a good place to start and they will be able to signpost you onwards if you need more specific support. They will have the most up-to-date information available.
Of course, different people will have different experiences in emergency accommodation, and I do hope yours is better than mine. I think it is important to be aware of possible issues that can arise, just in case.
Stay aware, maintain boundaries, and keep yourself to yourself as much as you can: those are probably the best bits of advice I can give.
Record everything and keep those records for a couple of years.
Get help from people or organisations that are impartial and that can support you. You don’t have to go through anything alone.
You will get through this and it doesn’t last forever, even if it feels like it at the time.
This article is my personal account of living with Visual Snow Syndrome.
When I realised something was wrong:
Everything began when I looked at the carpet one day and I could see lots of black dots dancing all over it, like the static on an old TV screen. It was a bit strange, but I didn’t think too much of it at the time.
But it didn’t go away. Even weeks later, every time I looked at the carpet, I would see these dots.
Then I realised that when I looked at the walls, the dots were there too, but they looked pink and green. I began to notice vague bands of shadow all over the walls. It looked like there were moving grubby, grey, rectangular patches all over them.
Again, I carried on without giving too much thought to it.
It was when I was watching the darts on TV a few months later, that I realised something was definitely not right.
When I looked at the dartboard on the TV and then I looked away, I could still see it in front of my eyes. I would look at the TV and then look at the wall next to it, and there would be a ghostly image of the dartboard for about 10 seconds, before it slowly faded away.
10 seconds sounds quick, but when you think that your vision is normally instant, as you look from one thing to another, 10 seconds is a long time for an object to remain.
The more I noticed it happening, the more it was bugging me. It happened with other things on the TV, too. When I watched the news and looked away, and I could still see the newsreader and their desk in front of my eyes.
It wasn’t an exact image, with colour, but an inverted, negative image in black and white, like this:
The TV became more and more difficult to look at, and I avoided watching it. But it wasn’t just the TV that was causing the images. When I looked at pictures on the wall, or pieces of furniture, they’d still be there when I looked away.
I began to notice mini flashes of light going off in front of my eyes, like those you get if you stare at a naked lightbulb and look away. I was feeling dazzled just from looking at a lightly coloured wall, or walking into a room with a window, even when it was not sunny. The TV became unbearable.
My eyes had become really sensitive to light, and I had to wear sunglasses whenever I went outside, even when it was cloudy.
If I got up in the night, the bright spots seemed to crowd in on me and block my view in darkness, and when I was in a brightly lit room, I could clearly see what looked dark blobs and lines right in front of my eyes, and they moved around as I moved my eyes around.
When I sat in my living room in the evenings in dim lamp-light with my partner and my cat, at times it became hard to make out the features of their faces. That made me feel sad.
All these things were beginning to get uncomfortable, upsetting, and disturbing.
I started searching online for my symptoms, to see if I could understand more about what was happening. I think I probably searched for ‘fuzzy dots in front of eyes’ or something like that, and I ended up coming across something called Visual Snow Syndrome.
These are the main symptoms of Visual Snow Syndrome:
Moving dots over your entire field of vision, like snow or static
Bright flashes of light or colour
Small objects appearing to float in front of your eyes
Being sensitive to light (known as photophobia)
Images of objects remaining, even after the object has left your field of vision (known as palinopsia)
Shadow images of floaters, that move as you move your eyes
Starbursts around lights, such as car headlights or lightbulbs
I was immediately sure that this was what I had: I could relate to all of it.
I discovered that the images that stayed when I looked away were something called palinopsia.
The blobs in front of my eyes that obscured my view were things called floaters.
I was glad to find a name for the symptoms I was experiencing, and that I was not the only one reporting them, but I was dismayed to see it was a condition that was not yet fully acknowledged by many medical professionals.
I read that there were doctors who thought it could be linked to migraine. Although I did get these, the eye symptoms were there all of the time, not just when I had a migraine.
From what I read, it seemed to be some sort of neurological disorder, but other than a few doctors that had showed an interest, it was largely unrecognised.
I had so many questions. I wondered in particular what had caused this to happen to me now.
I was also afraid that there might be something physically wrong with my eyes, and that my eyesight was deteriorating in some way. I knew I needed to get my eyes checked out.
Trying to get help
The first thing I did was see an ophthalmologist at my local Specsavers, and I paid to have as many tests done as she felt were necessary. I was continuously blinded by the lights she was shining in my eyes. The whole experience was disorienting and verging on painful, and I was embarrassed about coming across as a high maintenance customer, who had to keep stopping and waiting for their sight to recover.
The ophthalmologist was great, though. She told me that she could find nothing physically wrong with my eyes, which was a relief. She could see that there were some floaters there, but she said that was quite normal for someone who was approaching 40.
She went away to speak to her boss, and then came back and told me that they thought it was probably Visual Snow Syndrome. I had not mentioned it to her, because I hadn’t wanted to influence her opinion, so it was validating to hear her say it. She said she would write a letter to my GP, asking them to review my medications in case anything could help.
I was hoping I might be referred to a neurologist. I had seen one when I was diagnosed with fibromyalgia, only the year before. I was wondering if this was perhaps linked, especially as it was all coming after a period of poor mental health.
Unfortunately, I came up against some resistance when I finally spoke to my GP.
After I pressed the issue with her again, my GP said she would like to refer me back to the mental health team, which I had been discharged from some time ago.
I tried to explain that I didn’t think it was connected, but she still made the referral. I had no choice but to back down and just go through the motions, so we could rule out mental health as a cause, in a process of elimination.
I waited about four months for my referral to go through and during that time I went back to my doctor yet again, because my eye symptoms were beginning to really upset me.
I had told a couple of my friends about what had been going on, they were quite shocked at what I was having to deal with. They encouraged me to go back to my GP and demand more firmly to see a neurologist. I did exactly that, but I was denied again. She said that there was likely a psychological element to all this. Once again, I gave in and decided to go along with it and see it through.
I was allocated the same care co-ordinator I’d previously had. I told her about my issues with the visual snow. I mentioned that it was quite a rare condition that doctors did not know much about (big mistake!). On hearing that, she instantly dismissed it.
She told me that she thought it was to do with stress. I didn’t feel at all stressed, and I didn’t agree, but once again I decided to just go with what the professionals were telling me. There wasn’t much else I could do.
Even if you know in your heart that the professionals are wrong, sometimes you have to go along with their version of things, for as long as it takes to finally disprove it.
After a few sessions with the psychologist focusing on other subjects, I reminded her about my eye issues again. She said that she thought it was likely happening along with some dissociative episodes I had been having. I told her that the symptoms didn’t tie in with the other episodic dissociative symptoms, because they were there all the time. She listened, but then the eye symptoms were completely swept under the carpet and lost in amongst a number of other issues that we discussed.
I eventually completed the psychology sessions and was discharged from the mental health team once again.
Unfortunately, my eye symptoms have not improved at all. They have been the same for well over a year now.
I do think that if your health record has mental health issues on it a lot of what you experience can get attributed to your mental health by medical professionals, especially those symptoms that are harder for them to understand or solve easily.
Living with it:
The walls are still covered with moving pink, green or black dots. Everything lightly coloured looks permanently dirty and cobwebby, and I’m dazzled and disoriented as I go about my day.
It is like I’m looking through mist or a smudgy, dirty window all of the time, and I often need to frown or squint to see detail. I’ve started wearing glasses when I read, use the computer, or watch TV, and although they sharpen up a little of the fuzziness, they don’t do anything to help with the visual snow symptoms.
A lot of the time I try not to dwell on it, because thinking about it too much can make me feel hopeless, trapped, and overwhelmed.
Lying in bed at night is probably the most difficult time of day for me, because when I look around the dimmed or dark room, I feel surrounded by moving swirls of dots, shadows, streaks, and shapes. The tiredness at the end of the day makes it feel all the more exhausting.
The most distressed I have felt through all of this was the moment I realised that the dots, shapes, and lights did not go away when I closed my eyes. Lying in the dark in bed, I realised there was no escape. I couldn’t get away from it, ever.
I sometimes describe the symptoms to people as ‘tinnitus of the eyes’, in that it is a constant ‘noise’ in the background that you can’t turn off. At least with tinnitus, however, you can put on some white noise or music to block it out. There is nothing like that for my eyes.
In the absence of the input of medical professionals, I have my own theory about why I may have developed Visual Snow Syndrome. It began not long after a period of severe stress and trauma, which I experienced over an extended period of time.
I believe that my neurological system became so stressed that I developed fibromyalgia, visual snow syndrome, and tinnitus, all around the same time.
The common denominator for all these things is that they are neurological.
Fibromyalgia is a neurological condition that was not acknowledged for quite some time by the medical profession. There is still not consensus on why it develops, but it often occurs after someone has experienced mental ill-health or a traumatic experience.
Your neurological system works overtime and tells your brain that you are in pain when you aren’t. I’m not an expert, but my theory is that, in the same way, my neurological system began working overtime when it comes to the input from my senses.
My sight is altered, because the signals carried by the nerves between my eyes and my brain are not working properly and going off in ways they shouldn’t, and the same is happening with my hearing, causing the tinnitus.
The hunches or theories of patients and sufferers rarely hold much weight against the opinions of medical professionals, but I think it is important in this situation to try to understand why this has happened.
I hope that one day more will be understood about this condition so people like myself will finally be believed, validated, and given more support.
Customer service is often viewed as low-skilled work, but there is actually an art to doing it well.
I have had a number of customer service jobs, including working for various auto breakdown services, and a private pathology lab. I was often on the phone to distraught people: perhaps they’d had a smash on the M25, and they had 3 terrified children with them, or they were waiting for a breast cancer test result that was running late and were petrified the delay was due to bad news.
Those calls were much trickier than the average; however, through them I learned some fundamental principles that have continued to help me help others, including work with prisoners, rough sleepers, and those with mental illness, for many years since.
Whether you are dealing with a vulnerable person in crisis or a customer on the phone, these principles come in handy.
Here are 9 that I see as the most important:
1. What people define as a crisis is relative
A crisis can be an enduring situation where someone’s entire life is collapsing quite literally, or it can be a sudden, short-lived incident that causes acute stress but is able to be resolved within a day, or even a few hours.
What one person experiences as a crisis may not be the same as another.
Timing is also a consideration – someone might normally cope very well, but they might not have the emotional resources to cope at other times, depending on what else is happening for them.
All reasons for distress are valid and relevant because of the meaning they have for the person experiencing them.
It is best to avoid judging someone coming to you in crisis, even if their issue does not resonate with you, or it could be seen as minor or silly in comparison to others.
People need to feel like their problems are not just valid, but that the extent and gravity of their problems as they see them is acknowledged.
People, understandably, need to feel like they matter, and that their problems matter to you as much as they matter to them.
2. You can make a big difference in just one interaction
When someone is already stressed out, whether it is because they’ve dropped their phone down the loo, or they’ve found themselves suddenly homeless, the last thing they need is a difficult interaction when they reach out for help. This only makes people feel more stressed, angry, and frustrated with their situation.
We all know what a relief it can be to have a problem sorted out speedily and adeptly. The call handler is friendly, empathetic, and competent, immediately putting you at ease. They give you opportunities to ask questions, explain what you’re not sure of, and tell you what they will do to help. You come off the phone feeling lighter and less worried about your problem, now it is in someone else’s capable hands. Your stress levels decrease immediately.
Most of us have had experiences at both ends of this spectrum and can remember how differently we felt after each of them.
You can radically affect how stressed someone feels in quite a short space of time, depending on how you approach their issues and how you treat them.
You do not have to work in a call centre. The same principle works when supporting people in social or healthcare environments.
Make the most of those opportunities. Lessen their burden, instead of adding to it.
3. Anger is fear and a need to be heard
When someone in crisis appears angry, it is often fear in disguise.
Understanding this is key to being able to help someone whose stress comes across as anger.
If someone seems frustrated or angry, I stop talking and I listen. I let them do the talking.
After they get their initial rush of frustration out, most people begin to relax, especially if they aren’t coming up against resistance from you, and it is obvious that you are listening.
A calm, attentive reaction often takes people by surprise. They’ve most likely been expecting a battle, and you don’t let that happen.
You will notice their relief emerging as they begin to slow down, take some breaths & come to a calmer, more centred place. Sometimes people begin feel a bit embarrassed at their outburst, and they apologise. So many times, I have heard the words:
At which point I say ‘it’s ok, I understand that this is very difficult for you/stressful for you’ or something similar.
People often just need to be heard and have their fears acknowledged. They need to be able to share the impact a situation is having upon them and have someone be a witness to that. They need to feel the emotions they are having are externally valid.
Anger is rarely about you as the helper: it is more about the person’s situation, and how afraid and out of control they feel because of it.
(N.B. I am not saying anyone should have to tolerate aggression. It is not okay for someone to be abusive. I have found that active listening, followed by focusing on joint problem-solving, is very effective in de-escalating anger. If it isn’t working, it is important to be assertive and possibly end the interaction if they are being aggressive towards you.)
4. People need allies
Someone in crisis who is reaching out for help longs to feel that they aren’t alone.
Being distressed and alone is something no one should have to experience.
Knowing that someone is helping to shoulder the weight of their problem (especially someone who has access to resources to help them fix it) can make a huge difference to how powerless someone feels.
It doesn’t mean that you should do all the work for them, or that you should step outside professional boundaries. Even simply ensuring the person has a positive and genuine interaction with you will help them feel less alone. Be a human.
Even if there’s little you are actually able to do for that person, just listening and acknowledging their frustrations is a wonderful way to be an ally.
5. Be reliable
This is one of the simplest, but also most powerful, of these principles.
I cannot stress enough how important it is to be reliable when you are working with someone in crisis.
It is likely that you represent a glimmer of hope for that person, so don’t just throw that away.
If you say you’ll do something, you must do it. If you forget easily, make a note, or put it in your calendar.
If you’re not able to do what you said you would, let them know. Get in touch and tell them that you’ll need a couple more days to find something out, or that you’re going to be trying something else instead.
Not doing something when you said you would (especially when someone is relying on you to help them), shows that person that they don’t really matter – even if that is not your intention.
Don’t just leave someone in limbo, wondering what’s happening. Call them. Get in touch and let them know.
It might feel easy to get lazy about these details, but don’t let that happen. It is that important.
If you can’t commit to an action or communication, it is probably best not to make or state those commitments in the first place.
6. Be honest
Don’t take the easy road and simply tell people what they want to hear, just to make your life easier. Honesty is everything – even if it means delivering less than satisfactory news.
People appreciate being told the truth.
Most people prefer news that isn’t what they want to hear to lies or vagueness given only to placate. This is otherwise known as ‘fobbing someone off’, and most of us know how that can feel.
7. Move people forward
A manager and trainer at Citizens’ Advice taught me this:
You may not be able to solve someone’s problems in one go, but you should aim to move them on a step further than when they came to you.
Openness, warmth, and a listening ear may be helpful in the moment, but you should also think about what you could give the person that they can take away with them.
It might be something tangible such as an information leaflet or a telephone number to call, but equally important are hope, the relief of a problem shared, the courage that comes from having an ally, or even some restored faith in humanity.
We can all think of times when we’ve walked away from an interaction feeling more hopeful, whether it was from a medical appointment or a call to the insurance company.
Think about how you want that person to feel when they put the phone down, or walk away from your office.
People feel better when they can see where they are going, or what steps to take next. It is like finally receiving a map to somewhere when you’ve been completely lost.
8. Everyone can benefit
We could probably all do with more customer service in our lives! You don’t have to be in an official ‘helper’ position.
I use these principles in my daily life to support others, even my partner, my parents, and my friends. I regularly ask myself:
9. Be human
I’m not suggesting by using customer service principles we should all become call-centre robots. Not at all. Good customer service is warm, supportive, and validating. Everyone is treated as an individual equally as important as the last, and everyone’s plight is as valid as the next.
Nurse, doctor, receptionist, call handler, or friend: any of us can make a difference to other people’s distress by thinking about how we interact with them, and what effect that might have on them. It doesn’t matter who you are or what position you hold, these principles apply to everyone.
It is about being a human being talking to another human being: the simplest things are often the most powerful!
Being detained under a section of the Mental Health Act is an experience that can be difficult and stressful.
It involves being removed from familiar surroundings, sometimes against your will, and being placed on a mental health ward for the safety of yourself or others.
Not only can it cause a lot of stress at the time, but it can also have profound and lasting effects on a person, which may continue to have an impact long into the future.
This is something people don’t tend to talk about much, and it can be difficult to know where to turn for help if you have been affected.
Although different people may feel differently about this experience, here are 10 ways you might feel.
1. Ashamed or embarrassed
No one should have to feel ashamed or embarrassed by needing urgent mental health care, however due to continuing stigma around serious mental health issues, this is a common experience for many people.
Those feelings could be about things you said or did that were out of character for you. Perhaps you feel that you let yourself or other people down in some way. This often goes along with feelings of guilt.
Perhaps people around you, such as your loved ones, or even your neighbours or work colleagues, know that you were sectioned, and it makes you feel embarrassed, and you worry about what they think of you. This can cause you to lose self-esteem and confidence, and not want to be around those people.
2. Guilty or sorry
Feeling ashamed is often tangled up with feelings of guilt. You may wonder why you acted a certain way, or why you didn’t do enough to stop it happening.
Perhaps you did or said things that you did not mean because you were so unwell, and now you feel bad about it. Maybe you caused other people to be distressed or upset, or even broke the law, because you were not your usual self, and you are carrying feelings of regret.
You might even want to say sorry to certain people, but you don’t have the opportunity, or you don’t know how.
The experience of being sectioned is one that not a lot of people go through and it is also deeply personal. It is not something that is easy to talk about with other people.
Your loved ones may be too close to the situation for you to want to talk to them, or perhaps you feel that they won’t understand because they have not been in the situation themselves.
Because your experiences involve services or professionals, you might not feel you can talk to them about this, or you may feel like the last thing you want is to be involved with mental health services again.
4. Like you don’t belong
You might find you feel differently around other people now. You might feel that you don’t fit in anymore because you have been through something that has changed you so much that you can no longer relate to others in the same way.
You may prefer to be alone and away from other people because of how you feel.
You might still feel angry about what happened, and even harbour resentment about what you experienced.
This could be due to feeling let down by loved ones or people you thought you could trust. It could cause you to avoid these people.
It could be due to what happened whilst you were sectioned and how professionals or services treated you. It might lead to you not wanting to engage with services in the future.
You may find that bad memories of your experience come back to you, even years later.
You might see something on the TV, such as programmes about mental illness or movies where people are trapped, held against their will, or coerced into doing things they don’t want to, and find these things upset you because they remind you of your experiences.
You might get flashbacks or nightmares about things that happened, or physical and physiological reactions, such as panic attacks or dissociation.
You might not feel anything at all.
Sometimes when things are too painful and too much to bear, your brain may try to cope by shutting off, and that can make you feel numb.
You might be unable to properly feel happy or sad about anything. You might feel indifferent about everything and find it hard to connect with other people because of it.
You may prefer not to be around other people and might lose interest in a lot of things you’d usually enjoy.
Things may have happened during your experience that still don’t make sense to you. Things may have been said or done by people around you that you still don’t really understand.
Wondering ‘why?’, and not having any opportunity to ask or find out, can lead to thoughts, images, and questions that continually bug you. That can make you feel uncomfortable, confused, and make it harder to come to terms with your experiences.
Being restricted and having your freedom taken away can make you that you have very little control over your life, even after you have your liberty back again.
It is very hard to forget that feeling of helplessness once you have felt it.
You might not have the mental strength afterwards to even think about your experiences, let alone talk about them, and prefer to push them to the back of your mind.
Unfortunately, intense feelings and emotions don’t just go away, and may continue to affect you deep inside.
10. Any way you like
Everyone can have different experiences whilst they are sectioned, due to many different factors, and that will have a bearing on the way you feel afterwards. Everyone is different, and people deal with things in different ways.
It doesn’t matter if you feel differently from other people who have had this experience. There is no one way you should or should not be feeling. Just because someone you know seems ok afterwards, doesn’t mean you are expected to as well.
You might be feeling all or none of these things, or some that I haven’t even mentioned.
However you are feeling, it is ok to feel like that, even after a long time.
Even if you went through the experience of being sectioned some time ago now, you have been through something very personal and difficult, and it is okay if you are still not over it.
If you do have someone you trust to talk to about it, perhaps you could share with them how you are feeling. You could try writing them a letter, or drawing pictures, if it is easier to get your feelings out that way.
If you don’t have anyone you trust, you could write how you feel in a private journal, which no one else reads but you. You could create art that helps you express how you are feeling.
Contacting a mental health charity is another a good idea. They are independent from services and people who work for these charities do so because they care about people like you. You could call a helpline and speak to a trained person who will listen to you. They won’t judge you, and could help you make sense of what you’re feeling.
I want to raise awareness of the fact that there is a need for specific support for people who have been sectioned, on top of the support you might get for your mental health condition. Being detained in this way is an experience that can affect you very deeply, and it is important that this is recognised.
It is important that mental health treatment does not add to the trauma or distress that people are already experiencing, and that they don’t continue to carry that burden into the future.
If you are a mental health practitioner or healthcare worker who works with people who are/have been sectioned under the Mental Health Act, please be aware of the lasting psychological effect this can have on an individual. Checking in with how someone feels about their experience days, weeks, months, even years after a section is rescinded could be really helpful for that person’s wellbeing. Just being able to talk about it with someone who is compassionate and open to listening could make a huge difference to how someone feels about their experience.
Being detained under the Mental Health Act and confined to a psychiatric ward is something that is meant to happen in your best interests, but it most likely won’t feel like that at the time.
Of course, everyone will feel differently, but here are 8 ways you might feel.
Being free to mostly do as we choose is vital for us as human beings in today’s society. Being told that you cannot leave somewhere, or go out for a walk to stretch your legs, or being forced to do things and go places you do not want to, can have a profound and lasting effect on how you feel about yourself and about the world. It can make you feel like you have very little personal power left.
One of the most natural emotions to feel when you are no longer in control of what is happening to you is anger. You might feel angry with the professionals who assessed you, because you don’t agree with their decision. You might feel angry with your family or loved ones if you feel that this has happened because of them. You might be angry because you feel you are not being listened to, or because you feel that the staff are against you.
There are many things to feel angry about, and often other strong emotions, such as fear, can feel like anger.
Sometimes anger can lead to you lashing out and this is understandable if you feel stuck in such a confined and powerless situation. Unfortunately aggression may lead to further restrictive interventions or negative staff attitudes towards you, making you more angry and creating a cycle.
You may not be sure what is happening, know where you are, or know who these people are who are stopping you from doing what you want to do. You might be scared of the ward you are on, the other patients, or the staff, or what you think is going on.
The way you feel and act when you are afraid can often feel and look the same as anger.
No one should have to feel ashamed if their health has led to them needing urgent mental health treatment or support, but stigma in society around serious mental health problems continues, so it is not surprising if you do feel this way. Many people do.
Your feelings of shame may be about how you perceive yourself, and also about what other people might think about you.
You may only be able to see or speak to your loved ones at certain times or for short periods. You might not get along with any of the other patients, or be interested in them, and spend a lot of time on your own.
If you are moved to a hospital out of the area, it may be very difficult for you to have anyone visit you, and you may feel very far away from anything and anyone familiar.
You might not even want anyone to visit or call if you are feeling bad, such as feeling ashamed, or if you are angry with people seemingly playing a part in your current situation.
You can still feel lonely, even if you have purposely decided that you don’t want to see or speak to anyone.
When you are feeling irritable, you can get annoyed or stressed out at things very easily. This can happen for many reasons, such as in response to outside stress, or because you feel bored and fed up.
Psychiatric wards are usually not calm places. They can be noisy and uncomfortable, and boring if there are few activities, or if you don’t feel like joining in. All of these things can make you more irritable.
Other patients can be noisy or disruptive because they aren’t very well. Being stuck in a fairly small area, with people you would not normally choose to be with, can lead to you feeling irritable and agitated.
You may have children, a partner, or pets, and be worried about how you being away from them is affecting them. You might be worried about how being sectioned will affect your life in terms of your job or your reputation. You may be worried about your money situation or where you are going to live.
If you are an informal patient on a mental health ward, you will often be allowed to come and go as you please throughout the day.
As a patient on a section, however, you cannot go out for leave unless it is legally agreed to and signed off by a psychiatrist. This is called section 17 leave. If the psychiatrist is not in over the weekend to do it, or if they decide you won’t be allowed it yet, then you cannot leave the unit.
This means spending all your time in just a few spaces – a bedroom, hallway, lounge area, dining room, a small yard, maybe a quiet room, and occasionally activity rooms – sometimes for some time.
Feeling trapped can make you feel irritable, stressed, and angry, and more likely to feel aggressive towards others.
It can also have lasting effects on you mentally because of the stress it can cause.
These feelings are all very natural responses to the experience of being detained under a section of the Mental Health Act.
Although I have set them out individually here, these emotions do not happen separately, but are all entwined with each other. Feeling one will often make you also feel many of the others.
You may not even be able to tell which of them you are feeling because they all get so easily tangled and jumbled up together.
Your stress levels can affect the way you act and how you come across, which in turn might affect the way others respond to you and the care that you receive.
All of this can lead to an extremely stressful experience, the effects of which you might carry with you sometime into the future.
It is quite normal to feel any of these emotions, or any others, when you are in this situation.
If you are currently on a section on a mental health ward of any kind, it is highly likely that you are legally entitled to an advocate.
This is someone impartial, who is not part of the staff who are caring you, that will listen to you and support you to be able to express your views, and who will help you stand up for your rights.
If you would like to speak to an advocate, let a member of staff on your ward know. They will be able to organise that for you.
Alternatively, you can find one and contact them directly by searching online.
Here are some great UK charities with resources to get you started: