Dennis O’Connell takes us on a tour of a locked ward in a psychiatric hospital, where he worked as an orderly for seven years.
I worked on a locked ward for part of my nursing training and I remember the day room filled with patients all lost in their minds, seemingly never to escape. This book brought those memories back quite sharply, from the feeling of despair to the undercurrent of potential violence. Not all patients are capable of controlling themselves and they can be very dangerous when unwell.
O’Connell discussed how they managed this with deescalation when possible, medications if needed, and tossing the patients onto the ground in a control hold while they stabbed them with Haldol etc if nothing else worked. He mentions some other treatments- ECT, CBT, tapping- but the emphasis is on the conversations he had with the patients and his fellow staff.
It’s an eye-opening read, though the author is a wee bit too fond of his sense of humour - sometimes I got the impression he recorded things purely to show how witty he was- but it’s well worth a read. I read it for a book I’m researching and it will be very useful. ( )

This is an autobiographical account of life on a psychiatric ward, written by a Scottish nursing assistant and literature buff, who moved from caring for dementia patients onto Ward 25 of his local hospital after a little persuasion from his friend Charlie, the charge nurse for the Intensive Psychiatric Care Unit. He worked there for over seven years and wrote this book partly as a means of fighting the ignorance and fear that still surrounds mental illness for many people. As he writes in his introduction:

"I hope it will inform people about the nature of serious mental illness and how it is treated. I hope it will correct misconceptions, and show that people with serious mental illness can say or do funny things, sad things or bad things; be brave, resolute, irritating, selfish, generous, kind, cruel or petty just like everybody else. Mainly, though, I want it to celebrate a group of people who are misunderstood, mistrusted or viewed with apprehension - the patients."

I am a pretty devoted reader of anything to do with mental health problems, partially due to my own experiences and partially thanks to my interest in the social sciences generally, so this was a must-read for me. While there are many memoirs out there about the experience of depression, schizophrenia, addiction and any number of other issues, it's unusual to find a memoir by someone caring for those people in a professional sense. I must confess, while I don't have the same kind of fears and prejudices that I'm sure a lot of people sadly have about people with mental health difficulties, as 'one of their own' I DID have fears about what life was really like behind the locked doors of a psychiatric ward, because in the back of my mind I can't help but think that one day I could find myself in need of their help myself and I had all kinds of grim ideas about what they might be like!

Happily, just like Direct Red by Gabriel Weston made me feel better about the prospect of ever having surgery, The Locked Ward, despite its grim moments and the anger in the final pages over the decline in staffing and funding, was quite a reassuring book. It explains quite concisely what a modern psychiatric ward is like - how it's laid out, how it's run, what the daily routine is like - as well as introducing the reader to some of O'Donnell's most memorable patients. His dry Scottish wit is a perfect foil for the more brutal side of his work, and the warmth and compassion of not just him, but the majority of the staff on the ward, shines from the pages. Of course he's only human - as are his patients - and there are people he dislikes, people he is afraid of, and fellow orderlies who occasionally need to be smacked upside the head for making stupid remarks. But those aren't the people that really seem to stick for him - or for the reader. His affection for the eccentric, kind, kooky, spirited, gentle, stolid and sad people around him is truly heartening, and it's clear that the people underneath the illnesses were being heard, understood and befriended during their time on the ward.

This is where O'Donnell really shines, in my opinion: in being quite blunt about things like symptoms, medications, restraints and the unpleasant nature of some of his work, while never losing sight of the diversity and humanity of the people he helped over the years, their individual strengths and personalities, the way they kept fighting to claim those personalities back even after multiple admissions. The reader comes to care about some of the patients as much as O'Donnell clearly did, laughing at their more outrageous moments and sighing over their unhappiest ones. By turns moving, jovial, informative, funny, angry and earthy, this is a book I'll be heartily recommending to anyone with an interest in medical care and mental health, as well as those who fancy reading a mental-illness memoir told from the OTHER side, the side of a care provider rather than the patient. In fact, if I were a braver soul I'd be recommending it to EVERYONE - because the more books like this people read, the more they understand what mental illness means, the less stigma there will be towards the people battling their demons on a daily basis. That can only ever be a good thing. ( )