The established state and patient X’s rebellion
| Published date | 11 June 2018 |
| Pages | 128-133 |
| DOI | https://doi.org/10.1108/MHSI-02-2018-0003 |
| Date | 11 June 2018 |
| Author | Andrew Voyce |
| Subject Matter | Health & social care,Mental health,Social inclusion |
The established state and patient
X’s rebellion
Andrew Voyce
Abstract
Purpose –The purpose of this paper (anonymised case study) is to explore political perspectives on the
detention of patients under the Mental Health Act.
Design/methodology/approach –The approach is ethnographic and narrative.
Findings –The essay offers an exploratory explanation using political theory, of a violent and rebellious act by
a person detained as a formal mental health patient. The protest relates to the treatment offered to the
patient.
Research limitations/implications –This essay offers a new explanation for a protest for a person
detained as a compulsory mental health patient. The essay explores issues relating to political philosophy that
the patient applies to their detention.
Practical implications –An understanding of how a patient with a background in academic politics is
related in this essay. There is consideration of how an education in politics can be as valid in wellbeing, as a
medical degree. It may be that more patients will be spared multiple hospital admissions by the use of
effective therapies.
Social implications –There is consideration of the debate about the fitness of current mental health
legislation to enable wellbeing, and the debate about the review of mental health law begun in 2017.
Originality/value –This is a perspective of how political theory can inform individual acts. The political inquiry
is not of dogma or ideology, either critical or affirming. The discourse is of rebellion with a purpose, not of
revolution, class war or national dispute. However, aspects of works that are critical of psychiatry are included
in the considerations.
Keywords Mental Health Act, Political theory, Psychiatric medication
Paper type Viewpoint
This paper addresses Patient X who has been sectioned under the Mental Health Act. Her first
experience of the psychiatric system was 15 years previously. Her multiple admissions have
been characterised by non-compliance with medication after being discharged whilst prescribed
injections of antipsychotic medication.
Patient X has never refused medication by tablet, but she avoids the injections on discharge
because of the side effects: akathisia or extreme restlessness. This has led to contact with the
criminal justice system and homelessness, as well as previous sectioning. At stake is a trend best
described as a revolving door, a ping-pong ball, a merry go round. After being sectioned this
time, the doctors again prescribe injections after a period on oral medication in the secure unit.
Patient X declares that the British State is being used to abuse her in her weakness, so when she
has recovered after a week of akathisia she expects from an injection, she will abscond and hit
the British establishment where it is vulnerable. She declares that she will smash a Church of
England window. This, which is under the monarch’s realm as is the National Health Service as
part of the State, is where the establishment is weak. An injection is administered, and Patient X
duly smashes a Church window a week later. She is called before the psychiatrists who tell her
that the therapeutic effect of the injections is different from the therapeutic effect of the tablets, so
she will be put back on tablets.
Patient X goes on to pass out with an Honours BA and an MA, starts her own mental health
social enterprise, gives talks on mental health for over 10 years, becomes a published author,
Andrew Voyce is Peer Support
Worker at the CreativeBexhill
CIC, Bexhill, UK.
PAGE128
j
MENTALHEALTH AND SOCIAL INCLUSION
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VOL. 22 NO. 3 2018, pp. 128-133, © Emerald Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-02-2018-0003
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