A psyche ward houses many different clients in varying degrees of mental health.  The persons treated there suffer from a variety of mental illnesses which affect their personalities each very uniquely from the other.  For example; some patients will be suffering from relatively moderate forms of clinical depression, while others may be experiencing intense schizophrenic episodes.  This spectrum of patients will display radically different symptoms of their disorders and will interact with the ward population with extremely dissimilar mannerisms and reactions.  In other words, you will meet people on the ward who will seem “normal” and act in an appropriate manner towards others.  Then you will also encounter other patients who will seem “different”; they may be experiencing paranoid delusions, psychotic episodes, they may seem to fixate on others, display creepy perversity, or exhibit agitated mania.  These patients may not present suitable behavior towards other people on the ward or to the nursing staff.  Patients, such as these, can be deemed as disturbing or frightening individuals to a newly admitted person, and could in fact be quite scary.  

Depending on the hospital and the type of ward you are admitted too, the ratio of “Scary” patients to the more subdued less threatening personalities may vary.  The hospitals I have been a patient at have had a very low ratio of “frightening or scary patient” occupancy to the rest of the psyche ward population.  These patients can be encountered in many different shapes and appearances.  There is no steadfast stereotype of the “Scary Patient”; in fact, even the most affable patient (any one actually) can turn into one right before your very eyes at a moment’s notice if given the right circumstances.  What makes a patient “scary” is the state of their mental health and how they interact with their social environment, not necessarily whether they look or seem “normal” at first glance.  Some patients may appear terrifying when you first meet them, but after spending time interacting with them while on the ward they can soon become less threatening, even perfectly harmless in your eyes.  Their original appearance or attitude may have come across as aggressive or threatening, but once you are able to observe them mingling with the ward population it becomes obvious that they are not what you presumed them to be.

·        I was once roommates with a woman who seemed very high functioning and emotionally grounded until I had been in hospital for about two days.  Then she turned on me with a vengeance, it was the classic Dr. Jeckl and Mr. Hyde syndrome.  I was very frightened by the extent of her paranoid delusions and how she seemed to desperately need to pull me into them.  Yet, before I saw the true extent of her illness she seemed, for all intensive purposes, to be “normal”.  She acted, looked, and dressed the part.  So, don’t be fooled.

·        I will, however, for the purposes of this section, focus on certain “types” of patients in order to describe to the reader what situation they may expect to face and how to deal with such an incident if the need arises.

One type of character you may come across is the “High Risk” patient.  What I mean by “high risk” patient, and I don’t want to set off alarm bells resounding throughout peoples’ brains out there, are people who are more likely to become agitated easily and act out (potentially violently or aggressively) towards the ward population and nursing staff.  These people are usually easy to pick out in a crowd.  They will stomp into a room and glare at the occupants, then start yelling at a random victim for some issue only the “high risk” patient is privy to understanding, leaving the victim shaken and bewildered after he/she has stormed out.  They may start accosting the nursing staff because they are not able to go for a smoke during the dinner hour and end up in isolation because they trashed the lounge area.  They may yell frequently when they are refused their wishes, act out often, and approach other patients in an abrasive manner. 

Most of their reactions and reasonings don’t seem to make much sense to most of the ward population, except the nursing staff who are trained to deal with such psychotic personalities.  They are usually suffering from schizophrenia, intense mania, or a psychotic episode. They find rules and regulations extremely hard to endure, and giving them their medications is usually a huge endeavor because it is seen as a diabolical conspiracy to hedge their intellectual awareness from perceiving the true nature of what the universal establishment (or one world government) is plotting to…..blah …blah…blah. OR those frickin’ doctors are trying to dope me out of my skull again so that they can…and so on. They exhibit intense personalities, and are at times brooding, quite aggressive, and even when they wish to interact in an appropriate manner they are unable too.  I find once they have been on a medication regime for a number of weeks their personalities usually soften and they become less volatile.  They are then able to begin to display a somewhat more or less appropriate behavior towards others. 

Some patients will simply freak you out because they seem to quietly, with a stealth that belies human ability, creep up on you when you are sleeping and just stand there watching you until you wake up with a start.  They walk the halls watching you with a fascination that makes the skin on the back of your neck crawl.  At meal times they like to sit opposite you and gape open mouthed, food trickling from their lips, as you try to eat avoiding eye contact with them at all times.  Patients like these, we’ll call them “Scary Looking”, whom I have come in contact with, have usually been visually frightening.  They are unkempt and smell like urine.  They wear the same clothes everyday.  They might be large weighty persons with problem skin and hair that hasn’t been washed in weeks; at least that has been my experience.  It is clear that they haven’t anyone who cares enough about them to take the time to clean them up.  They walk the halls of the ward half dressed talking to themselves and very few visitors ever come to see them.  These people aren’t really scary, just creepy.  A lot of these sorts of patients are typically harmless.  They just seem disturbing.  And, probably we find them disturbing because they raise a fear in ourselves of what we could become if the circumstances were different.  These patients are actually very lovely people deep inside.  Most of the time people don’t give them the chance to show a redeeming side. They need compassion, maybe more than most, not fear.  When you meet one of these patients, you don’t have to make fast friends with them, but perhaps don’t turn away with disgust if they glance in your direction. 

• Now don’t get me wrong, there are some disturbing patients that will fixate on a person and sneak up on them in their sleep for dirty purposes and this should be brought to the nurse’s attention immediately. 

There are some patients that are suffering from paranoid delusions who will at times pull other patients into their tangled web of psychosis.  These patients can at times become quite aggressive and demonstrative towards that said patient causing that person to fear for their personal safety.  I once experienced this situation myself.  It has only happened once in all the times I have been hospitalized, but after that experience I have always taken measures to ensure it doesn’t occur again.  The situation was made intensely difficult because of the close quarters I shared with this specific patient who happened to be my roommate.  This situation was different in a sense from a “High Risk” patient; however at times she did get a bit hysterical, what made her frightening was the emotional strangle hold she had over me whilst we were sharing our accommodations.  I was always in a state of angst and intimidation.  She never allowed the emotional stress level in the room to slacken or relax; there was always a crisis or a plot against her.  If I didn’t agree and sympathize, I was with them and not her.  She made my life miserable if I didn’t side with her.  At one point, I actually was afraid to sleep at night for fear she would wreak some sort of retribution on me in my sleep.  It was exhausting; finally the nurses stepped in and changed my room.   

Then there are the odd few patients who you could refer to as “Creepy Perverse”.  These patients are few.  Most of the time the ones I have come in contact with have just been patients with dirty minds, they didn’t act out their fantasies any further than just trying to peep in a female patient’s room.  The nurses are very adamant that female patients report any inappropriate behavior by these patients; they have a zero tolerance policy for such conduct on the psyche ward.  These patients may follow a female patient into their rooms, or watch them while they sleep, or sometimes they will do inappropriate things to themselves in public areas of the ward while female patients are present.  If there is a male patient who is making you feel intimidated in this way inform your nurse immediately, she will take action at once to correct the behavior of the offending patient.  He may even be transferred to a separate facility if it is deemed necessary.     

• I was once in a smoking area with a few of my friends having a cigarette when a schizophrenic man from the upper ward came and sat down across from us.  He seemed agitated and stared at us in a grotesque lecherous manner.  We simply ignored him.  Then one of my friends elbowed me quite sharply in the ribs.  I turned to her with a grimace wondering what was it I had said to deserve such a jab.  She had a tight-lipped grin on her face and her eyes were fixed on the man sitting opposite us.  So, my eyes followed her stare, to my surprise the trail led straight to a penis.  The man was sitting there masturbating while we stood huddled in a little pack smoking and chatting unawares.  To make a long story short we all piled out of there screaming and laughing at the top of our lungs.  I don’t even think most of us finished our cigarettes; the crush to escape was so great I lost my shoe.  We went straight to the nurse’s desk and reported it immediately.  There were two things we did wrong in this situation.  We shouldn’t have made such a huge hoopla or reaction to his masturbation.  We should have left the area without giving him any reaction at all.  He was looking for attention and got it.  When we noticed he was agitated and there was something wrong with his attitude we should have left instead of giving him a prime target to fixate and fantasize on.   We did do one thing right; we reported it to the nurse’s desk as soon as possible.  He was disciplined immediately.  It is not your job to instill morals into these patients, so don’t even bother.  You can tell them to get lost, but leave the reprimands to the nurses.