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“He is not allowed his small reprieves”

I don’t usually find much to sympathise with over at the Bella Caledonia blog. This account by Jonathan Rowson, whose brother has been committed to a psychiatric ward, was an exception:

Smoking and the Forbidden Garden – a Dereliction of Sanity?

Defending the rights of the mentally ill to do something that harms them is not a popular cause, but this much needs to be said: preventing psychiatric patients from smoking on hospital grounds is inhumane.

I am responding to the situation in a particular ward in a hospital in NHS Grampian region. At the time of writing my forty year old brother Mark is there, as he has been before. He is surrounded by other adult patients, many of whom are thought disordered, dysfunctional, and up to their eye balls in medication. Mark has given me permission to write publicly about his situation, but he is not well enough to grasp the full context. I am taking the liberty of making the following case on his behalf.

Many psychiatric patients are habitual smokers, but at the moment they are strictly not allowed to smoke anywhere on hospital grounds. Smoking has been banned in hospital buildings for about a decade, but in the hospital in question secure gardens adjacent to the locked wards and smoking shelters within the general grounds of hospitals were available to smoke. This arrangement seemed to work until the authorities decreed that the shelters should be knocked down and the secure gardens should be smoke free. Some psychiatric patients, staff and visitors now face the mild stigma and hassle of having to escape the hospital to smoke, but if you are sectioned under the mental health act it’s not so simple. The hospital ward is your de-facto home, and also your de-facto prison, so where do you go?

The ruling is unenforceable. In fact most staff feel they have no choice but to turn a blind eye. Patients are now smoking in their rooms or in the bathrooms; anywhere where the staff can have plausible deniability of not seeing them. Alas, the collateral damage of this necessary open secret is that none of the patients can now go to the outdoor area assigned to the ward. The small secured gardens are the most humanising place on the ward and a vital source of fresh air, but they lie unused due to the risk, not that patients will smoke, but that they will be seen to be smoking, and get staff into trouble as a result.

Most of the comments are supportive, but not all. This one by Clive Scott was notable for its self-righteousness:

What about the employer’s responsibilities to provide a safe working environment for employees and the rights of non-smokers for wholesome air? It would be ridiculous to permit the mentally enfeebled to flout regulations for the common good simply because of their illness. Smoking is a disgusting foul habit and addiction and every step possible should be taken to eliminate it from society.

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28 comments to “He is not allowed his small reprieves”

  • John Galt III

    Change from Tobacco to Marijuana and the administration staff and the leftist nanny state losers will say, “Hey, way cool, that changes everything and why didn’t I think of that.”

    Patients might be happier too.

  • Paul Marks

    The “Health Fascists” are rather cruel people.

    They claim to be compassionate – but they clearly are not.

  • staghounds

    Many psychiatric patients are habitual urinators on the floor, assaulters, self exposers, and so forth. Some are fire setters, some suicidal, and some so detached from reality that they cannot manage fire.

    Many convicts, ordinary hospital patients, and people doing essential business in courthouses and government offices are habitual smokers.

    And the patients can go to the garden, they just can’t go there and smoke. Or crap, or have sex, or be naked.

    “Cruel”, sheesh.

    Mr. Rowson is getting psychiatric treatment AND a respite from smoking. A twofer.

  • Natalie Solent (Essex)

    Staghounds,

    Do you think it’s helping, this respite? Do you think it’s a respite for the staff?

  • Ellen

    Resist this sort of ban. We all know that as soon as smoking is banned, hamburgers are next. Or perhaps malted milkshakes, or pork chops — the exact details are hazy, but sure as the sun will rise, once a ban takes full effect, the next campaign-to-ban will be cranking up.

    So, Staghounds — what will you miss the most? It very well could be next.

  • thefrollickingmole

    I spend 3 months working in a secure Psych facility.
    A real eye opener, everyone should have a bit of exposure to.
    Nearly everyone smoked, it has a calming and more importantly distracting effect on most people. Being able to have a ciggie and the voices in your head fade away for a while…great.

    Of course the same government that “cares” about the mentally ill make it $1+ per cigarette through taxation here as well.
    Great place to look at though, most patients knew they were unwell and wanted to get better, and also, nearly every new arrival was in possession of a variety of street drugs. Self medicating or exacerbating their illness?

    And currently the sciense for “2nd hand smoke” is definitely contested.

    A large-scale study found no clear link between secondhand smoke and lung cancer, undercutting the premise of years of litigation including a Florida case that yielded a $350 million settlement.

    The article in the Journal of the National Cancer Institute details a study of 76,000 women over more than a decade, which found the usual link between smoking and cancer. Lung cancer was 13 times more common in current smokers, and four times more common in former smokers, than in non-smokers.

    The study found no statistically significant relationship between lung cancer and exposure to passive smoke, however. Only among women who had lived with a smoker for 30 years or more was there a relationship that the researchers described as “borderline statistical significance.” Over at the Velvet Glove, Iron Fist blog, however, journalist Christopher Snowden notes “there’s no such thing as borderline statistical significance. It’s either significant or it’s not,” and the reported hazard ratio was not.

  • thefrollickingmole

    Oh and from that study comes this pearl of truth from a health Nazi.
    One researcher in the article said the most important effect of indoor-smoking bans may be on smokers.

    “The strongest reason to avoid passive cigarette smoke is to change societal behavior: to not live in a society where smoking is a norm,” said Dr. Jyoti Patel of Northwestern University School of Medicine.

    So the truth didnt matter as our aim was pure.
    Bastards.

  • Lee Moore

    I’m not sure Natalie is being quite fair to Clive Scott. In the NHS Grampian region, employees are recruited by the press gang. If they desert their posts or try to get other jobs, they face being strung up from the yardarm, after only a very cursory hearing. If NHS Grampian employees could freely choose to work anywhere they wanted it would indeed be ludicrous to whine about imposing an unhealthy environment on non smokers, particularly as the mortality rate from “passive smoking” is slightly lower than that from stabbing yourself with a fish finger.

    But with forced labour, Clive has a point.

  • Nicotine is proven to be an effective treatment for schizophrenia and a host of other mental maladies. When you smoke it, you have the ability to accurately self-dose, literally smoking just enough to make the voices go away.

    Not only is this a vicious and cruel policy, it is also medical malpractice.

  • Nicholas (Rule Yourselves!) Gray

    Let us not forget that companies have an interest in turning us into wards of the state, also. Or at least into thinking we have some sort of illness. If you are happy, you are really hysterical, if you seem sad, you are really depressed. Both of those can be treated by new pills!
    And if you are neither happy nor sad, like most normal people, then you are abnormal! They’ll soon have a pill for that! Meanwhile, spend some time in a ward. The staff need experience at dealing with patients claiming to have nothing wrong with them. There are machines and pills to handle delusions like that.
    I wonder what the prescription is for not following Groupthink, as libertarians tend not to? Anti-aspiring pills?

  • Schizophrenics are notorious tobacco fiends. American facilities at least acknowledge this. But often smoking is only allowed outdoors – brutal in Midwest winters. Or indoors only at designated times.

    CBDs have been found helpful to some schizophrenics. American medicine does not acknowledge this.

  • Niall Kilmartin

    It’s easy to imagine Clive Scott’s reverse-style self-righteousness if he ever heard someone refer to another lifestyle (one that can likewise increase one’s chances of catching a fatal and incurable disease) as “a disgusting foul habit”. How fortunate that, thanks to the hate speech laws, he will not hear that. And how fortunate that, thanks to the hypocrisy that is an additional filthy aspect feature of these evil laws, there is no danger of his ever being accused of violating them, whatever he says about smokers.

    I remember (more than a decade ago, now) when a team I worked with back then were told of a new site policy: the smokers (who already had to go outside) were not to stand near the entrance but to walk round the block while smoking. When it was very mildly suggested that there were already enough rules against smokers onsite, without adding rules when they were offsite, a recently hired graduate instantly said, “They deserve it!”.

    Some people never get the idea of freedom – not even freedom from prejudice. Even as they’re “the enlightened ones” in the imaginations, their still full of it – in every sense.

  • Andrew Duffin

    One does rather wonder, if it’s so difficult for patients to leave the hospital, where they are getting the fags from? Does the hospital sell them in its shop?

  • Natalie Solent (Essex)

    Andrew Duffin, where a product is prohibited or semi-prohibited, an unofficial market in that product is sure to thrive.

  • staghounds

    I don’t believe that keeping matches and lighters away from people who are CONFINED BECAUSE THEY ARE INSANE is an unreasonable requirement.

    http://listverse.com/2012/02/18/10-tragic-prison-and-asylum-fires/

  • Natalie Solent (Essex)

    Staghounds, “insane” isn’t a yes or no quality. If it were we’d put every inhabitant of a psychiatric hospital in a straightjacket 24-7. There are no doubt reasons why Mr Rowson needs to be confined in a secure hospital. But obviously the staff do not see him or most of the other patients as about to burn the place down, since they are turning a blind eye to smoking in the rooms and lavatories. That suggests either that the staff are not anxious to extinguish every vestige of the patients’ freedom just because liberty of movement has had to be curtailed, and/or that the staff see some actual benefit to smoking in that it calms the patients.

    A second point is that the absolute smoking ban has made fires more likely, by moving smokers away from doing it openly in the gardens to doing it surreptitiously in the rooms and lavatories.

  • PersonFromPorlock

    I’d think the real question here should be “How is how the state treats those in mental hospitals different from how it treats ‘regular’ citizens?”

  • John Galt III

    The answer is e-cigarettes. No smoke, no fire and you get your nicotine fix. Why don’t the leftist nanny staters try that.

  • Laird

    thefrollickingmole, the link you provided to the Forbes article doesn’t work (it takes you to a generic entry site), and I couldn’t find any such article even using their search feature. Can you please provide a better link, or at least the proper title of the article?

  • Alisa

    Laird, all you have to do in such cases is google a paragraph from the quote.

  • Laird

    Thanks, Alisa. I guess I’m just not that clever.

  • thefrollickingmole

    staghounds

    In decure facilities i have worked at the guards carry lighters and light up on request.
    As you can imagine it made “free” lighters very valuable, and they would be pinched if you took your eyes off them for a second.
    Even empty lighters were valuable if you could pull off a “switcheroo” and hand the guard the empty one back and you kept the full one.
    Also when trying to stop smoking in the blocks we ended up with people playing with electrics to form coils with 240 volts to light up.

    Heres an old “bushie” trick to start a fire if your vehicle breaks down.
    Thin piece wire (thin works best) placed over the pos/neg terminals of the battery of the vehicle will pretty quickly become fire lightingly hot after less than a minute due to resistance.Thin bits of wire will get red hot and deform themselves after a while.

  • Back in the 60s I ran into an electric heater/lighter that screwed into a light bulb socket. I have no idea if those are still made. It had a push button beside it that you held down until the heater wire glowed. Then you lit your fag.

    Kind of worked like a automobile cigarette lighter. But 120V (US).

  • Julie near Chicago

    Nicholas,

    Good points. I ran afoul of that “too happy” business myself, in my student days. I do have moments of mild but very pleasant euphoria (but I try to keep up a good front and never to display a lack of disgruntlement in public). The condition is also known as hypomania, but never mind. I remarked on this to a student psychiatrist in UC’s Student Health Department, and he immediately went all Freudian on me. (UC became one of the earliest of the American incubators of Freudiansim, and as of 1964 the effect had not worn off.) Anyway, I was put through a grilling as to what my excessive happiness was repressing, what dreadful things had I done that left me feeling so guilty I had to cover it up with this “happy” feeling, etc. etc.

    The urge to flee was strengthened by a rush to the head of common sense, so I skedaddled STAT. And thereafter Iavoided all psycho-practitioners like the plague for a hundred years. Possibly longer.

    . . .

    Speaking of that, one of the most helpful, if not THE most helpful, self-help books I ever read was Karen Horney’s Self-Analysis. And why is it such a great book? Well, because she comes right and says that the very best psychotherapist a person can have is — himself. (Well, at the time it was a much-needed yanking back to reality for me. The psych books and gurus tend to mess with your head. Not all of them, of course. The worst offenders seem to be those frightened into Freudianism at an early age.)

    Yikes!!

    However, there’s one other book I would recommend very highly to anyone trying to make some sort of peace with himself: Shadow Syndromes, by John Ratey. (The link really does take you to the title’s Results Page on Amazon. 🙂 )

    I just tried to present the general point of the book and the effect it had on me, but I can’t articulate it well enough at the moment. So let me just state the full title:

    Shadow Syndromes: The Mild Forms of Major Mental Disorders That Sabotage Us.

    In other words, for almost all of us almost all of the time, the psychic unpleasantnesses that our selves experience are not indications that “there is something wrong with us” in any major sense; they’re in fact a relatively mild form of a trait present in almost all of us, that in some cases becomes a “major mental disorder.”

    It’s very, very helpful to know that even in your misery (or your wonderful state of exceptional happiness, by extrapolation anyway) you’re not so freakishly different from the rest of humankind.

    Highly, highly recommended.

    And those are the only two books that I think are worth five *s. There are two or perhaps three others that might get 3 *s for a single passage that’s worth 5. (Shad Helmstetter, IIRC: “Somewhere there MUST be some adult who knows what’s going on!”; Somebody Burns, but I forget why; the “Where Did They Put My Cheese” guy.) The rest of the pop-psych self-help “literature,” well, you can have it. Junk and tripe that leaves you furious with the writer, who seems utterly obtuse. I’ll spare us all the rant. I suppose most of them mean well. Snarl.

  • Alisa

    You are welcome, Laird, and it has nothing to do with cleverness 🙂

  • Julie,

    Ah. A UC alum. Me too x63. #2 son graduated with honors in Russian Language.

  • Julie near Chicago

    Aha! Well, Simon, have you seen what they have done to our beautiful campus? For our sins, have a look the new Pahlevsky dorm complex, I think it is.

    https://upload.wikimedia.org/wikipedia/commons/0/0a/Blue%2C_orange_and_pink.jpg

    However, there really are several pretty good photos of the campus, including a couple of standouts, in the series. 🙂

    By the way, my husband and I (entered in 1961) designated Hinds as “the radiator building” as soon as we clapped eyes on it. That was in 1971, I think. (We’d been in NY and then Lafayette from 1965-1971. Back to UC for his postdoc and for me to finish my S.B.)