Memoirs of a Psychiatric Orderly: Behind locked doors

As a psychiatric orderly, Dennis O'Donnell encountered violence and despair – but also strength and compassion. His new book offers a moving insight into this unseen and little reported world

In 2000, Dennis O'Donnell was working as an orderly in a geriatrics ward of a large hospital in Scotland when he was approached by the charge nurse of the intensive psychiatric care unit (IPCU), which treated people with depression, bipolar disorder and schizophrenia. A member of staff had proved unsatisfactory and he needed someone to join his team. A man, specifically. He wanted O'Donnell.

"I don't know if I'm the man you want," he told the charge nurse. "I'm not a fighter."

"I don't need fighters," the charge nurse replied. "I need people who can listen."

It took some convincing for O'Donnell to leave behind his job of caring for the elderly; of shaving, dressing and feeding them. He had grown fond of the old men in his ward. But eventually the prospect of a new challenge grew too tempting and O'Donnell accepted. "I thought it would be something different; I thought, 'Don't fester, don't tread water,'" he now recalls. "The clincher was him telling me that I wouldn't be working on 'the shite detail' any more, meaning I would no longer be attending to the elderly's lavatory needs."

It is the seven and a half years that O'Donnell spent in the IPCU that he focuses on in his new book, The Locked Ward: Memoirs of a Psychiatric Orderly. It is not merely a string of tragic and funny anecdotes about working with people suffering from psychiatric illness, but a wider look at the ways in which these patients are treated, society's prejudices against them, how they found themselves there and, above all, a tribute to the individuals he encountered.

O'Donnell, now 60, first became an orderly to make some money one summer when he was a 20-year-old English literature student. With a rather romantic view about life at an asylum ("I thought it would be cool and hip, an absurdist dream," he writes), O'Donnell soon discovered that it was actually a lot of hard graft. Nor was he prepared for dealing with the old men with dementia and the hopeless lives he encountered there. "All the sap, all the goodness, all the hope in their lives, had long ago dried out." Still, he found the work rewarding and grew close to a number of the characters there; there was one who believed he was the King of Egypt, another who would smoke loo paper. One man waited patiently every day for a visit from his daughter that never came.

After graduating, O'Donnell went on to become an English teacher, work he enjoyed until he grew disillusioned with the system and the endless administration it had started to entail. "If I hadn't stopped teaching at that time then I would have ended up in the ward as a patient rather than a member of staff," he now jokes in his naturally jovial tone. So, after 30 years, he decided to return to work as an orderly. "It is fantastically hard work but I wanted to do it again because I had enjoyed it and I felt that I had contributed to something for once," he says.

After agreeing to transfer from the geriatrics ward (or care of the elderly, as it had come to be known) to the IPCU (and been promised that he was not going to end up being used as a punching bag), O'Donnell first had to take part in a control-and-restraint course for five days, which was designed to protect staff from aggression and help to restrain individuals safely. O'Donnell questioned whether he had made the right decision after learning that a nurse had accidentally broken a patient's arm after trying to restrain them. "It is different to what the police do, where you are allowed to put someone in an arm lock until they behave," O'Donnell says. "We had to be very careful not to hurt anyone during a restraint because we weren't restraining people who were bad, we were restraining people who were ill."

Needless to say, life at the IPCU was challenging and he came across men and women with all sorts of illnesses. "I say in the book that there are as many mental illnesses as there are people who suffer from them," O'Donnell says. "And everyone needs to be treated as an individual. In psychiatry there are no textbook cases. Some people on the ward would be very guarded and hostile, which occasionally focused into aggression. Then some were just withdrawn and would rather be left on their own, others would be manic, and some were so normal it was hard to believe there was anything wrong with them at all."

Certainly there was violence. O'Donnell says he never got used to the measure of restraint that he would sometimes have to use against patients. "One of the characteristics of severe psychiatric illness is that very often there is no insight to the condition, so people do not realise that they are ill," he explains. "This is where a lot of the resentment comes from, which can sometimes be channelled into aggression towards doctors and nursing staff. People believe that they are being kept against their will."

However, O'Donnell is keen to stress that it is to themselves that the patients pose the biggest threat. One typical story he relays is of a man with religious mania who bashes his own skull against the basin taps after he sees the Devil in the mirror. This, O'Donnell says, is much more typical behaviour of someone with paranoid schizophrenia than to inflict pain on another person, a misconception he addresses in the book.

"While I was writing the book, there were one or two high-profile cases in the media of paranoid schizophrenics attacking people, sometimes fatally," he says. "It's a very rare occurrence but now the term 'paranoid schizophrenia' is enough to frighten people. Those cases encapsulated people's fear of people with paranoid schizophrenia – that they are unpredictable and violent – and it's an example of how misunderstood that world is."

Unlike working with the elderly, when the only reason for a patient to leave the ward was death, in the IPCU patients being discharged was a positive thing. Though, sadly for many, it was not the last time that O'Donnell would see them. "We called it the revolving-door syndrome: patients would be discharged, integrate back into society, feel they were cured, stop taking their medication and, of course, gradually their condition would deteriorate again. That was common. It was so sad to see them return to the ward; it was probably the hardest part of being there."

To deal with the issue of patient confidentiality, O'Donnell has changed names and altered genders, ages and physical attributes. It was paramount that the book would not lead to anyone being identified. In fact, so committed was O'Donnell to not betraying his patients, he almost didn't write it. In the end, he reasoned that while there were books written by doctors and by sufferers of psychiatric illness, there was little literature by third parties, by orderlies such as himself who helped the patients in their day-to-day lives and who had got to know them and understand them better.

"The greatest lesson I learnt from them was the indomitability of the human spirit," he writes. "Despite suffering from the most hair-raising, sometimes completely incapacitating illnesses, people's determination to rise above the abyss was utterly remarkable."

'The Locked Ward: Memoirs of a Psychiatric Orderly' by Dennis O'Donnell is published by Jonathan Cape; £16.99

Alexis Sanchez has completed a £35m move to Arsenal, the club have confirmed
sportGunners complete £35m signing of Barcelona forward
Poor teachers should be fearful of not getting pay rises or losing their job if they fail to perform, Steve Fairclough, headteacher of Abbotsholme School, suggested
voicesChris Sloggett explains why it has become an impossible career path
world cup 2014
Ray Whelan was arrested earlier this week
Life and Style
ebookA wonderful selection of salads, starters and mains featuring venison, grouse and other game
Arts and Entertainment
In a minor key: Keira Knightley in the lightweight 'Begin Again'
Arts and Entertainment
Celebrated children’s author Allan Ahlberg, best known for Each Peach Pear Plum
peopleIndian actress known as the 'Grand Old Lady of Bollywood' was 102
Wayne’s estate faces a claim for alleged copyright breaches
newsJohn Wayne's heirs duke it out with university over use of the late film star's nickname
Life and Style
It beggars belief: the homeless and hungry are weary, tortured, ghosts of people – with bodies contorted by imperceptible pain
lifeRough sleepers exist in every city. Hear the stories of those whose luck has run out
Mick Jagger performing at Glastonbury
Life and Style
fashionJ Crew introduces triple zero size to meet the Asia market demand
Santi Cazorla, Mikel Arteta and Mathieu Flamini of Arsenal launch the new Puma Arsenal kits at the Puma Store on Carnaby Street
sportMassive deal worth £150m over the next five years
Arts and Entertainment
Welsh opera singer Katherine Jenkins
musicHolyrood MPs 'staggered' at lack of Scottish artists performing
Life and Style
beautyBelgian fan lands L'Oreal campaign after being spotted at World Cup
Arts and Entertainment
Currently there is nothing to prevent all-male or all-female couples from competing against mixed sex partners at any of the country’s ballroom dancing events
Potential ban on same-sex partners in ballroom dancing competitions amounts to 'illegal discrimination'
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Business Analyst Consultant (Financial Services)

    £60000 - £75000 per annum: Harrington Starr: Business Analyst Consultant (Fina...

    Systems Administrator - Linux / Unix / Windows / TCP/IP / SAN

    £60000 per annum: Harrington Starr: A leading provider in investment managemen...

    AVS, JVS Openlink Endur Developer

    £600 - £700 per day: Harrington Starr: AVS, JVS Openlink Endur Developer JVS, ...

    E-Commerce Developer

    £45000 - £60000 per annum + competitive: Progressive Recruitment: Exciting opp...

    Day In a Page

    A History of the First World War in 100 Moments: Peace without magnanimity - the summit in a railway siding that ended the fighting

    A History of the First World War in 100 Moments

    Peace without magnanimity - the summit in a railway siding that ended the fighting
    Scottish independence: How the Commonwealth Games could swing the vote

    Scottish independence: How the Commonwealth Games could swing the vote

    In the final part of our series, Chris Green arrives in Glasgow - a host city struggling to keep the politics out of its celebration of sport
    Out in the cold: A writer spends a night on the streets and hears the stories of the homeless

    A writer spends a night on the streets

    Rough sleepers - the homeless, the destitute and the drunk - exist in every city. Will Nicoll meets those whose luck has run out
    Striking new stations, high-speed links and (whisper it) better services - the UK's railways are entering a new golden age

    UK's railways are entering a new golden age

    New stations are opening across the country and our railways appear to be entering an era not seen in Britain since the early 1950s
    Conchita Wurst becomes a 'bride' on the Paris catwalk - and proves there is life after Eurovision

    Conchita becomes a 'bride' on Paris catwalk

    Alexander Fury salutes the Eurovision Song Contest winner's latest triumph
    Pétanque World Championship in Marseilles hit by

    Pétanque 'world cup' hit by death threats

    This year's most acrimonious sporting event took place in France, not Brazil. How did pétanque get so passionate?
    Whelks are healthy, versatile and sustainable - so why did we stop eating them in the UK?

    Why did we stop eating whelks?

    Whelks were the Victorian equivalent of the donor kebab and our stocks are abundant. So why do we now export them all to the Far East?
    10 best women's sunglasses

    In the shade: 10 best women's sunglasses

    From luxury bespoke eyewear to fun festival sunnies, we round up the shades to be seen in this summer
    Germany vs Argentina World Cup 2014: Lionel Messi? Javier Mascherano is key for Argentina...

    World Cup final: Messi? Mascherano is key for Argentina...

    No 10 is always centre of attention but Barça team-mate is just as crucial to finalists’ hopes
    Siobhan-Marie O’Connor: Swimmer knows she needs Glasgow joy on road to Rio

    Siobhan-Marie O’Connor: Swimmer needs Glasgow joy on road to Rio

    18-year-old says this month’s Commonwealth Games are a key staging post in her career before time slips away
    The true Gaza back-story that the Israelis aren’t telling this week

    The true Gaza back-story that the Israelis aren’t telling this week

    A future Palestine state will have no borders and be an enclave within Israel, surrounded on all sides by Israeli-held territory, says Robert Fisk
    A History of the First World War in 100 Moments: The German people demand an end to the fighting

    A History of the First World War in 100 Moments

    The German people demand an end to the fighting
    New play by Oscar Wilde's grandson reveals what the Irish wit said at his trials

    New play reveals what Oscar Wilde said at trials

    For a century, what Wilde actually said at his trials was a mystery. But the recent discovery of shorthand notes changed that. Now his grandson Merlin Holland has turned them into a play
    Can scientists save the world's sea life from

    Can scientists save our sea life?

    By the end of the century, the only living things left in our oceans could be plankton and jellyfish. Alex Renton meets the scientists who are trying to turn the tide
    Richard III, Trafalgar Studios, review: Martin Freeman gives highly intelligent performance

    Richard III review

    Martin Freeman’s psychotic monarch is big on mockery but wanting in malice