In January 2020 as the Commissioner to the historic Victorian Royal Commission into the Mental Health System was working away, I was sitting inside the padded seclusion room of the psychiatric ward at the Austin hospital in the Melbourne suburb of Heidelberg. Of course, I didn’t know what the Commissioner was doing. I couldn’t care less. I wanted out of the seclusion room and back onto the general ward. Here I would be allowed to move around freely between the dining room, bedroom, the lounge and the courtyard with its ping pong table and of course the freedom to light up a smoke, which I desperately needed. In the seclusion room I had nothing to do, no one to interact with other than the nurses and nothing to pass the time other than a TV and a set of Connect-Four missing at least half the pieces.

I was confused. I knew I was unwell, but I didn’t think it was fair for me to be put into the seclusion ward because I was being “too demanding of the staff” and acting erratically. But who knows how I was actually acting. It’s all a blur.

So much of psychosis is like that — a jumbled-up mixture of memories, emotions and scars, wounds that feel fresh and pulsing, others well healed. I remember during my first psychotic episode a few years earlier sitting at home at my apartment in Marrickville, Sydney, watching Buddy Franklin playing footy on the TV and thinking that every word of praise the commentators had for the legend was praise for me. I was him and boy, was I flying across the SCG that night. Years later I remember sitting in the swimming pool of the Singapore Airport hotel and calling a friend, to give them the heads up that I was about to cause the global stock market to crash. I remember a lot of things. A lot I would rather forget.

But the public seems to have shorter memories. It was only five years ago that Victorian Premier Daniel Andrews stood up and promised to implement in full all the recommendations of that royal commission. He said the system had failed Victorians who were either “not sick enough” for help until they were “too sick” to treat outside of hospital.

Andrews promised a new system entirely. He promised mental health professionals and paramedics would be the first responders to mental health crisis triple zero calls, not the police. He promised more community housing to those living with mental illness and more funding for community-based supports and cares before people needed hospitalisation. He promised to establish a lived-experience agency to advise the government on all elements of mental health care. “As a government, we recognise these profound failures”, Andrews said.

None of this work can be achieved overnight. It will take our ongoing action and effort and commitment. But our goal is as simple as it is necessary: taking mental health out of the ‘too hard basket’ once and for all – and making sure Victorians can access the care they need, when they need it, wherever they need it.

That phrase, the “too hard basket”, stuck with me. If we take Andrews to be sincere in his wish to address this issue, to take it out of the basket, perhaps society wasn’t yet ready to address it with him. It’s five years later and we, the people living with severe mental health conditions, are firmly back in the too hard basket. Most reforms have been stalled and delayed or been cancelled all together. All that ambition has been stifled by harsh “budget realities”.

How do you consider your life when society puts someone with your condition in the “too hard basket”? How do you frame your existence when everyone expects you to go on a violent rampage, even though in fact you are statistically much more likely to be the victim of police violence? When you tell someone about your condition and the best you can hope for is indifference, the other common options being patronisation or hostility?

Bipolar disorder, my condition, is difficult. It requires lifelong medications and vigilance to avoid major relapses that will land me back in hospital. It requires medical treatments that drain your time and energy, not to mention your wallet. It requires me to consider it in all my life choices and decisions. It also asks of others. It asks of my partner and those in my life who care for me. It asks for understanding from my employer and in some ways and in a more esoteric sense, it also asks of society. It asks to be taken out of the “too hard basket” — a request that is yet to be met.  

*

It’s hard to describe psychosis to someone who has never experienced it before. Perhaps I can start by painting a scene. It’s 2017 and I’m sitting in an emergency waiting room at the Northern Hospital Epping in Melbourne’s outer northern suburbs. I haven’t eaten for several days after becoming convinced that spies were poisoning my food, and now I fear that they have reached the hospital. My mother is with me and she is doing her best to stay calm and keep things under control as we wait for my name to be called. There are children crying all around me and it’s breaking my heart as I strongly believe that the poison is beginning to infect them. I reach over and whisper to my mum, “they’ve come for the babies now, look they are all getting sick”. She tries to reassure me that it’s going to be okay, but there is so much confusion in her eyes. This is my first psychosis episode and it’s her first time supporting me through one as well. That was then, we are both adept at it now. Though of course each time is different and traumatic, it does in some ways get easier.

I’ve been severely unwell with psychosis on three occasions. The last time I got sick was in 2023 and I had so much self-awareness by then that I realised I had to go to hospital before my partner. It was then that I was finally diagnosed with bipolar disorder. I hope that being diagnosed correctly and given the right medication will mean that I continue along the path of mental health stability that I have for the last three years. I pray I never have to return to the psych ward again. No one who has spent any serious amount of time in those places ever wants to go back, but there are times when you need to go. There are other times when society feels like it doesn’t know how to cope with you and it needs to put you there. But approaching three years since my last stay I sit down to write with the sombre knowledge that eventually there may be a day that I do have to go back. Bipolar is after all a lifelong condition with no “cure”. I write in the hope that the psych ward I do visit next, if that unfortunate day comes, is a reformed one, a changed one and one that treats its patients with a level of dignity and respect not always seen in the past. 

*

It’s a Monday night and in the backroom of a local library in Melbourne’s inner northern suburbs a group of people like me are gathering. We are all living with bipolar, and once a month this is where we come. This is our safe space. I arrive early, as I almost always do, and begin to rearrange the tables and chairs into a U shape where we can all see each other, can all be heard. We go around and introduce ourselves and raise the topics that we want to discuss as a group this month. There are familiar themes: someone wants to know if sweating excessively on lithium is normal; another asks about morning routines and how people deal with disorientation in the morning; a third wants to know if anyone has tried Ozempic and whether it counteracts the weight gain of so many anti-psychotic medications and mood stabilisers. The room is always sterile to begin with but warms up as the evening wears on and we bond and come together. We find commonalities and connections. The organisation has no budget for tea and snacks, though an attendance list is passed around in the hope that, by demonstrating regular attendance, we’ll be able to find funding sources in the future. For me and the fifteen or so other people that come each month, this is care. This is community. This is a form of prevention. But because it is lived experience-led, it also means this is undervalued.

*

Getting better is tough. Leaving hospital is almost as hard as going in. You are lost and the world is disorientating. You need to find your centre again. You need to find things to cling onto and to ground yourself. Every little thing feels hard and you don’t know who you are anymore.

Slowly you get better. You take it day by day, sometimes even hour by hour. The contrast is jarring. Inside the hospital you have wrap-around support, you have 24-hour nurses, you have daily psychiatrist appointments, you have groups and activities, you have visitors and structure. Outside you have family, if you’re lucky. I was lucky. But still. You have appointments at an outpatient clinic, with professionals who regularly change and who sometimes aren’t very professional. You have to fight at the clinic for a psychiatrist appointment. You aren’t sick enough to get a public appointment, they tell you. You are too broke and have no private health insurance coverage for a private one. You have to wait on hold for the suicide prevention phone line. You have to empty your wallet at the chemist each month.

You learn to manage the best you can. But a politician who thinks this system works for people with severe mental health conditions would have to be hospitalised themselves with what my doctors would call “delusions of grandeur”.  You make do. You grow and lean on those around you when you can. Your support networks get you through. You survive and you slowly return to yourself in spite of the system, not because of it. Eventually, if you’re lucky and have the right supports like I have had, you learn how to thrive again.

Looking around the U shape on that Monday once a month, many aren’t as lucky as me. Some members come each month and manage to hold down successful jobs and careers. Others come and go. Many struggle to find and maintain work. We all go through periods of ups and downs — some last for longer than others. For some, normal is not functioning the way society expects us to.

I think a lot about one guy who used to come regularly, but hasn’t come in many months. The last time he came he was sleeping rough on the street and was self-medicating with illicit drugs. Each month I come now I hope to see him again, I hope he shows up and reports that his life is back on track and things are okay for him and his children. It’s been almost a year now and he never shows. He has slipped through society’s cracks and been placed in the too hard basket. We as a collective would rather forget about him. We as a collective don’t have the time and the space to hear him out, to care, to show concern and support. I don’t know where he is now and it breaks my heart. I know it breaks others hearts too, even if it remains unspoken in our U shape. Sometimes the topics get dark, sometimes the conversation grows dire, but often we try to remain optimistic. Sometimes, if you don’t laugh, you cry. And we have all done enough crying for a lifetime.

*

In years gone by I would write about everything. I would bare my soul on the page. Now I write professionally crafted and journalistic sentences, structured and concise. Considered and measured. I detach myself from the words and the words carry weight that is removed from me, but in service of someone else’s story that I am telling — an issue in society, a topic I am investigating. That is my job and I am good at it. But sometimes I long to be tethered to the word again. I long to be nailed to the emotions of each line, every blotch of ink weeping in service not of a journalistic prose, but merely of an emotional honesty. A truth that serves no other purpose than to let someone know that there is a pulse here.

That is how I am writing today. That is how I am writing this. I’ve spent so long being diligent. Taking my medications like clockwork, attending my appointments and staying well. Thriving professionally. And sure, I still am doing those things today, but I am also bearing witness to what I have been through. The pain I have suffered and the trauma of psychosis. There are somethings you don’t forget from episodes. I don’t forget the fear. The fear of death, of being chased by things that you can’t see, of being tracked and hunted by hunters who aren’t real. I have spent so long avoiding these memories, these scars, that today as I write them it is like picking at a scab. Sure, it bleeds again. Sure, the wound is fresh. But it isn’t as deep as I thought it would be. Each one seems silly to put down on paper. Ridiculous even to write. I wonder how they read. Do I sound ridiculous? Does it matter?

*

Daniel Andrews will be remembered by most for his lockdowns and response to the COVID pandemic. For his tough love and “health advice first” approach during the pandemic that divided Victorians. But perhaps I will remember him more as someone who promised so much mental health reform and delivered on so little. I will remember he was big on hope and rhetoric and short on follow-through. Someone who said all the right things on reform, but when it got to the less sexy nitty-gritty of implementing and funding the big changes that needed to take place, went missing, and was nowhere to be seen. As someone willing to grab the headline and then scrunch up the newspaper minutes later, when few were still reading and paying attention.

It’s not like Andrews didn’t have the time to set things on course. By the time he stood down as Premier in 2023, many of the reforms were already behind schedule and the wheels of the promise to implement every recommendation of the Royal Commission were already starting to fall off. Then he left and handed over to a new crop of politicians, even less bound to the promises of reforms he had made just a few years early. And slowly many of the reforms faded away into the background, into the “we will deal with that later” column, until they were nothing more than lines on long report, which few bothered to read and fewer still will read in the future. 

As for me, of course, I got out of that padded seclusion room. I got out of the psych ward, too. Slowly brick by brick, I built my life back up and now I sit in my study surrounded by books and photographs, paintings and records, afternoon sunlight streaming in through the windows. I sit at peace, thinking about a disappointing man named Daniel, who led a disappointing system that wouldn’t change. A system which was never designed for or by people like me, and which for a second there entertained the prospect of shifting to actually centre us. A flickering thought, that passed as quickly as it came.

Image: Richard Stachmann