Ricky was an electrician. He also had bipolar affective disorder. The two things did not necessarily go well together.
Back in the mists of time (well, in the very early years of the 1983 Mental Health Act at any rate) I was called on to assess Ricky on two separate occasions.
You’ve read my advice to AMHP’s in the previous two posts. Now see how many rules were broken during these assessments.
The First Assessment
I was called by Dr Grundy, an old style country GP, an amiable but slightly idiosyncratic man, as most country GP’s seemed to be back then.
“Ricky’s gone completely bonkers, old chap,” he said. “He was doing some electrical work at my house, but this morning didn’t turn up. He eventually rang me to say that he had run out of electricity and had been delayed because he was generating some more to bring over to replenish my supply. I think he might need sectioning.”
I arranged to meet with Dr Grundy at Ricky’s house, which was in a small village. Ricky answered the front door, and it was immediately apparent that he was as high as the proverbial kite.
“Come in, come in,” he said expansively, without enquiring as to who I was (he recognised Dr Grundy) or the purpose of our visit. “Let me take your hats. No hats? Well let me give you some hats!” He himself was wearing a deerstalker at a jaunty angle, and he rummaged in a chest of drawers in the hallway, muttering, “Everyone must have hats, everyone must have hats”, until he finally produced a straw hat and a motor cycle helmet which he gave to us. Dr Grundy put on the straw hat, but I put the motorcycle helmet down (There are some things I draw the line at.)
“Dr Grundy thinks you may not be well at the moment,” I began. “He thinks maybe you need to be in hospital.”
“Does he, does he? Hospital, eh? Hospital. Lots of different hats in hospital, aren’t there?”
“You can have as many hats as you like, if you go to hospital,” Dr Grundy said. I rather wished he hadn’t. You shouldn’t lie to patients.
Somewhat to my surprise, Ricky agreed. I think he was dazzled by the thought of all the hats he would be able to wear.
“Let’s go then,” he said. “No time to waste. No time at all.” He strode out of the house and climbed into the doctor’s Volvo estate, which Dr Grundy had left unlocked. (Rule 47: Never leave your car unlocked when conducting a Mental Health Act Assessment.) He then locked all the doors from the inside.
Dr Grundy knocked on the car window. Ricky beamed out at him. Dr Grundy mimed winding down the window. Ricky also mimed winding down the window. Dr Grundy found this amusing. So, it must be said, did I. But then, Ricky hadn’t locked himself in my car.
Eventually, after a great deal of furious miming on the part of Dr Grundy, Ricky cottoned on and wound the window down a little way.
“Can I help you, Dr Grundy?” he asked in a serious voice.
Dr Grundy choked a little on his laughter, then said, “Would you be a very good chap and get out of my car? You’ll be going in the other car.”
Ricky leaned out of the window and looked at my car dubiously. “That looks like a German car. I don’t like German cars.”
“It’s not a German car,” I assured him.
“I like this car better,” he said, and wound the window up again. He started to move the steering wheel round as if he were driving.
Dr Grundy was trying so hard to control his mirth that I began to fear he might have an aneurysm. But he had a cunning plan. The tailgate was unlocked, so he opened it and crawled into the boot, then climbed over the back seat until he could unlock one of the doors. It was the first time I had seen a GP get so hands on during a Mental Health Act Assessment.
Ricky eventually agreed to get into my car. I had him sit in the back seat. But as I was alone, and the doctor needed to get back to his surgery, I did not have an escort.
However, Ricky seemed more than happy about going to hospital, and we set off on the 15 mile journey.
He laughed and chuckled and fidgeted in the back seat. I wondered what he was up to, and tried to keep an eye on him in my rear view mirror. At one point he said, “Are you sure this isn’t a German car?”
“No it definitely isn’t a German car. It’s a Fiat. A Fiat 127.”
“Only I don’t like the Germans. They fought us in the War, you know. Who makes Fiats?”
“The Italians,” I replied, without thinking.
“Weren’t the Italians in the War too, on the German side?” he asked, a little threateningly I thought.
“Er, no, I’m sure there weren’t,” I lied.
“Well, that’s all right then,” he said, and went back to his chuckling and fidgeting.
Eventually we arrived at the hospital. I pulled my seat forward to let him out.
That was when I discovered that Ricky had taken a screwdriver with him. And throughout the journey, he had been systematically removing all the screws he could find in the back of the car. The screws were in a tidy heap on the back seat. The component parts of the interior of the rear of my car were in another tidy heap.
The Second Assessment
I received another request from Dr Grundy to assess Ricky a year or so later. Deciding that it was likely that Ricky would agree to an informal admission if required, I went out initially without Dr Grundy this time.
The front door was ajar. I knocked, but there was no reply. The garage door was open, so I had a look. Ricky’s nearly new Rover was parked inside. However, there was something badly wrong with it. The words: “Brooom! Broooom!” were written down the side of it in large letters in matt black emulsion. The driver’s door was open. Ricky had obviously been busy with his screwdriver again, because most of the dashboard had been dismantled, and dials and wires and various other components were scattered all over the front seats.
I went into the house, calling Ricky’s name. There was no reply. I went into his living room. There was again something very wrong about the room. It was dark, for one thing, although it was the middle of the day, so I turned on the light. That was when I realised that Ricky had painted the glass of the windows with matt black paint. The TV was on in the corner, but he had obscured the screen with matt black paint.
I continued on my journey through the house, into the kitchen, where I saw that the central heating thermostat had been dismantled and was hanging from the wall. The lid of the chest freezer was up, and inside was a dismantled toaster.
But there was still no sign of Ricky.
I went out of the open back door and into the back garden. I finally found him in the greenhouse, sitting on a deck chair and wearing his deerstalker hat and sunglasses. He beamed up at me, lifted up his sunglasses, winked at me broadly, and then gave me a piece of paper. On it he had written: “Jul Aug Sep Oct No Wonder!” I puzzled over this for a few moments, then suddenly realised that this was a list of abbreviations for months of the year, but he had then gone off on a tangent: classic flight of ideas.
“I think it’s time you went to hospital again,” I said to him. Ricky nodded and stood up.
But this time I made sure he didn’t have a screwdriver with him.