Vanessa was a woman in her late 20’s, who lived on an estate in Charwood with her two sons, aged 6 and 8. Vanessa had bipolar affective disorder. About 20 years ago, over a two year period, I had to assess her under the Mental Health Act on 8 separate occasions, invariably during a hypomanic episode.
Most of the time I liked Vanessa. Most of the time she liked me. I felt I knew her. And that was my mistake.
Her default state was to be vivacious and amusing. When she was high, her vivaciousness increased exponentially. She could be deliberately (and also unintentionally) funny.
I remember one evening assessing her in her home. She had taken a liking to the GP. A great liking. She started to flirt with him. Ignoring the psychiatrist and me, she concentrated all her powers on attempting to seduce him with her feminine wiles. She did this by the device of lighting a match, fixing her eyes on his, then pretending to blow the match out. Her lips quivered seductively, on the point, the very cusp, of extinguishing the flame. Her breath would cause the flame to tremble and gutter. But then, teasingly, she would desist, allowing it to burn a little longer, narrowing her eyes a little as she gazed into the GP’s own perplexed and startled eyes. She repeated this with increasing levels of salaciousness. And finally, at the moment when the flame was about to reach her fingers, she delivered the coup de grace.
We were all entranced by this display. But it didn’t stop us detaining her.
It also didn’t seem to interfere with my ability to work with her. Usually, when she recovered, she would recognise that, if on occasion I had had to exert my authority under the Mental Health Act, it was done in the interests of herself and her sons, and did not hold it against me. But over time, an edge of irritability and maliciousness crept into her character, especially when she was high.
The last assessment I undertook (at least in that two year period – there was one more, but that will remain for another post) was also the most spectacular. We knew Vanessa was going to become unwell again because she was refusing her medication. It was only a matter of time. One day, her community nurse reported that she was becoming high again. I contacted the Consultant Psychiatrist and the GP, and in the meantime, we went out to see her to see if she might agree to an informal admission.
“Hi there, Vanessa,” I said as she opened the door. “You can probably guess why I’ve been asked to come to see you.”
Her face was sour. “You’d better come in, I suppose,” she said, ungraciously.
It was the middle of summer. Her two boys were at home. She sent them to play upstairs. The three of us sat in her kitchen. She made herself and the nurse a cup of coffee, but pointedly did not ask me. As I asked her questions about how she had been and whether or not she was taking her medication, she just stared at me with increasing animosity. Finally, she looked at the nurse and said to him, “Is he always this much of an arsehole? Shall I throw this coffee over him?”
“Actually, Vanessa, I wouldn’t do that,” the nurse said supportively.
She suddenly stood up and started to shout at me. I backed off.
“You always come here smarming your way in, then you put me in hospital when there’s nothing whatever the matter with me. I know your fucking game, mate – you’re trying to get my kids aren’t you?”
I tried to reassure her, but she wasn’t having any of it. She left the kitchen and went into her living room. I followed her.
“I’m going out for some fresh air,” she shouted. “I can’t stand the stink in here!” She went out of the patio doors into her back garden. The nurse and I cautiously followed her.
She continued to shout to no-one in particular. “The arsehole’s here to steal my kids!”
The neighbours could certainly hear her. They knew her when she was well, and they knew her when she was unwell. They knew something interesting was going to happen. Down the terrace in either direction, I could see people bringing out their deckchairs or leaning out of upstairs windows in order to get the best vantage point of the spectacle to come.
I didn’t particularly like conducting a Mental Health Act assessment with such a large audience.
“Let’s go inside, shall we?” I said. "You don’t want everyone watching, do you?”
Vanessa did not like this suggestion at all. She suddenly launched herself towards me, arms flailing. She proceeded to box my ears, hitting me hard on either side of the head and knocking my glasses into the grass.
I backed off, while the nurse grabbed her from behind and pinned her arms to her sides, giving me a chance to find my glasses.
“Leave my kids alone!” she shouted, her arms moving uselessly as the nurse attempted to restrain her.
“Leave our mum alone!” her boys shouted at me from the upstairs window.
Before I knew what was happening, they started firing down a rain of toy arrows, which, although the suckers were not actually painful, were certainly humiliating, especially as the observing neighbours were making appreciative comments.
Vanessa broke free from the nurse and ran back through the house and out of the front door.
I followed her, keeping a safe distance, grateful to get away from the arrows.
“Have you heard a joke?” she shouted at the top of her voice to the entire street. “It’s a fucking funny joke. It goes like this.”
She started to walk down the street, shouting as she went. As she passed each car, she deftly snapped off its radio aerial.
“What’s the difference between a Rottweiler and a Social Worker?” she shouted. “You’ll like this, it’s a fucking funny joke. You get your kids back from a Rottweiler! There, that’s a funny fucking joke isn’t it?”
She continued in this vein until she reached the end of the street and went off through the estate.
A police car came round the corner and stopped. The lone police officer wound down his window as the nurse and I approached.
“We’ve had a complaint,” he said. “A report of shouting.”
I explained to him what was happening, and suggested that she be detained under Sec.136 so that she could be taken to a place of safety to be assessed (with less risk to the assessors).
“I think you’ll need more than one officer to detain her,” I said. “She’s wild.” I explained what had happened to me. He did not seem impressed.
“I’ve got a colleague in another car on the way,” he said. “I’m sure we can handle her.”
As he was talking to us, we heard his colleague over the police radio.
“I’ve located the suspect,” we heard him say. “I’m about to apprehend her.” Then we heard a lot of shouting and screaming. “Assistance requested – aah!” we heard the other officer say.
“You get your fucking kids back from a Rottweiler!” we heard Vanessa shout in the background.
The officer drove off at full speed to assist his colleague.
I went to the police station. By the time I was ushered into the custody office, I knew Vanessa was there. I could hear her shouting at the top of her voice from one of the cells. She was saying something about Social Workers and Rottweilers.