Wednesday, 9 December 2009

Tackling The Mental Health Minefield Part 5 - Please Sir, Can I Have Some More?

(This post continues the story from Tackling The Mental Health Minefield Part 4 - Life On The Admissions Ward)

The rest of the posts in this series will give details of a particular aspect of my time in the mental hospital. So the decision has been to decide what would be the first subject to be tackled. In the end it wasn't very difficult to decide; it had to be FOOD. One of the best blogs to have appeared recently has to have been Traction Man's Notes From A Hospital Bed which attracted huge numbers of visitors when he started showing the awful food that he was being served with in his long sojourn in hospital and it was reported on the BBC New website.

Hospital food is nearly always something that one endures while a patient; although you are likely to be given a menu card to choose what you want for your meals, the likelihood of you actually getting what you asked for and it being edible is not high. I should admit at this point that I am a bit of a fussy eater even when I am not in the depths of depression. I do eat a wide range of things, and I am a great fan of food from other parts of the world, but at the same time there are a number of quite ordinary things (cauliflower, cabbage, and Brussels sprouts to name a few) that I really cannot abide and absolutely nothing will persuade me to eat them. I am also allergic to a couple of things (tomatoes and pineapple) which make me really ill if I eat them. Bearing this in mind I was not sure how I was going to fare if I was going to be in hospital for a while. The longest hospital stay that I have had in the past was seven days on two separate occasions (surgery both times) and I managed to lose weight on both occasions.


The first meal of the day was pretty typical of what you might get in any hospital. The day staff came on duty at 8am and one of the oncoming team would go to the kitchen and get the the things ready for us, so that breakfast was usually available by 8.15am. There would be a choice of variety-pack size cereals, usually cornflakes, rice krispies, bran flakes and fruit and fibre. Hot and cold milk would be available to suit the individuals preference. I'm not a great fan of cereals and my choice would always be shredded wheat, but this was not one of the options available so cereal was off the menu for me.

The other item on the menu for breakfast was toast. The staff member who was on breakfast duty would toast a loaf of white bread and a loaf of brown bread. If you like your toast hot then you made sure that you were there ready to snatch some bread off the plate the moment that it came out of the kitchen. Usually there was a choice of butter or low fat spread to put on the toast and if we were really lucky there might be individual portions of jam or even Marmite. I have to admit to having been a Marmite baby so if it was available that would always be my choice of topping.

There was usually enough milk available for you to have a glass of milk with your breakfast (either full-fat or semi-skimmed) but if your preference was for a hot drink, then the vacuum jugs would have been filled with hot water for you to make a nice cup of tea or coffee.

I suppose that I should point out here that we were not allowed anywhere near boiling water, so we had to make our hot drinks from hot water in a couple of vacuum jugs. this was fine as long as you managed to make a drink just after they had been filled, but after that you were left with a lukewarm drink that you would throw away at home but which you drank thirstily on the ward because it could be ages before you could manage to persuade a member of staff to refill them.

The first ward that I was on had only plastic plates, mugs and cutlery; on the second ward the plates and mugs were melamine and there was a selection of both plastic and metal cutlery.

Lunch and Dinner

As is common in hospitals today, the main meals of the day were cook-chill prepared elsewhere and then heated on the wards. This did mean that the food was always hot when it was brought to the dining room. There was always a meat dish and a vegetarian dish, usually a couple of choices of potatoes and at least two other vegetables. Unfortunately gravy was often missing from the food delivered to the ward which meant that because I hate eating vegetables without gravy I often went without. In addition to the choice of hot meals there was also salad (always with tomatoes cut up in it so I could have that as I am allergic to tomatoes) and usually sandwiches (again often with tomato in them). At both lunch and dinner there was a dessert, usually tinned fruit at lunchtime but something more substantial and often hot at dinner such as apple pie or spotted dick, or if it was a cold dessert cheesecake or gateau. Soup was also available at dinner.

Although I am very definitely a meat-eater, I have to admit that I did have the vegetarian option quite often. The vegetarian sausages were really nice and so were quite a few of the other vegetarian dishes. Once everybody had been served, and we were usually all hanging around in the dining room waiting for our meals, there was the opportunity for seconds if there was anything left over.

The only days on which you could predict what would be on the menu were Friday, when there would always be fish and chips for lunch, and Sunday, when there was always a roast for lunch. The menus for the following day were put up on a board in the dining room after dinner so that you knew what was coming the next day. Even though I am a very fussy eater as I have already mentioned there were only three meals during the month that I was in hospital where I didn't like anything on the menu, and as these were all on different days, I didn't go hungry.


The changeover from day staff to night staff took place at 9pm and as with breakfast one of the oncoming staff would go to the kitchen and toast a loaf of white and a loaf of brown bread. There would often be cheese and biscuits and yoghurts too. If you didn't happen to be in the dining room (which doubled up as a day room on both wards and as the television room on the second ward) then the staff would go round the rooms to tell you that supper was ready.


One thing that was imperative was that the patients didn't go hungry. If you didn't fancy a meal there would be an inquisition as to why you weren't eating. the fact that there was always supper to rely on meant that if you had missed out on a meal you wouldn't go to bed hungry. The food was of a very high standard for hospital food too. I don't know if the same food was served in the adjacent hospital but one assumes that they would try to ensure that the food was quite good in a mental hospital because the last thing that they would want would be a schizophrenic going hungry and taking it out on the staff.

As with many depressives, I lose my appetite when I get really depressed, and I hadn't eaten a proper meal for more than a week when I was admitted into hospital. I hadn't stopped eating, I just couldn't be bothered to eat properly and I had been surviving on a couple of cheese rolls each day. I was encouraged to eat from the moment that I arrived in the hospital starting with the cup of tea and toast that Dr Hugh got for me. It didn't take me long to be eating at all four meals during the day and if I was hungry in between meals I could always ask for some crisps or biscuits (I didn't though). Unbelievably, I didn't put on any weight while I was a patient, nor did I lose any weight like I had on my two previous week-long hospital stays.

To be continued.


steph said...

It's lovely to hear a positive aspect of your hospital experience. Too often, we hear nothing but complaints about hospitals despite definite improvements in service. I'm a great believer in giving praise where it's due.

Being in hospital is bad enough but if the food is crummy, then there's very little to break the monotony of the day. The catering in the NHS hospital I was in, was absolutely appalling. The cooked food was virtually inedible so I've great sympathy with Traction Man.

When I ended up spending a month in a public (equivalent of NHS) hospital back in Ireland, the catering was fantastic by comparison. Meals became the highlight of the day! Yet, the same hospital served appalling food on my previous incarceration four years earlier.

I made sure to mention this improvement to hospital management.

Anonymous said...

You may have inspired me to write a "hospital food" post...

I'm a vegetarian, which is not really all than uncommon of a thing these days, and yet the hospital I was just didn't seem able to handle it.

Memorable meals: French fry pizza, which was a cheese pizza covered with french fries. Second memorable meal: the night they brought me up mashed potatoes, french fries, and a hunk of french bread (no butter). Starch anyone?

jessa said...

Hi, new reader over from mental nurse.

I'm glad the food for you was bearable. I'm generally fine with the concept that hospital food will not be great. It doesn't have to be, although it should be edible and nutritious and it shouldn't make anyone ill.

The one place where I think the food should be thought out more is on eating disorder wards. When I have been in for anorexia, we ate the same food as the rest of the patients in the psych hospital. We were taught about "normal eating", there was even some inspirational poem about it (I am not kidding) that they gave us. Whenever we complained about the food, we were told that "normal eating" means that sometimes you have to eat things that you do not like to eat. Our arguments that "normal eating" can also include skipping a meal because it is not something we like to eat or because it is inedible went ignored. We had "practice foods" (outside of the hospital cafeteria food) where we ate food and they tried to convince us to let ourselves enjoy food. The argument that it is difficult to learn to like food when you are primarily fed unlikable food (even by the standards of most "normal" eaters) fell on deaf ears.

When I was admitted, I told them that I was a vegetarian. They asked how long I had been a vegetarian (7 or so years at that point) and how long I had been anorexic (3 or so years at that point) specifically so that they could figure out which had come first. Many anorexics become vegetarians primarily as an excuse to cut things out of their diet, which is a fine thing to try to avoid letting patients do. But despite the very obvious fact that my vegetarianism was not related to my eating disorder, they tried to make me eat meat anyhow. (They warned me in advance that there was no guarantee that there would be a vegetarian option at every meal. I said, find, whatever, I want to get better. I did not tell them I had no intention of eating meat. For me, it is an ethical decision, unrelated to my eating disorder, and if I eat meat I will get sick. Wouldn't they want to avoid forcing anorexic patients to eat things that will cause them to vomit involuntarily? I would have thought so. But no.)

There was one time when I ordered "pasta primavera" and it was dull limp vegetables, which would have been fine enough, but they were smothered in a gray sauce the color of dust. I ate everything not covered in the dust-sauce, turned to the staff member next to me, and asked, "can I be done?" We were always supposed to clean our plates or get a "supplement" (nutrition milkshake), and we had to get staff to check our plates. That staff member said "yes" and took my tray herself to the tray return so that none of the other patients, who had chosen meat, would notice I was getting off easy, and she did not make me have a supplement. That was the most human act by staff I ever experienced.

In sum, I don't expect them to feed eating disorder patients gourmet meals, but I do expect them to pay more attention to what they feed them than they do to most patients, beyond making sure they eat enough. That is how I feel about hospital food.

Anonymous said...

The food... Breakfast was the same! I actually got into the routine of having breakfast in hospital and started to become a cereal fan, rice krispies and often some toast if I could get to it when it came from the kitchen – there was nothing worse than the toast after it had gone cold and soggy!

I always had the fresh soup at lunch time since it was homemade and delicious with usually a sandwich and because the warm food in the evening was always to filling and bulky I seemed to live on salad and yoghurt which I think often came as a surprise to the staff that the fat girl didn’t have the school type puddings!

I actually liked the hospital food on offer, considering it was my first stay in hospital in June for three weeks I didn’t have any complaints about what was offered and served up! It's the same with what was offered and served to mum during her stays in hospital, bearing in mind she was in for six months last year / this year but I feel there was always a good choice!