Mr Adams Vs Mental Health Professionals

As an Occupational Therapy student in August 2006 my final university placement was working in a small Mental Health team specialising in Rehab and Recovery - patients varied in diagnosis but all were severe and enduring- none particularly harmful to themselves or others, most stable and just struggling to function in day to day activities such as shopping, personal care etc. This community based team in the West Midlands would visit patients in their own home (occasionally on the wards if they had been admitted when unwell) so during my time there I had visited many patients' homes- every type of home you could imagine -accompanied by various members of the team. It was not until the last few weeks of my placement that I realised how accustomed I had become to what most would consider "abnormal" and it was due to the following event that I realised this and it will be one of my first experiences I would like to share on this site.

To give some background, this day in particular was the same as any other to start with; we had been to see a schizophrenic lady in her 50s who lived alone first thing that morning. Before even knocking the front door she had opened it in fluster ushering us in screeching at the top of her voice that Morris was choking and we needed to help. Morris turned out to be a "Tickle me Elmo" with a face covered in beans suffering with flat batteries- much to the relief of my educator - a lovely psychiatric nurse called Jeanne. Jeanne and I then went to carry out a generic initial assessment on a new patient the Psychiatrist had passed to us - again a particularly psychotic schizophrenic, male, aged 42 -Afro Caribbean, always hearing and responding to auditory and visual hallucinations, but compliant with his medication and friendly. Having read his file and referral this man had a history as long as your arm of trying to commit suicide, socially isolating himself, and experiencing severe paranoia - that was until the team had picked up his case and he started to get some real help. He was now considered as "stable" as he would ever be. His referral stated that he lived alone with his mother.

Around 11. 30 that morning we pulled up outside Peters house. Jeanne commented on the old Caucasian man standing in the window upstairs peeking at us from behind a net curtain, we both smiled politely as we walked down the small path to the house -a little worried that we had been given the wrong address -but we hadn't. Peter answered the door and invited us in, his mom offered us a cup of tea and we casually started talking to Peter about why we were there and asked him about his illness- his mom also helped with this as Peter didn't have a lot of insight into his illness. He was open about his obsessive behaviour and paranoia though - things like holding a very old fashion (broken) radio all the time because he like the song it kept playing and he had covered the mirror in the hallway with tin-foil because "people can come through it and the tin-foil locks the mirror". In all honesty he was one of the most interesting patients I had met, very sweet and likable too.

Throughout talking about his daily activities the thing he spoke most about that day was Mr Adams. He said that since he started his medication he didn't hear bad voices anymore which once encouraged him to try to kill himself and now he could see Mr Adams more which he was very pleased about. When I asked who Mr Adams was his mom explained without a hint of doubt that Mr Adams was a an elderly neighbour who had died when Peter was very young and she said that he visited them quite often although she only ever saw him twice in the 30 odd years he'd been dead. Once by her bed and once in Peter's room during a time he was hospitalised. She said he moved things and that her husband (now deceased) had said on many occasions that he had seen him standing by their bed in the middle of the night. She laughed and rolled her eyes explaining that she was not "mad" like her son and didn't care if we thought she was because all she cared about was that Mr Adams always helped Peter. Peter explained that when the voices were bad Mr Adams would hit them with his walking stick or sometimes he would sit next to Peter and tell him not to harm himself. Between themselves they recalled many incidents such as finding their beds dressed in a "hospital corners" type fashion, things being moved and doors opening and closing. Peter reported frequently seeing Mr Adams and speaking to him. He did see other "people" e.g. Another man who dressed as a pirate but Peter didn't seem as interested in talking about him and his mom made it clear that Pirate wasn't real!

Although we sat there bemused (for the first time in ages) and I was completely out of my comfort zone it hadn't yet clicked, although Jeanne admitted later she had her suspicions. Peters mom smiled and said that she'd watched us both look to the upstairs of the house smiling as we walked down the path to the front door earlier and she knew he must have been upstairs peeking on the visitors. Jeanne with her poker face on asked what Mr Adams looked like and Peter said "old skinny white man" and we both nervously laughed. We finished the assessment by having a look around the house asking Peter to show use what he did on a day to day basis, if he could use the kitchen safely etc. And there was definitely no-one else in that house apart from the four of us. No old man at all!

Without a doubt we had seen someone who had totally disappeared from the house that day - that was the initial mystery. The more we talked about it and tried to rationalise it we just couldn't explain how someone could have left the house without passing us. We had both seen a man very similar to the man Peter and his mother had described. Back at our base we told the team who were all baffled and interested, a few rolled their eyes and we were a bit embarrassed to be honest. We sounded like we had been fooled big time but we both knew there was no one else in that house. We documented what the patient had told us. We could not prove there was someone in the house so it was not mentioned in our report only what Peter and his mom had said about Mr Adams. The Consultant read it and mentioned that the mother had said similar things to him and it is Peter's most common hallucination. Peter's Social Worker Maria told us in my final week on placement when we all went out for a "goodbye" meal, that she had visited Peter a week after us and said she had seen the old man we described walk past the kitchen door whilst she was talking to Peters mom, she had asked who he was and Peters mom said it was Mr Adams the ghost. Maria was baffled too.

So what do you think? A lot of things bothered me about this incident especially the more we spoke about it, and although I'm quite embarrassed to admit it- we both believed we had seen a "ghost" that day. It's such a difficult experience to analyse as we were dealing with a mentally ill patient who regularly experiences hallucinations but then we also had our own experience and the accounts of others to consider. This experience left me a little sad too, I felt guilty for doubting Peter because he was such a likable character and what if he really did have sensitivity to spirits mixed in with his hallucinations?

I'd really like to hear your thoughts and answer any questions you have, by all means tell me how we have managed to imagine it all as I'd like to rationalise it! I've never SEEN anything since- although I've had quite a few other totally difference experiences I am keen to share with you when I get time.

Sorry I've been long winded!

Thanks for reading,

27Flowers

*Patient's real name not used