Local physicians heard firsthand from a former psychiatric patient how unsettling and traumatising the actions of health care workers can be on their patients.Alan Rowland, of Birmingham, England, gave a detailed account of the events that eventually caused him to suffer a complete mental breakdown.He’s been a key player in Birmingham’s efforts to revamp its mental health care system to be more client-directed.The Bermuda Hospitals Board brought him in to present at its Continuing Medical Education (CME) session WHEN??? and to give a public talk on his experiences.A specialist in graphic design and photography, Mr Rowland told how he went from being the managing director in a publishing company to applying for jobs as a van driver.In retrospect he was able to see that depression caused him to avoid seeking positions where he would have too much responsibility.At the time he didn’t realise how skewed his reasoning had become. He said he didn’t hear back from most of the places looking for van drivers and now realises how odd his resume must have looked to those companies.Giving real insight into how he felt and thought at the different junctures of his experience, Mr Rowland’s story was very touching.He painted a picture of a man who was clearly in need of psychiatric help, who tried to get it, but who the system failed.At one point he had managed to restart a publishing company, when thieves broke in and stole all his equipment.He said his six staff were committed, and voluntarily brought in their personal computers to carry on the work.He said he contacted all his creditors, explained the situation and assured them they would all be paid if they gave him six months’ grace.All agreed, but a collection agency appeared on his doorstep shortly after.He said huge moving vans came, the police and locksmith were called in and everything taken by the collection agency even the personal computers of his six staff members.He said he stayed in the room for a long time after everyone left. He then went to his car where, for hours, he would start to put the key in the ignition and then forget what he was going to do, sit for a bit, and do the same thing again.After a few hours he managed to drive himself to a mental health facility but when he went in, found he couldn’t speak, so he left and went home.At home, he said he stayed in a chair for months, unaware of what was going on around him. He said he would eat if someone put food in front of him, and he would drink, when someone gave him something to drink, but didn’t really do much else.He didn’t wash, or shave, or change his clothes, and couldn’t recall what he thought about. He said the TV would be on but he wouldn’t take in anything in at all.Eventually he decided to commit suicide. He wrote notes to his family and was sending them away but his wife refused to leave and made him promise to see a doctor for a month.Their agreement was that if after a month there was no improvement, she would go.But when Mr Rowland went to his GP he found he could not talk. He was anxious and frustrated. The GP sent him to a mental health facility but told him due to a lack of funding, it might not prove very helpful.He arrived at the facility and was made to wait for almost an hour in a corridor. The long wait heightened his anxiety and he left without seeing the doctor.He made a second appointment and again had a long wait but then the nurse appeared and asked if he minded a student sitting in.Despite his opposition the nurse brought in a chair for the young female student and started to question him. He said he was so upset after the session that he walked the four miles home.“I call this the ‘very edge’ because when I left I was supposed to go into the day hospital down the corridor but I just left there and walked home. I was never going back because those people just hadn’t got a clue,” he said.Wanting to honor his promise to his wife he said he eventually returned and attended the day centre three times a week.He was in a large common room with other patients, all of whom sat quietly, consumed in their own worlds.The nurses never came in the room but would instead poke their head in or call out directives.“They would call out my name to go to room number four. I had no idea what was going on in room number four,” said Mr Rowland. “I would say I’m going to step outside because I feel really ill and I think I ‘m going to be sick and I would stay outside until the place emptied then I’d come back in and sit on my chair.”He said for three weeks he did this and no one bothered him. “They didn’t know the clock was ticking down for me,” he said.But one day a support worker sat with him, drank tea, and engaged him in light conversation. He said this changed his life and eventually he was able to talk more and meet with therapists.After several months of therapy Mr Rowland asked if he could teach an art class. He said it became so popular that patients skipped their therapy sessions to attend. He said the nurses became jealous and schemed to have him fired.The district officer came to deliver the bad news to him but was impressed with the impact the class was having on the patients the nurses were reprimanded.Mr Rowland’s gentle humanistic approach to delivering mental health has seen success in Birmingham, where his input is highly valued.He has presented to The House of Commons Select Committee and through the World Health Organisation has helped Albania and Kosovo in revamping their mental health systems.He has lectured at Birmingham University as well as University of Central England, and trained mental health care workers at facilities in Britain and Europe.His philosophy is for therapists to be caring and for them to look patients in the eye when speaking with them.He also recommends therapists have conversations with patients, rather than demanding answers and issuing directives.Mr Rowland explained that this approach empowers mental health patients and better enables them to return to functionality.