Food & Identity: Does A Mental health diagnosis change our relationship with food?
There is no question that food is apart of our identity. What we eat, how, when, where, and if we eat a particular food speaks to our culture, ethnicity, history, and relationship with food. People with a mental health diagnosis are no exception. & yet, in hospitals, specifically psychiatric centers, food is often abysmal. In Westchester County, the psychiatric patients eat the same food as the prisoners in the correctional facility. This is a very sad fact for people with a mental health diagnosis. There is no comfort food for people with a psychiatric disability.
I still remember my early hospitalizations. Close to my discharge, I would be given a day pass, and as a celebration, my family would pick me up and we would go to a restaurant. But this is a privilege. It is not the usual circumstance for people recovering in the hospital. In most cases, people are hundreds of miles from family and there is no day pass for these patients. Instead, people are left to the devices and the barely consumable in the ward.
In the state hospital in Greater Binghamton Health Center, sauces are not only hidden away from patients, use of them is discouraged by staff because it is a chore to cater to the palate of so many patients during meal service. It took me three months to discover there was in fact Barbecue sauce in the locked the fridge and which technician to ask when it was time to eat if I wanted some ketchup on my hamburger.
I am writing this to make it known to family and caregivers how important food is to people locked away from the amenities of the world. When I was in the hospital upstate years ago, my speech was riddled with “word salad” from psychosis. I couldn’t form sentences correctly or access language when necessary. With all this said, I knew to tell my family when they visited: “I want Quiznos”. Sadly, I never did get that Quiznos, but I have been blessed over the years in my many in-patient experiences with just about any dish I desired when my family came to visit.
In earlier postings, I discussed snack time. In Can I Spit in Your Lemoncake? I explored the nuances of snack time and its importance for people on the unit to both escape from their day and pleasantly nourish themselves as people do in the their own homes in the community. The hospital is no different, with few exceptions.
Yes, the exceptions, what are they? Well, it is assumed by dietitians in the Office of Mental Health that if you have a psychiatric disorder, regardless of the diagnosis, you are incapable of regulating your food intake. In my blog article, No Flowers for People with a Mental Health Disorder, I again explored this ridiculous notion on the part of clinicians in the state office of mental health. As I discussed in the article, I have more documentation from this Hospitalization than clinical records. Why? Because I wouldn’t accept the situation in the hospital.
When I was first admitted, I engaged in a behavior called trading. Trading is when you have an extra drink or side dish, or just a particular food you don’t want to eat, and trade it with someone at your dining table willing to accept it in exchange for something else. Seems innocuous right? I couldn’t have been more wrong. Trading landed me in isolation in the dining room every time. If caught trading, a person would be immediately put on restriction and put at a table to eat by his or herself. Seems harsh, doesn’t it?
The justification for punishing trading is that a person might consume too many or two few calories. Given the calories are calculated down the to the single digit, the odds were that trading would change the algorithm for OMH’s state sponsored in-patient diet for people with a mental illness. After I was discharged, my family would remind me of the many phone calls complaining about isolation and eating alone. Because, it wasn’t enough I was eating in an asylum, I needed to sit by myself and sit with my thoughts at dinner or lunchtime.
Something has to change. Perhaps the office of mental health can begin by ruling out specific diagnoses which actually to impair perception and in turn, food intake. I can understand these measures be put in place for an eating disorder unit or other specialized treatment centers which need to be very careful with monitoring food intake. But in the general admissions unit at the state psychiatric level, we can begin by granting some patients ownership over what they put in their mouth.