Struggling to Breathe – The diary of a Psychiatric In-patient

Struggling to Breathe follows the journey of Niamh, a psychiatric inpatient in Northern Ireland, over a 30-day period, from admission to discharge. It is an honest, sometimes uncomfortable, account of the internal struggle faced by one young woman upon her admission to a psychiatric inpatient ward.

Niamh gets off to a rocky start, with the only bed available being in a ward for older adults. To cope with her new surroundings, she starts to write a diary. It is this diary, transcribed almost verbatim, that makes up the entire book, published in an effort to reduce the stigma around mental ill health.

The reader gets an account which feels like it's happening in real-time. Niamh describes many of her mental struggles: she wants to die but she wants to live; she wants to sleep but she can't; she wants company but she wants peace; she doesn't want to teach but she doesn't know what else she will do. Throughout the book, these inner discussions make salient the feelings of disturbance and intrusion experienced by people with mental ill health, that can be hard to put into words.

As a first-time inpatient, Niamh also describes features of the environment as she finds them. These seemingly mundane, often overlooked features – bedsheets, food, noise levels – come to the fore and pose questions about the relationship between a comfortable, well-designed environment and timely recovery. 

Perhaps most importantly for those working with clients in psychiatric care, she describes a longing desire to receive help and an ensuing ennui with the help that comes; whilst sympathetically recognising the stretched resources of our mental health system. Whilst it may not have been the intent of the book, for someone interested in care quality, it felt like a call to arms.

The tone of the book changes with every step of Niamh's recovery, until her eventual discharge, and ultimately, it becomes a story of hope. Within the book, Niamh advocates for the charities which helped her, whilst recognising her time in the wards as a necessary intervention which got her on her way to recovery. It is a must-read for those looking for some exposure to the in-patient world. By the time you finish reading, you'll be cheering Niamh on, and wondering what more you can do with the resources you have.

Reviewed by Jill Poots, PhD Student in Psychology Applied to Safety and Health, Leeds Beckett University