Romy’s spirit in the sky

I recently read Dr Elizabeth Ford's deeply moving account, Sometimes Amazing Things Happen, about her clinical experiences working at Bellevue Hospital Psychiatric Prison Ward, a maximum-security hospital and inpatient psychiatric unit for the inmates of the New York City jail system, with its hub on Riker’s Island.

It brought to mind a memory of a very troubling but rewarding supervisory relationship with Romy (not his real name) after I was allocated responsibility for his probation order (now community sentence). 

I remember that I recoiled when asked to interview him for the first time. This was not due to any professional aversion to working with clients with a diagnosable mental illness, but because I sensed a nagging lack of casework confidence in how best to engage and contain someone who at times might evince florid psychotic manifestations with loud and voluble outbursts in public places. 

Romy had been convicted of assaulting a 'complete stranger' in the street, who he had punched, believing that he was 'under threat' and I found his documented history of volatile behaviour most unsettling.  

Meeting Romy

He attended his initial supervisory appointment at the probation office with his partner, whose dignified equanimity and consistent support, offered him (and me) a stable anchor point in the months ahead. 

I arranged a home visit at his temporary address, and Romy's partner opened the door, with a tell-tale expression of apprehension. Once inside it was clear of his changeable mood, compounded by non-compliance with his psychotropic medication, he was 'unfit' to be interviewed and arrangements had already been set in motion for him to be assessed under Section (2) of the Mental Health Act 1983. 

Following his hospital admission, I remained in contact with the consultant psychiatrist and subsequently visited the unit which was a short distance from the probation office. I was informed by staff that Romy had been cooperative and was now taking his prescribed medication and, as such, he had been given permission for unescorted home leave. 

Indeed, as I was leaving the hospital, I heard something of a commotion ahead of me and recognised Romy who was expostulating with a member of the security staff. This ‘misunderstanding' was soon resolved but his partner who was with him, had to attend to other matters. 

A trip to the pub

Romy and I walked together with a view to him taking public transport for his home leave. I had not envisaged that the events of the next hour or so would offer an altogether different professional perspective on how I viewed his resourceful presentation. 

Without notice he entered a public house, crowded with a group of foreign tourists, and proceeded to offer an impromptu 'floorshow' fuelled by two pints of quickly consumed beer, which a somewhat reluctant barman had poured for him. 

I had no immediate cause to demur as I had had no prior indications from the mental health staff that he was not to imbibe alcohol or enter public houses (of which the area was plentifully supplied!). 

I sensed a situation fraught with the potential for conflictual misunderstanding, I hesitated to introduce myself to the enraptured young tourists, as his ‘probation officer' feeling, I recall, uncomfortably compromised in my statutory role. 

But mindful that Romy was behaving in an exuberant and unthreatening manner and conversing in a quizzical style (as the heavy accented English exchanges gave rise to further amused interactions),  he started to sing, in a most mellifluous voice, a very recognisable pop song. He had an attentive 'live' audience listening and wondering whether he was, as I overheard, 'a booked act'.

I was nursing a pint of beer at that point. Later, upon reflection, I asked the question as to whether I was perhaps collusive, which helped normalise the situation. An hour or so later, the party of tourists and some of the bemused locals left the public house and Romy mused to me that he still had a 'fine voice' and asked if I’d like another pint.

At this point, I politely declined and indicated that I had to return to the probation office, but enquired whether he would be safe to leave. ‘But of course, Mike...I didn’t think probation officers had much of a sense of fun!' 

Once back at the office, I wrote up my contact log on his case file, ensuring that my entry was suitably anodyne, noting that, 'Romy evidences a welcome capacity to engage well with people in a public space, in an unthreatening and socially responsible manner’.

Settling Romy

He was later discharged from his mental health section and we arranged a follow up appointment at his newly furnished permanent accommodation. We reviewed how his supervision had favourably progressed and how his mental health had stabilised since the outset of his order. 

His partner was in the room, and Romy informed me that he was confident that one of his children from a previous relationship would now be able to visit him to supplement the support on offer. 

One abiding olfactory memory of my home visit was the fragrant smell of incense wafting across the room. In his deeply resonant voice, when we reflected on some of the salient features of his period under supervision, Romy said, 'Mike, I was watching for your reaction when I went into the pub. You know when I was under Dr **** care, [then after a long pause] I thought about it and now I'm going to recommend you to the spirit in the sky!'. 

As I penned the last case note write-up on the expiry of his order, I wryly thought about Romy's aftercare arrangements which were now grounded in a network of local supports, and his probation order (in the words of the aforementioned song) had now been laid to rest!

Mike Guilfoyle is a retired probation officer