Patrick Cockburn: My son, the schizophrenic

Patrick's story

On 10 February 2002, I called my wife Jan by satellite phone from Kabul, where I had been writing about the aftermath of the fall of the Taliban. As soon as she began to speak I noticed that her voice sounded more anxious than I had ever heard it before, as if she had been stunned by some event, and I instantly felt a sense of dread that some disaster had occurred.

She said that our 20-year-old son Henry, a student at an art college in Brighton, was in a mental hospital. He had tried to swim Newhaven estuary fully clothed the previous evening and had been found by fishermen as he left the near-freezing water. They feared he was suffering from hypothermia and took him to a general hospital in Brighton. The doctors there, suspecting that he might have been trying to commit suicide, called the police, who ran Henry's name through their computer. They found that they had arrested him for a few hours some 10 days earlier, on 28 January.

Passers-by had seen Henry, barefoot and dishevelled, climbing the dangerously high wall of a railway viaduct and reported him as a potential suicide. He stoutly denied to the police that he was trying to kill himself, claiming that he had climbed the viaduct only to get a better view of Brighton. Taking into account this earlier incident, the police decided that Henry was a danger to himself and should be sent to a mental hospital. The National Health one was full, so he was sent to the Priory clinic in Hove as "overflow".

I told Jan I would rush home. Kabul was then about the worst city in the world from which to leave quickly in an emergency. I could not find any flights and decided to drive to Islamabad in Pakistan and get a plane from there. I explained my plan to my driver, Mohammed, who gulped at the thought of going through the Kabul Gorge to Jalalabad and the Pakistan border because bands of Taliban were still attacking travellers on the road. I told him my eldest son was very ill and he said that, if such was the case, he would simply drive over anybody who tried to stop us.

In my case, there was probably something expiatory in this mad dash as I wondered what I had been doing talking to Afghan warlords and drug smugglers when my own son was in such trouble. I reached Peshawar, across the border in Pakistan, safely and took the first plane from Islamabad to Heathrow and went to Brighton the next day.

Henry was very pleased to see me. He was in a neat room on the third floor of the clinic, in a large villa in Hove. A nurse came in every 20 minutes to check on him. Henry seemed baffled and subdued by what had happened. He downplayed the idea that he had intended to commit suicide, and said he had felt the urge to walk barefoot back to his old home in Canterbury, 70 miles away. Newhaven estuary had simply been an obstacle to be crossed. He felt that being held in the Priory was a form of persecution or at best a misunderstanding: the police and doctors were overreacting to his eccentric lifestyle.

Henry always had great intelligence, wit and charm. From an early age, he showed an intense interest in other people and made friends easily. He later told me that he felt "shy and inhibited" as a teenager and as a student at King's School in Canterbury, but I do not think this was really true. He painted and drew very well and had won at least one valuable prize for his painting. He had no difficulty in getting the A-levels to enter Brighton art college at the end of 2001. I had been proud of Henry's ability to get on well with my friends, mostly foreign correspondents, though they were far older than he was, but I also worried that Henry was something of a Peter Pan, a boy whose magical charm made it difficult for him to grow up.

I sat on the bed in Henry's room in the Priory and he lay on the floor. Sometimes he beat out a rhythm on the bottom of an upturned waste-paper bin and chanted snatches of rap, but mostly he was listless and remote. He had grudgingly told the doctors at the clinic that he was seeing visions and hearing voices. This had started earlier in January. "I tried to climb the bank by the railway station because I thought the Hanging Gardens of Babylon were on the other side," Henry told me many years later. "It sounds dotty, but I felt there was another world beyond the railway tracks. Trees were talking to me like somebody speaking in my head. Earlier I had asked an old woman with a dog the way to a coffee shop. She giggled and pointed the wrong way and I truly thought she was a witch."

Jan and I soon became familiar with the distorted landscape of the strange world in which Henry was now living. The visions and voices, though the most dramatic part, were infrequent. He spoke vaguely of religious and mystical forces and was extremely ascetic, adopting a vegan diet and not wearing shoes or underpants. He was wary of anything mechanical or electronic, such as watches, mobile phones and smoke alarms.

The consultant at the Priory diagnosed Henry as being in the preliminary phase of schizophrenia. I knew almost nothing about the illness except that it did not mean having a split personality. I had spent many months in a general hospital in Cork and London when I got polio in an epidemic in 1956, but I had never been inside a mental hospital in my life.

I knew that schizophrenia was serious, but not about its devastating impact on its victims. I read up about it with increasing dismay. I discovered that an American doctor had described schizophrenia as being to mental illness what cancer is to physical ailments. The average age for the onset of schizophrenia is 18 in men and 25 in women. There are 250,000 diagnosed cases in Britain, though the true number may be closer to half a million, and 2.2 million in the USA. In the world, an estimated 51 million people suffer from schizophrenia. Symptoms do not include violence, though the suicide rate is very high.

The illness can be alleviated and controlled, but not cured, by drugs developed since the 1950s. Nevertheless, its treatment now is at about the level of the treatment of physical sickness a century ago. Medications may work, but it is not clear precisely why they do so, or why they are effective for one person though not for another.

The causes of schizophrenia have been the subject of prolonged, rancorous and inconclusive debate among scientists. People generally develop the illness because they are genetically predisposed to do so; doctors invariably ask victims if anybody else in their family has been mentally ill. But it is not genes alone that are responsible for the disorder. Tests show that if one of a set of wholly identical twins develops schizophrenia, then the other twin has a 50 per cent chance of becoming schizophrenic as well. But the second twin, although genetically identical to the first, has a 50 per cent chance of not developing the illness. This must mean that there are other forces at work, such as events in the life of a person at risk, which determine if they will develop schizophrenia or not. Its onset might be brought on by some personal disaster like the loss of a job, academic failure, the breakdown of a love affair or the death of a relative. Or it might also, though this is unproven, be the result of taking mind-altering street drugs such as cannabis or skunk.

I only started talking to friends about mental illness after Henry was diagnosed as being schizophrenic, and I was astonished to discover how many of them had close relatives who were mentally ill and about whom they had never spoken to me. It is as if ailments of the mind, and schizophrenia in particular, still carry a charge of terror greater than any physical illness aside from Aids. Across the world, fear of madness still strikes as deep as it ever did.

In the Priory, the doctors explained to us that "a third of people diagnosed with schizophrenia recover completely, one-third have further attacks but show improvement, and one-third do not get better". In reality, the statistics are more complicated and less comforting than this. We did everything we could to help Henry. Jan and I and his younger brother Alex visited him often. I took a room at the Old Ship Hotel on the seafront in Brighton and walked around the town with Henry most days until he was released about nine weeks later and came home to Canterbury.

The medication had done him good but he clearly saw taking the antipsychotic drugs twice as day as an imposition and began to secretly spit them out. He, who had been so alert, original and enquiring, sank into gloomy passivity. At the end of the summer he went back to art college in Brighton, on the advice of a local consultant, but could not cope. He returned to Canterbury and by early 2003 had been sectioned in a mental hospital there, the first of a succession of hospitals and halfway houses we were to get to know all too well over the next five years.

It is not that Henry became a wholly changed personality. Most of the time it was possible to have perfectly sane conversations with him, and he remained affectionate, witty and intelligent. But periodically there were terrifying flights when he would disappear into the Kent countryside, running through brushwood and streams until he was found, often naked, dirty and covered with scratches.

The grim aftermath of one of these disappearances comes across in Jan's diary entry for 4 February 2004, when we saw him in the hospital just after he had been found. "They showed us into his room where he's on the bed, looking terrible," she wrote. "He's scratched all over – especially on his feet, his face too – the scratches very red and sore. He looks at us with such apparent terror that I wonder if he's hallucinating. We sit down with him, Patrick with his arm around H's shoulders, I at his feet. I touch these gently and he shudders. He weeps and grimaces silently for about 10 minutes, then gradually calms down."

I was always frightened that one day Henry, so often soaked to the skin and without food, would not return from his wanderings. But though he did dangerous things very easily, he retained just enough survival instinct to come back. When freezing or starving, he would seek help.

At least he has survived, which is not true of so many schizophrenics, and in the last 18 months in a clinic in east London he seems, slowly and painfully, to be getting better.

Henry's story

The first time I heard the word "schizophrenic", I was in an art class at King's School in Canterbury and somebody had done a series of good drawings. The teacher said they "looked like the drawings of a schizophrenic". I had an idea that schizophrenia just meant a split personality.

I heard the word again after I swam the estuary at Newhaven and I heard it used in hospital. Some sailors took me there saying I had got hypothermia. The doctor told me it was common for people of my age to have mental illness. But I didn't think of it as an illness but as an awakening, a spiritual awakening.

I had started that morning from my art college opposite the market near the Levels on the London road in Brighton, walking barefoot along the edge of the sea. I went east towards my home in Canterbury. I felt that brambles, trees and wild animals were all urging me on. It was as if they were looking at me and I could feel what they thought. Once I went to a little spring and washed myself. I walked along the seashore beside a high sea wall holding back the cliffs. The wall seemed a hundred hundred feet high. I believed there were prisoners hidden behind it and I sang to them.

Now that I find myself in a mental hospital, I look back on my days in Brighton as the best days of my life. I liked the beach, the architecture, the college. I made many friends there and got on well with my housemates, though I am sad that none of them has rung me since I was in hospital.

I was always good at art. I was highly influenced by an American artist called Jean-Michel Basquiat. His style was mainly of symbols and signs, and in his paintings I caught a whiff of magic. At Brighton, my painting had become circular and I was trying to break away from that. A few weeks later I was in Ireland, where I picked up a book on Jackson Pollock. It said he was possessed by daemons and when an artist starts drawing circles it is the first sign of madness. I firmly shut the book because I believed that some ghost in the cottage I was reading it in was trying to tell me I was mad.

I saw myself as a direct descendant of artists from Basquiat to Picasso. Was it just a dream I had a long time ago or was I really as good as I thought? For a kid growing up, the world is a complicated place. My main strength was art, and it was through art that I understood my world.

After I was rescued from the water in Newhaven, I was transferred to the Priory clinic in Hove. While I was there I used a metal bin as a drum and I made up a song to go along with the drum beats. It went: "Through and through and on to Peru/ Through every taboo and on to Peru." I had been in Peru for my cousin's wedding the year before.

A drum was also involved in an experience I had a week before I walked to Newhaven. It was the first time the trees spoke to me. I wanted to make a drum for my brother Alex because he was coming to Brighton. I went to a shop to get materials for it, and I walked about picking up pieces of wood. There were seagulls going south and crows flying away from me. I kept walking. I felt I was going on a mission. You know fire hydrants are yellow and have an "H" on them? I thought the "H" stood for Henry. I was beside a tree near a railway track in Preston Park when its roots started moving and it spoke to me as if somebody was speaking in my head. It said I could rap. It said I was the best of rappers.

About this time, I had a vision. It was on the beach in Brighton. I saw two birds fly across each other, and where they crossed I saw a golden Buddha. When I was arrested for walking barefoot by the police and they asked me: "Have you seen things?", I neglected to tell them this. The police were good to me, though I thought it was a bit much to be arrested just for having bare feet.

The worst hospital I was in was in Canterbury. It was violent; someone punched me. You weren't allowed to go to your room during the day because two people had hanged themselves just before I came. I ran away 18 times. I got out in different ways. I would run through the door if it opened for a second, or I climbed the fence. Once I swam in Westbere Lake but I started to get cramps and turned back. I saw a telephone box and called the police. On another occasion, it was snowing and I got frostbite. I warmed up my feet too rapidly and it was very painful.

It was while at art college in Brighton that I changed. I gave up smoking cannabis and started going barefoot. I took a lot of marijuana between the ages of 14 and 19. I was quite shy and inhibited. My teenage years would have been different without marijuana. Was it more than others? Not really. Why did we smoke so much? Maybe it was because of the music scene. My generation smoked more dope than the one before. I was taking a lot of hash. It would have been better if I hadn't but about half the people I knew in Canterbury were smoking dope. I took skunk but not often. It tastes different and not very nice. Most of my family and friends believe that my being sectioned was because of what I did then.

Do I have schizophrenia? I don't know. My mother, father and the dreaded psychiatrist definitely believe I am schizophrenic. They have grounds for their belief, such as my being found naked and talking to trees in the woods. Yet, I think I just see the world differently from other people, and maybe if psychiatrists understood this I wouldn't be in hospital. When people hear about a psychotic episode they probably relate the word "psycho" to someone with violent tendencies. I would not describe myself as a violent person. I really feel the strain of being in hospital. Being locked up for so long in a small world really dampens your spirits. You feel forgotten.

Schizophrenia: the facts

* About 1 per cent of the population are diagnosed with schizophrenia during their lives

* Schizophrenia affects men and women equally. It is a highly complex condition that is still not fully understood.

During a psychotic episode, patients may be completely unable to separate reality from fantasy and may see the world in a highly distorted way.

* Some patients may have only one psychotic episode. Others may have many episodes during a lifetime, but lead relatively normal lives between episodes.

* Those with chronic schizo-phrenia may need long-term treatment, usually involving drugs, to control their symptoms.

* Some patients experience hallucinations; the most common is hearing voices. They may be anxious and confused, or wide awake and alert, and may hold false or irrational beliefs.

* They are no more prone to be violent than the general population and typically prefer to withdraw and be left alone. Mentally ill people are much more likely to harm themselves than others.

* There is no single cause for schizophrenia. It is thought that some people have a genetic vulnerability and that environmental factors may then trigger the illness.

* Treatment with antipsychotic drugs is effective and though modern ones have fewer side-effects, many patients dislike them.

* The demand for talking treatments exceeds the supply.

* The outlook for patients has improved over the past 25 years, and many patients can lead independent, satisfying lives.

By Jeremy Laurance, Health Editor