Mental illness and the family
Hearing voices from miles away,
saying things never said
Seeing shadows in the light of the day, waging a war inside my head
Feeling strangers staring my way, reading minds never read
Tasting danger with each word I say, waging a war inside my head
- War Inside My Head
by Mike Portnoy
o matter where you are in Jamaica, you see them walking around - dirty, unkempt and badly in need of attention. There is no second-guessing if these people are mentally ill.
The greater danger, though, is in those living under your roof, who show no immediate signs that they are precariously on the edge of becoming unhinged.
The sad reality is that mental illness is something that most Jamaicans are not adept in dealing with, or even able to tell it's taking place until it is too late.
Many have family members suffering from the condition right under their noses and they are blissfully unaware.
Often, it is not until that loved one goes berserk and maims or even kills another member of the family that shock and anger are expressed that the person could be so 'evil'.
Family and Religion reached out to Fay Tee Robinson, a mental health nurse based in Clarendon, for insight on this condition, that, unfortunately, is too often regarded as a taboo.
"Mental illness may be defined as any condition that affects a person's thinking, feeling and behaviour, as well as their social, occupational and other important areas of functioning," Robinson explained.
Commenting on the diagnostic process and the classification of the various forms of mental illnesses, she said Jamaica is guided by the Diagnostic Statistical Manual, which originated in North America.
"Some of the major classifications include psychotic disorders, for example, schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; trauma and stressor-related disorders, for example, neurodevelopmental disorders," Robinson shared.
In the past, she said families would take their loved ones who manifested any symptoms of mental illness to Bellevue - the Kingston-based hospital for such patients.
But according to her, since the advent of psychotropic medications in the 1950s, Jamaica joined the quest toward de-institutionalisation and decentralisation. Hence, Bellevue Hospital is no longer the mainstay of mental health-care delivery.
"Persons who are living with mental disorders are offered care in health centres, and in case of relapse, may be admitted to any general hospital across the island. The community mental health service also provides home visits and emergency responses on a case-by-case basis, guided by specific criteria," she pointed out, adding that the onus is on the family and clients to equip themselves with information to enable them to participate in and take responsibility for their care.
Although early detection of the onset of mental illness can be difficult, Robinson shares some of the obvious early signs that something is wrong.
"Deterioration in appearance - neglecting grooming or hygiene; sleeping or eating pattern disturbance; and strange speech or behaviour are some of the warning signs," she said.
IMPACT ON FAMILY
There is no doubt that the impact on family members from one of their own suffering from a mental disorder can be a lot to handle.
Mental health officer for Clarendon, Melissa Burke, pointed out some of the ways it can affect the family.
"Mental illness can affect the family in three ways - emotionally, financially and socially," she said.
The main financial impact is especially when the afflicted person was the main breadwinner, "or the one taking care of that person might have to take time off from work and, depending on their job, they could lose pay for the time off", said Burke.
Emotionally, she said, it can be really stressful taking care of a mentally ill family member. She shared that children can be affected, too, as they can become frightened of the person who is ill.
"Also, some persons may be relatively stable, but simple things or a major event may trigger them, like the loss of a family member. They become stressed by that fact. They then go from stress to depression, and that can affect the family," she explained.
"Marriages can also be broken up when one spouse becomes mentally ill and there is a lack of family support. Without the support, the caregiver can become overwhelmed and say enough is enough."
On the social level, Burke said the stigma this is attached to mental illness - deeming that person as 'mad' - can see them relocating to another community if the pressure gets too much.
"Children are teased at school, and in doing this, the child or children become aggressive and deviant and another cycle starts," said Burke.
She also stressed the importance of ensuring that afflicted loved ones keep up with their treatment. If they are stubborn about taking their medication, she said the caregiver should find creative means of administering it without their knowledge.
"The best thing to do is to keep them from having a relapse. You can do that by ensuring they keep up with their clinic visits," the mental health specialist advised.