Marleise McBean-Graham | Destigmatise mental illness

Mental illness has from time immemorial been an enigma to mankind and in the ancient world was attributed to demon possession, meddling in witchcraft or retribution for bad behaviour from the gods. Mental illness has not been totally understood by mankind, and even though it has been specially studied in the discipline of psychiatry, oftentimes the practitioners cannot perfectly cure the affected. Mental illness, however, affects individuals from all nationalities and all walks of life, whether rich or poor, brilliant or simple. Interestingly, some of the outstanding achievers in history have been credited with varying forms of mental illness, but this did not prevent them from achieving greatness. To name a few: Abraham Lincoln (first and one of the greatest American presidents) suffered from depression; Ludwig van Beethoven (greatest composer of all time) was reputed to have suffered from bipolar disease; Sir Isaac Newton (father of modern science) was a manic depressive; and Charles Dickens (greatest English novelist of the Victorian era) suffered from depression.

Mentally ill persons are considered as non-human or inferior by some persons, hence the general attitude is that nothing can be done for them, and repeated admissions to psychiatric institutions do not generate any real efforts aimed at rehabilitation. The treatment of mental illness throughout history has bordered on the extreme and unbelievable because practitioners did not understand the conditions, practices such as removing a part of the skull known as trephination, bloodletting, removal of the teeth, tonsils and even the uterus. Females with mental illness were designated as witches in the 15th century and thousands were hunted and killed in several countries. Research has improved the understanding and treatment of mental illness somewhat, but despite the various interventions, the majority of mental conditions still remain chronic.

The persons who are unfortunate enough to be diagnosed with mental illness have for the most part been stigmatised and treated as outcasts. This kind of treatment is sometimes as a result of fear and misunderstanding on the part of the family member or onlooker. Some mentally ill individuals have hallucinations (experiences that involve all the senses), so that they see, feel, taste, smell and hear things that are happening only in the mind. Sometimes they can be responding to these hallucinations unconsciously and cause harm to persons around them. The life of a mentally ill person is not considered valuable and oftentimes they are physically abused or murdered by persons who are sworn to uphold the law. The unlawful death of a mentally ill individual may not even cause a responsive investigation, unless there is outcry from a family member.

In developed societies, mentally ill persons may be confined to institutions where they are ‘cared for’, but in a setting similar to a prison. In essence, they are given the basic necessities for existence. However, they are kept locked away and sometimes have very little contact with the outside world. In developing countries, however, a vast majority of mentally ill individuals are hungry and homeless on a daily basis, they wander around trying to find food and many times use abandoned buildings for shelter. For the most part they are poorly dressed and are sometimes physically, sexually, and verbally abused if they venture near to others. Some of them who are confined to institutions are often sexually and physically abused by caregivers.

The institutionalisation of mentally ill individuals does not improve the condition; rather, it causes deterioration, by reducing social interaction which is very essential for human beings. Some mentally ill persons who are confined in institutions for decades become even more ‘lost in their minds’ as they do not receive the needed psychotherapy and exposure needed to keep them in touch with reality. Due to the stigma, relatives do not visit after a while and the mentally ill person is basically abandoned. In situations where rehabilitation of the affected person allows them to be discharged home from institutional care, they return to find that property and financial means that they own have been seized by family or community members and they have to become homeless. Are there any laws in place to safeguard property or money belonging to the mentally ill?

Non-humans

It is the responsibility of government to provide for the vulnerable, albeit mentally ill persons are not the only ones disadvantaged, but they do need extra consideration. Mentally ill persons have been stigmatised in society so much so that some individuals continue to treat them as non-humans or inferior, and rage and expressions of distaste is the norm once these individuals appear. Blind persons can be considered as being extremely vulnerable, but there are many willing hands extended if they need help to manoeuvre across the street or to get into a public passenger vehicle. For the mentally ill, there are very few hands extended, even for the basic necessity, food.

Invaluable service

The mark of any societal progress is reflected in how they treat their most vulnerable. Persons with mental conditions, for example, schizophrenia, bipolar disorder, mania, depression and personality disorders, to name a few, did not choose these conditions. Some of these conditions were genetically determined and some occurred due to trauma such as the post-traumatic stress disorders; these are our mothers, fathers, sisters and brothers. Many of them still hold important positions and give invaluable service to society but take medication which helps them to manage successfully on a daily basis. On the other hand, some individuals are so severely affected by the conditions that they cannot manage to work, or to even take care of themselves on a daily basis.

Persons with mental illness are human beings they feel pain, they have hopes and dreams, they need love. We need to restore the dignity of these persons, our brothers and sisters. We need to provide them with proper shelter, food, and clothing where needed. It is time for us to embrace these individuals who are mentally ill and restore them to their place in society.

Healthcare workers are at the forefront of care for the mentally ill and have often suffered from physical injury and verbal abuse, but they are unwavering in their purpose to provide care for this vulnerable group of individuals. This is the year of the nurse and the midwife; special mention is necessary for mental health nurses who are a part of the team of caregivers doing a tremendous job working with the mentally ill. They provide therapy, support, interaction, and companionship that is sometimes very lacking from family and friends. They are not afraid to get close to individuals who need assistance and follow them up in their communities to ensure that they are maintaining progress. Mental health nurses cannot do it alone; they need the support of the families and friends of this vulnerable group to destigmatise mental illness. Let us restore the dignity of our brothers and sisters; they need our support and love.

Marleise McBean-Graham is an assistant lecturer at The University of the West Indies School of Nursing.