When a relative is mentally ill

Wendel Abel, I AM WHAT I THINK

This article discusses some of the difficulties faced by people with mentally ill relatives and attempt to offer some solutions:

1. The person does not accept their mental illness or lacks insights. This is very common. Such persons often do not keep appointments; are reluctant to take medication and, as a result, may have frequent relapses resulting in frequent hospital admissions. As a concerned relative, you should stay on message and reinforce the fact that the individual has a mental disorder and needs to take medications.

2. The person who is paranoid and suspicious. It can be difficult to live with this individual. They often accuse others of conspiring against them, spying on them, poisoning their food or trying to take away personal possessions or property. They may believe that their telephones are tapped and that cameras are planted in the house. Paranoid features may be observed in persons living with schizophrenia, persons who use marijuana and elderly persons who develop dementia. There are strategies used by mental-health professionals to manage paranoid individuals. Discuss this with your health-care provider.

3. The person who refuses to take medication. Many persons living with mental illness refuse to take medication. The commonest reason for refusing medication is side effects. We encourage individuals to discuss their medication and possible side effects with their doctors. Fortunately, we have many options in medications. One strategy is to use the lowest dose of medication, or monthly or biweekly injections. We have health teams in Jamaica that visit the homes of persons who refuse to attend clinics and take their medication.

4. Individuals who become aggressive. This is especially so for persons who are paranoid and or use marijuana. It is important that these individuals take their medication regularly. Avoid confronting a paranoid person as this could make them more aggressive. If you are concerned about your safety, contact your local mental-health team.

5. Securing the property of mentally ill people. Under the law, you may make an application for guardianship. The court may appoint a committee to oversee the estate of such individuals.

6. The persons who smokes marijuana. Persons who are mentally ill and use drugs can be difficult to manage. We refer to this as 'double trouble'. Marijuana addiction is very difficult to treat especially among mentally ill people, but ensure that the individual complies with his or her medication. When the mental illness is under control, it is easier to manage the marijuana use.

7. Mentally ill people with nothing to do. Many people with mental illness can lead productive lives. Unfortunately, due to the high level of unemployment many people cannot find gainful employment. There is a facility in Kingston that provides structured activities for mentally ill persons, although it does not offer jobs. Contact 977-1108 for further information.

8. Join a support group today. We have a number of groups such as CUMI and MENSANA, that provide support and advice to mentally ill people and their families. I strongly advise family members and persons living with mental illness to join a support group.

Dr Wendel Abel is a consultant psychiatrist and head, Section of Psychiatry, Dept. Of Community Health and Psychiatry, University of the West Indies, 977-1108; email: yourhealth@gleanerjm.com.