Matter of the mind and soul

Society needs to shed its perception of the mentally ill and give them the chance to recover.

WHEN I was talking to Kong Chin Siong I found myself talking to a normal person.

He converses like any ordinary person would. Like any normal person, he can rationalise and analyse.

If no one had told me he is mentally ill, I would certainly not have known this when he joined me for lunch recently.

The soft-spoken 46-year-old man has been working for two-and-a-half years for a businessman, who wished only to be called David.

A shy man of few words, Kong has a ready smile. But there is an unmistakable feeling of sadness about him.

He has a diminished sense of self and has little social support. He self-deprecated, talked about his poor memory, his tendency to forget things, and at times, being slow.

His confidence and self-esteem have obviously taken a heavy beating due to the stigma associated with the illness.

Just like a person with high blood pressure, taking medication properly and at the right time stabilizes him.

When asked about his assessment of Kong, David says he is a good employee who performs well in his job and makes himself useful and helpful.

“I could see he is able and therefore I have the confidence to take him in as one of my workers,” he said.

Kong’s family members, however, has yet to see this in him.

David, 40, hopes they will embrace him and welcome him back into the family fold.

Kong looks forward to seeing his siblings again – two older sisters and two younger brothers.

He hopes fervently that they would come to visit him.

Kong does not know where they stay because he used to live with his late mother in one rented house after another. She passed away in 2006. His father died much earlier.

As he has no family to spend his Chinese New Year with, David has him over in his house on the whole of the second day of the festival. Kong, who completed Form 5, has been suffering from schizophrenia.

For the time being, the hospital is his home. He goes to work at Jalan Permai from Monday to Friday, and goes back to the hospital, which is just across the road, after work.

Having him around has not posed any problem to the hospital staff. On his pay day, he would even hand out treats. Part of his pay, he uses to buy his daily necessities and the rest he saves in the bank.

Outside the hospital it can be quite a different story. There is still stigma attached to mental illness, compounded by the fact that many still do not really know what mental illness is all about.

David fervently hopes that the public can have a better understanding about psychiatric illnesses.

“Let us open our hearts to understand, appreciate and care for the mentallyill so that they can feel that society cares and will recover faster, ” he urges.

Sibu Hospital Director Dr Chin Zin Hing said: “When patients come early for treatment, and comply with the doctor’s treatment plan, the majority of them will recover.”

He said where mental disease was concerned, family support was important.

Patients with acute disease will — after treatment — be fit for discharge and the hospital authorities would like them to go back to their own homes, he said.

“The family plays an important role to give them the support they need, such as making sure that they comply with the treatment,” he stressed.

Omaramiyah Mejah, who is in charge of the hospital’s psychiatric unit, said many people have this misconception that mental illness is forever that when a person has been labelled with mental illness they can never recover. Happily, the reality is not so.

“There are lots of people out there who live a normal life while taking medication for a mental illness,” he said.

The unfortunate thing is most people continue to interpret normal swings of emotions as symptoms of continuing illness.

Giving an example, he said there is a tendency among some families to treat their mentally ill member differently, such as making decisions for them and talking for them. No adult likes to be treated this way, he pointed out.

Due to too much pent-up frustration, that person is brought to snapping point and when he has an emotional outburst, people think it is a relapse.

It is not. He explained: “Even a normal person will do the same under such circumstances. We all have times when we feel depressed, get unreasonably angry or over-excited.”

He said anybody who is under a lot of mental pressure can lose grip of his normal self and may have a melt down to vent his feelings.

But thinking it is a relapse, the family forced the poor guy to the hospital, and this only makes the person even angrier.

“He was actually just behaving normally because he is a human with emotions, not a robot who does not know how to be sad, angry or happy,” Omaramiyah stated.

“If a so-called normal person flies into a rage and brandishes a parang, nobody would use the word ‘relapse’ on him, but if a person who has been mentally ill does the same thing, it would be a completely different matter.”

Omaramiyah said a patient’s tolerance level can be lower than normal such that if a normal person can stand working at a job for one day, the patient may work for only half a day.

Yet this is not always the case. Sometimes, the patient has a higher tolerance level than a normal person who may be impatient, having a short fuse, or egoistic.

Omaramiyah said psychiatric patients are in hospital because they need stabilisation and recovery from their crisis so that they can resume normal activities.

According to Omaramiyah, a lot of patients admitted into the hospital’s psychiatric ward would be discharged after a month and go back to their respective families.

No matter how people develop mental illness, there is usually some form of help available which will help them to have improved health and a productive life.

The support of family, friends and employment is also critical as well as the patient having the willpower to recover.

Omaramiyah further said there was no particular way to develop a mental illness.

For some people, it occurs due to genetic factors in their family. Other causes may relate to environmental stressors such as experiences or being spoiled as a child, or on the other extreme, grew up in a rigid environment.

Poverty or its opposite of having too much wealth, isolation, loss, neglect or abandonment can also lead to mental illness.

It can also occur in combination with substance abuse, like drug abuse.

A child having high fever can end up becoming mentally sick. Likewise, an infection, a fall or an accident leading to head injuries are all possible causes.

“There are a lot of possible external causes. Anything abusive can lead to mental illness, even too much pesticide or weedkiller” Omaramiyah said.

National statistics showed the number of mental illness cases rose by 15.6% to 400,227 in 2010 from 2009.

The psychiatric ward on the 3rd floor of the Sibu General Hospital here currently houses 27 patients out of which males made the majority totalling 17.

The youngest among them is 20, while the oldest is 70 years old.

Most of the men are singles, while the females are mostly divorcees.

The psychiatric unit provides four services, Omaramiyah said. Apart from inpatient care, there is also the specialist clinic, home visiting (community service), rehabilitation and job replacement.

Omar noted that it was easier to find jobs for the patients in Peninsular Malaysia as compared to Sarawak because over there, they had various companies offering opportunities to those who were mentally ill.

“I hope the people here will also have a better understanding about mental illness and will reach out to help the patients,” he enthused.

He said some in-patients here are in fact running a mini canteen in the hospital.

They also enjoy gardening in the hospital compound.

Occupational therapy aside, the unit staff also celebrate with their patients all the four main festivals of the country and their birthdays.

Recreational activities include telematches and outings at Jubilee Park, at YMCA Camp Resort and even to as far as Mukah, Similajau and Kuching.

“This year, we are planning an outing to Kabong, Sarikei,” he said.

NGOs, corporations, food outlets, and individuals who would like to be a part of this programme to bring some joy to the patients are welcomed to do so.

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