Stigma still rife in mental health
Discrimination against people with mental disorders makes it difficult to reintegrate them into society. Psychiatric health specialists blame this on the lack of understanding of mental illness and not knowing how to deal with someone who is mentally ill. In this report, we meet someone who has experienced first-hand such discrimination.
‘I was diagnosed in 1991. It’s quite a long time ago. Most people don’t understand it’, Charlene says. She has been living with schizophrenia for nearly 20 years.
‘Once a person presents symptoms of schizophrenia, which is hearing voices, seeing things that are not there, having irrational thoughts, feelings of people being after you, threatening to harm you… it is quite a scary experience’, she says.
Schizophrenia is a common mental disorder. Some of the symptoms range from hallucinations, lack of emotions and delusions. Zunkel says these symptoms are often scary, but what was even scarier was her family’s reaction. ‘My family didn’t quite understand it, especially in the beginning. They had the attitude of ‘you must pull yourself together it’s just all in your mind’.’
What’s worse, the medication prescribed to Charlene at the time gave her side-effects which made her family even more confused. ‘As as a result of the medication’¦ the side effects like stiff walking’¦ they said ‘you don’t need the medication. Look at what it is doing to you’. They quite often encouraged me to stop taking my meds, which I did often and, obviously, I re-lapsed. Literally, only years afterwards did they begin to understand that I need the medication to function. Now, I must admit I have a better relationship with them’, said Charlene.
But Charlene has not been incapacitated by schizophrenia. She works as a development worker at the Central Gauteng Mental Health Society and is based at a halfway house in Bertrams, Johannesburg, which currently houses about 80 people, mostly suffering from bipolar disorder and schizophrenia. At half-way houses, mental health patients re-learn the basic skills that they once knew such as sweeping, washing dishes, cooking and gardening. Charlene says this is to keep patients busy so they may remain stable.
Despite efforts by half-way houses, specialists in mental health say it is extremely difficult to return someone with a mental disorder back into the open labour market.
An independent Occupational Therapist, Heather Hill says that most businesses are reluctant to employ such people because of the huge stigma attached to mental disorders.
‘All a manager needs, or all that a company needs, is one bad experience: For someone to have a complete freak-out, and they will in their heads think it is schizophrenia or bipolar mood disorder for the rest of their being. Those who have employed people with a mental illness and who had a bad experience with them are very reluctant to try it again. It’s very hard. There are more failures than success’, says Hill.
Hill and her colleagues run a private practice to assist those with mental disorders to find jobs. Their consultancy also seeks to ensure that companies abide by the Employment Equity Act and do not discriminate against mentally ill people. Hill says stigma is even more visible in rural communities.
‘In places like deep Kwa-Zulu Natal and Limpopo, I have seen how they treat people with mental disorders. Often, they are locked away and people think that they are bewitched or cursed. Those people are shunned away from society. They are given a plate of food under the door.’
Back at Charlene’s workplace, the majority of the patients whose functionality levels are low may never get out of the institution, while others have been abandoned by their families. Charlene says it’s easy for someone to re-lapse depending on what they are going through at that point in time. Her own, last major re-lapse was four years ago.
‘I do go through dips every year, sometimes even with seasons changing – seasonal affective disorder. I got it well under control. I do take it easy. My last hospital admission was in the beginning of 2006, more than 4 years ago’, she says.
Wits University Clinical Psychologist, Dr Vinitha Jithoo, says in many cases re-lapses occur because patients lack support from families due to being misinformed about mental illness.
Jithoo says one of the challenges facing Third World countries is that they lack adequate resources to cater for people with mental disorders. ‘We don’t have the facilities to put them into rehab. Instead, they are isolated or put in homes. This increases their level of aggression. It can destabilise them. We just lack the facilities provided by First World countries’.
It is difficult to tell or identify someone with a mental disorder as it’s not very easily visible. But specialists say it’s important for people to understand that mental disorders can be controlled.