Let's be absolutely clear about mental illness

Thursday, September 13, 2018

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Mental illness has long been a touchy issue — not only in Jamaica.

A common feature in human relations is that mental illness can often become associated with shame and disgrace. That's how it has been for thousands of years.

Obviously, in those societies with a high degree of public education and understanding, this problem of perception is less acute.

It seems to us that in Jamaica the “stigma” which health officials so often complain about has a lot to do with public ignorance. People simply do not know enough about mental illness.

For example, many, perhaps most Jamaicans, believe that the mentally ill are those who walk about in rags, or little or no clothes, apparently in a world of their own — presenting a constant source of fear, suspicion and uncertainty for those around them.

Many assume “mad people” have no ability to reason, or that they are unable to apply logic, in other words, “Dem nuh have nuh sense.” How often have we heard comments such as, “Him nuh mad; if him did mad him wouldn't run when him see police a come”?

Also, there are many in the general population who do not understand that there are those among them who have been diagnosed with a mental illness of one sort or another and who may even be on medication, but who live normal, productive lives — going to work or school every day.

Indeed, some people who are otherwise quite normal are vulnerable to mental depression and other related ailments which can lead to utter hopelessness and complete loss of a sense of self-worth — a condition which can lead to suicide.

It seems to us that in the push to remove the stigma adversely affecting the drive to treat the mentally ill, the authorities need to find a way to make John Public more aware about the vagaries of the ailment. Mass media is useful, but for the long term school is always a good place to start. A proper, comprehensive, multi-faceted public education programme, holding nothing back, would help, we believe.

Also, while community care for the mentally ill is being proffered as the best way, Jamaicans need to properly understand how “de-institutionalisation” of the mentally ill affects them.

Jamaicans are hearing that the Bellevue Hospital should now be reserved only for “special cases” but people going about their everyday lives as well as those in law enforcement and at the local authority level need to be clear on what represents a special case.

If someone starts to verbally threaten his relatives and neighbours, is that worthy of being considered a special case?

Or is it only when he starts to throw stones at his neighbours or, worse, starts wielding a machete?

When is it okay for the authorities to remove from the community and place in a secure institution an obviously deranged person who shows a propensity to violence?

Anecdotal evidence suggests that even the police and the local municipal authorities are a little unclear about this. The authorities need to make the policy absolutely clear and simple, for all to understand.

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