A battle for understanding

Relatives of schizophrenics are fighting a silent battle against the stigma of mental illness, encouraged by the occasion of World Mental Health Day on Sunday to speak out and attempt to break the taboo.

Talking openly about the problems they encounter in dealing with the lifelong mental illnesses of their family members could help those in similar situations, raising awareness on the issue and eradicating ignorance on the subject, which only leads to discrimination.

Although they are battling the stigma of mental illness, they too are victims of it to a certain extent. Josephine Borg (fictitious name), whose husband and son are both schizophrenic, was interviewed in her car, insisting on anonymity.

"I do not exactly go on my roof and wave a flag but I have opened up with people I trust," she said. "I educated the members of my family myself and, today, I have more support from relatives, who are treating me the way I would like them to even if they do not fully understand."

She stressed the need for education on mental illness. "I just want people to see it as it is. Mental illness is an illness like any other; it is biological. When a diabetic has an attack he has to be treated. So too in the case of a schizophrenic.

"The public needs to understand that when schizophrenics are controlled they are normal and deserve to be treated as such. They cannot simply be called mad and confined to a mental home. However, neither can they be treated as though there's nothing wrong with them or be made to feel guilty that it is their fault they are sick."

Although giant strides against the stigma of persons with disability - who, in the past, were hidden away from society - have been registered, mental illness still has a long way to go Ms Borg maintained.

A pillar of strength, her suffering has not carved its way into her physical appearance and, at 60, she could be a decade younger even though she has had to deal with her husband's schizophrenia for the last 13 years, while her bright 27-year-old son got ill at 21.

"I have had bad times, been broken and cried a lot, even rebelled against God. But I am a survivor, I have no expectations and my spirituality has saved me. God gave me a lot of everything: both suffering and help. I do not have financial problems, which would have made things much harder and my husband and son have a supportive family, which is a major plus.

"Before I got married, I thought there was a problem but I was not aware of the gravity. I thought my husband was just suffering from a mild depression but the illness is always there and rears its ugly head.

"When he gets an attack, he becomes a totally different person and is convinced he will become a judge. Sometimes he can be hard on me but I take into account his illness and take it with a pinch of salt.

"Schizophrenics cannot cope with any stress. They have to take their medication to keep their condition under control, but this has side effects and leaves them tired and drained, meaning they cannot live the active life they used to lead.

"My son was born business-minded. He was instrumental in developing our company before the age of 21. He was insightful and intelligent. Then, suddenly, everything changed and he started thinking he was a god.

"Today, he knows he is suffering from a mental illness and that he needs his medication. It is his decision not to have a girlfriend and he does not want to have children because his illness is hereditary. In his prime, he cannot drink, or be as active as his friends, but, at least, he is conscious of his limitations.

"He still works for the company but he gets up later and cannot handle as much."

For Ms Borg, employment is a major concern and as important as medication for people suffering from mental illnesses. "They cannot possibly be allowed to wake up and have nothing to look forward to. The difference between a patient who is occupied and one who is neglected in hospital is huge. If the mind is idle, the disturbance comes out.

"It is important that employers are not harsh and do not put these workers under pressure if their input decreases slightly, which can be the case.

"I do not believe and will not delude myself that persons with mental illness could ever work in the private sector but the government should have a set-up of the sort, with professional involvement, where skills are assessed and channelled into the areas where they can contribute. They have to see their potential and not demand more, because stress turns them into time bombs. You do not give a diabetic sugar!

"In my case, we are fortunate that we have our own business but what happens to the others?"

Ms Borg has reservations about Mount Carmel Hospital, its environment and the level of staff dedication. She is concerned that there is no alternative. "If patients are undergoing a mild depression and are not in an 'attack' phase they have nowhere to go but Mount Carmel. There is need for a respite centre with experienced - and not only qualified - staff.

She called for the involvement of professionals in the Mental Health Association. No one understands the patients the way those who love them do but family members are often the most "broken" and need help themselves as well as being taken up by the full-time care of their loved ones.