Dignity In Mental Health

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Margaret Gill was a young mother, living and working in Trinidad, when she was diagnosed with bipolar disorder in 1987. Today, she is an advocate for persons with mental illness, sitting on the National Mental Health Commission as the voice of users of mental health services, their families and friends.

Acknowledging the stigma associated with mental illness, Margaret said it was challenging to disclose her diagnosis and she fully understands why others are reluctant.

“Stigma is not something that you can ignore. Stigmatisation can cause you not to get promotions at work; stigmatisation can make you not get a job; stigmatisation can lose you relationships; it can prevent you from owning a home. So stigmatisation is not a joke and it is something that prevents people, not only from letting others be aware of the condition that they have, but also from seeking care.”

The lecturer at The University of the West Indies Cave Hill Campus stresses the importance of seeking professional help early. “I think what was a great help to me was I decided to seek help. I say I decided, but I was also helped by friends to come to that decision.”

She said it was a friend at work who recognised that she was very depressed, and he contacted her general practitioner and asked the doctor to persuade Margaret to seek psychiatric help.

“He recognised that I perhaps would not have listened to a non-medical person telling me that I needed to seek that kind of help, so when I went to her (the doctor), she told me that she wanted me to talk to a psychiatrist , and that first seeking of help is what enabled me to continue to live.

“You can’t stop living. When you get a diagnosis of diabetes, you don’t stop living; when you get a diagnosis of a heart condition, you don’t stop living. What you do, as with those diagnoses, is that you live within the parameters of the diagnosis.”

Dr. Jo-Ann Brathwaite-Drummond, consultant psychiatrist at the Psychiatric Hospital, strongly supports this point. “In our society in Barbados, we have persons from all walks of life, we have doctors, we have lawyers, we have teachers, we have politicians, we have persons from every single class and creed who have mental health problems, who function, and function well.”

The medical practitioner revealed that one in four persons worldwide was affected by a mental health problem. “The ones that persons tend to know a lot about, or at least have a lot of concern about, are what we call the psychotic disorders which involve very stark changes in behaviour that people are afraid of. Persons have things like hallucinations, or false beliefs called delusions which tend to impact behaviour.

“But interestingly, they are not the most common. They are the ones that are probably the most visible because of the change, but depressive disorders are the most common mental health disorders, not just in Barbados, but worldwide. Anxiety disorders are also extremely common and often under-recognised, just like depression.”

The psychiatrist explained that while everyone experienced changes in mood from day to day, it was the extremes that should cause concern.

“When you have a sustained change, a change that is severely affecting function, whether it’s social functioning, how you interact with friends and family, or a change that is affecting your occupation, how you interact with your colleagues, sustained changes in your productivity.”

“Or even if your productivity is not yet affected but you personally realise ‘I don’t like how I feel, I’m always sad’, or ‘why is it that I have started to feel suspicious of my colleagues’, or ‘why is it that I have started to feel that all my family members are against me at all times’. When your thought patterns change, or your behaviour and your ability to function change, then there is definitely a need to have some sort of intervention.”

(Stock Photo)

(Stock Photo)

Dr. Brathwaite-Drummond lamented the stigma attached to mental illness, noting that it went back centuries. “Back in the 1800s, persons who manifested changes in behaviour as a result of mental health problems were confined to asylums and treated with beatings and blood-letting and enemas and all sorts of strange things.”

Today, she said, ill-treatment continued with persons being excluded socially and being made to feel incompetent to make decisions.

“Some persons in society believe that you do not even have the autonomy that a child would have to say this is what I want for myself or this is what I want to happen to my property. These are basic human rights that are often completely removed as long as a person has a mental disorder.”

The doctor stressed that help was available for everyone experiencing challenges with their mental health (See box). In terms of recovery, she explained that there were some types of anxiety disorders that were not considered chronic.

“We treat the patient, the symptoms resolve, we stop medication and we expect that person to return to their baseline function and be able to work and function socially.”

Then, there are mental disorders which are chronic. “And what we aim for is control and not cure, just as the endocrinologist is not aiming for cure of diabetes but is  aiming for good control,  and that person is expected to be able to work and function in a capacity that is in keeping with their own abilities,” the psychiatrist said.

The theme for World Mental Health Day 2016, Monday, October 10, is: Dignity in Mental Health – Psychological and Mental Health First Aid For All.

It is a message Margaret Gill wants all Barbadians to take on board, and particularly those who struggle with mental health issues like herself: “You haven’t lost any dignity as a human being by being diagnosed with a mental illness. Being diagnosed with a mental illness is like being diagnosed with any illness – it is an illness. It’s not a character flaw, so you have to accept your own value as a human being and don’t let anybody take that away from you.”

