Loving people with mental illness

5 Nov 2018

By Tan Yu Jia

American photographer Melissa Spitz fills her Instagram feed, @nothing_to_worry_about, with shots of white pills that treat anxiety, a wrist with a hospital tag on it and a middle-aged woman smoking a cigarette among other images.

The 30-year-old’s account has almost 700 photographs, as part of her photography project “You Have Nothing To Worry About”, which documents her mother’s daily battle with mental illness and substance abuse. In recognition of her work, TIME magazine named Ms Spitz 2017 Instagram Photographer of the Year.

Ms Spitz said that her project has helped her grow closer to her mother and empathise with her mental condition.

The issue of mental health is becoming salient worldwide but in Singapore, there remains little empathy towards people with mental illness. It is time to raise more awareness about mental health problems, if Singapore is to be a supportive and inclusive society for people who suffer from them.

A survey released by the National Council of Social Services (NCSS) last September found that more than five in 10 respondents here are unwilling to live with, live nearby or work with a person with a mental health condition.

This is despite the fact that more people are living with mental health issues here, according to statistics from the Institute of Mental Health (IMH). In 2017, 43,000 people sought outpatient treatment at IMH, a 22 per cent increase from 2010.

Not “crazy” people

We might think that individuals with mental illness are dangerous, violent or threatening. But most of them do not act this way.

My elder brother was diagnosed with bipolar disorder when he was 16 years old. During his manic episodes, he would have heated rows with other members of the family, air his grandiose thoughts about being the world’s most famous artist and wander away from home on his own.

However, he was never a threat to us. Any form of violence he expressed during these episodes was directed towards himself. During a period of severe depression, he punched his room wall repeatedly until his knuckles started to bleed.

Patients with mental illness are generally neither non-violent nor dangerous, according to a study by the U.S. Department of Health and Human Services. They found that only three to five per cent of crimes involving violent acts were linked to people with mental illness. The majority of these crimes were committed by individuals who were mentally stable.

Moreover, the study found that people with severe mental conditions were 10 times more likely to be a victim of violent crime.

Due to this false stereotype that individuals with mental illness are “dangerous”, they are often marginalised, leaving most of them on their own. As a result, they have become one of the most helpless and vulnerable groups in society. The onus therefore falls on us to care for them more.

Listening is the first step

Living with my brother has taught me some important lessons. His speech and emotions would seem extremely negative and irrational when he broke down. I would feel confused, especially when he withdrew into his own world and made hurtful comments.

As a 14-year-old at the time of my brother’s diagnosis, I was deeply affected when I heard my brother speak repeatedly, and sometimes incoherently, about suicide during his moments of depression.

Sometimes, I wondered why my brother could not just “pull himself together” or “snap out of it”. After years of talking to him, I eventually realised that these statements do not help people with mental illness, and are even detrimental. Instead of criticising people with mental illness, we could help them by listening to their concerns.

Ms Mary Yip, a caregiver support specialist at Caregivers Alliance Limited (CAL), a non-profit organisation that trains caregivers of people with mental illness, says that listening is vital because it assures them that they are not alone, especially in moments when they feel helpless.

“When they want to talk to you, we might think that it’s just a normal conversation. But in their eyes, you may be the only one they want to talk to at that moment,” Ms Yip said, adding that this could make a huge difference to their mental state.

Some practical steps we can take, as recommended by The National Alliance on Mental Illness in the United States, include asking open questions such as “How are you feeling?” and reflecting back on what they have said.

For example, if they share that they feel extremely anxious about interacting with others, we can say: “I hear that you feel very anxious, and you feel that speaking to strangers is very scary for you.”

We can also ask if we have understood them correctly and not interrupt them with our opinions.

During my brother’s multiple relapses over the past few years, I learned to support him by listening. My mother and I often stayed up just to sit with him as he told us about what made him upset that day.

Even if we did not have the answers, we listened. We assured him that our family would always be there for him. Even though his mood would not change immediately, I believe the constant support was what allowed his condition to stabilise over the years.

The dangers of isolation

If my family had not provided emotional support for my brother, he might have become withdrawn from other people.

SANE Australia, the country’s mental health charity, found that loneliness is prevalent among the mentally ill. Over two-thirds of people with mental conditions feel lonely compared to just 10 per cent in the general population.

The same survey also found that close relationships are vital for a person’s recovery from a mental health condition. Nearly 90 per cent of them said that social relationships were “important” or “very important” to them in managing their illnesses.

According to Dr Ang Yong Guan, a consultant psychiatrist in Singapore’s private practice with more than three decades of experience, long-term institutional care for mental patients is a thing of the past, as more effort is being made to reintegrate them into society.

“The mentally ill need the support of their friends and family, in addition to good medical treatment,” Dr Ang said.

CAL’s Ms Yip added that caring for someone with mental illness can seem very troublesome at first. However, she encourages caregivers to imagine this: If the tables were turned and we were the ones who needed help, but were left alone, how would we feel?

“(People with mental illness) are not objects with no feelings, they are living beings too,” the 48-year-old added.

Life is not easy for people with mental health conditions. Spitz’s mother, for example, frequently has panic attacks and suicidal thoughts. Meanwhile, my brother battles social anxiety every time he is in a crowd.

However, having people by their side makes all the difference in their lives.