A friend, who is also a local National Alliance on Mental Illness member, recently confided in me a surprising story. Her son, who was diagnosed with schizophrenia 11 years ago at the age of 19, has somehow changed lately.
She told me, “You know how Freddy, with his mental illness, doesn’t ever talk much, even to his dad or me? He comes over, but he keeps to himself. He listens to music on his iPod. That’s about all he has done for the past 11 years.
I nodded, as she continued. “His friends from high school have moved on, he has no social life. Day after day, he listens to his iPod. That’s his whole life.”
Sadly, I knew the story. The sociable, amiable young man with a bright future seemed lost to her forever.
My friend continued with her story. “But when he entered Mercy Hospital a month ago for a medical emergency that had nothing to do with his schizophrenia, he got so much care and concern it blew me away. Day after day, the hospital staff was kind, respectful and constant in engaging him as they tried to figure out where his symptoms pointed. Not only that, but each day he was there, somebody came to visit him either from NAMI or our church community.”
“When he came home nine days later, he was changed. Even though he has to manage a second serious illness, his mood has lightened. Now he talks willingly and frequently. He jokes. He is cheerful. I can almost begin to wonder what might be his next step in life.”
I mulled over my friend’s story while searching for a topic for this month’s column. Then I came across a recent NAMI initiative on engagement. Engagement is defined as “winning and keeping trust, expressing that you care.”
A sobering fact is this, 70 percent of folks seeking mental health services drop out after their first or second visit. The question raised is, how is it we fail to engage folks with a mental illness so that they are willing to return to receive care?
To help answer this question, NAMI gathered clients of mental health services, their family members, as well as professionals of all stripes, who deal with those with mental illness on a regular basis. Together they wondered, how do relationships and interactions effect the outcomes for people with mental illness?
A father described how his son, frightened by his own symptoms, voluntarily went to see a psychiatrist. The psychiatrist told him point-blank, “You will be on medications for the rest of your life. They will probably cause you to gain weight and you won’t be able to hold a regular job. If you don’t take the medications, you are going to end up homeless, in jail, or dead.” The son’s reaction was to reject all that the psychiatrist said, and close the door on treatment.
In the mental health field that young man would be termed non-compliant. Compliance is a commonly used term, much more so than engagement.
What if the psychiatrist had asked the young man what his hopes and dreams were for his future? What if he had told him, Yes, you have a very serious illness, but I will be here for you every step of the way, and together we’ll figure out the best treatment so that you can live your best life?
If the doctor had engaged the young man in that way, is it likely that the young man would have closed the door on treatment?
Think about how our hospitals handle a person in cardiac crisis--with the utmost concern and compassion, much like my friend’s son had been cared for at Mercy Hospital. On the other hand, a person in a psychotic crisis gets shackled, locked in a stark room in a locked ward or is taken to a jail cell. That person may be discharged to the parking lot.
My friend attributes her son’s behavior change to the engagement he received from the Mercy hospital staff and the many visitors. People—doctors, nurses, many others, seemed to really care about his well-being. They engaged him in a way he has not experienced for the past eleven years. Engagement made a big difference in his current outlook on life. One mother is hoping it will impact his future as well.
There were many testimonies in the initiative I read that pointed to engagement as a way of treating people in the throes of mental illness that can really change the outcomes.
Often it is easy to see what works or doesn’t work in our mental health care system.
Currently our biggest concern in our local NAMI affiliate is this: When will our community get the long-promised mental health crisis and respite unit?
Perhaps you are not aware, although their first names have been mentioned in this column, many citizens of our county have died for lack of a crisis and respite unit here. Our NAMI affiliate remembers all of these folks. Each was a special individual who died for lack of the appropriate services.
We continue to hold on to hope. Our hope is that when the dust settles as to the running of our local mental health care system, the opening of the crisis and respite unit will soon follow.
In the meantime, if you or a loved one suffers from a mental illness, you are welcome to join us at our monthly NAMI information and support group which meets at 6 p.m. the first Monday of every month at the Vine Street Baptist Church, 2152 N.E. Vine St., Roseburg. Our next meeting is November 7.