Voice for the Voices

I have an older brother who is just under a year older than me.  My mother always reassuringly tells me how she felt suicidal when she found out she was pregnant with me when he was that little.  That never mattered to him or I.  He used to come and lay down underneath my cot, tap for my bottle, take a sip, and pass it back.  When we got a little older, “we” levelled up, and he would go and exchange the milk for guava juice.  When we went to pre-school, he boisterously protected me on the playground, sealed my juice bottle after lunch, and dutifully sat me down in my row when the bell had gone.  But that was a very long time ago.

Since then, we’ve both been diagnosed, and tried to live with our mental illness, as best we could.  Sometimes it wasn’t best.  But I think what’s common is that we both didn’t know how.  No-one in my opinion has written a definitive guide on how to deal with scary hallucinations, voices, moods, anxiety, and all that other glorious stuff the mental illness Pandora’s Box throws your way.  Oh yes, and then there’s that practical thing of needing to eat chocolate, cigarettes and food (in that order) which you have to pay for, with a job, with mental illness.  And neither him nor I are able to do that at the moment for very, very different reasons.

He is currently in prison for a crime, well, he so painfully regrets that he cannot sleep, eat or be himself anymore.  I walked into the prison waiting room, and saw him there, saw my little brother with the badly knitted cable jersey my Mom had made, ready to close my juice bottle – and he shouldn’t be in prison.  Not him, not anyone with mental illness.  I asked him a little about the conditions and his eyes glazed over slightly.  What he did tell me was a refined version.  Was a version that I could not stomach, but that he had watered down for me.  I think tried to water down for him.

He has access to a psychiatrist once every three months, a psychologist once a month, and a social worker who monitors his progress (but with a view to discussing whether he is eligible or not for parole).  He has access to medication sometimes.  And that medication makes him sleepy which means that he cannot protect himself at night.  So they take turns to keep watch in the cell and hopefully so thwart some of the impending violence that looms every minute, of every hour, of every day in prison.  They are allowed access to sunshine once a week if at all, and even then it’s for a few hours.  Exercise is walking around the cells for a while, and even then you have to be on alert.   Supper is six slices of dry bread, and if you can get money from outside, you can buy meat (from the Government supply) and hopefully go to the tuckshop.  It’s not guarenteed though that you will actually eventually consume what you buy.

And all this screamed to me that it was not about rehabilitating him,  It was not about promoting his mental health and goodness knows the human rights of any and everyone in that prison.  If people really understood mental illness – I can almost naseously laugh – they would know that we need no other bars, no other punishments, no other deprivations.  In closing, I saw an awesome picture.  It said: “You don’t have to be a voice for the voiceless.  You just have to pass the Mic”.  And I thought Yeah!!  After having seen my brother, understand what he and others go through I’ve changed my mind though.  I’ve got news for you.  Where they are – where I am – where people with mental illness are who are discriminated against and hurt – there is no voice, and there is no mic, there aren’t enough eyes, ears, and hearts that are dedicated to stopping what is happening.  Please help me change that.  Be part of those who support us as opposed to those who don’t.  I am 4 M’s Bipolar Mom.

The Craziness of Mental Health

I’ve read about the mental healthcare systems abroad, some of the “things” that are available (like therapy) and thought a lot about ours.  I’m not suggesting that things are rosy everywhere else, but merely to reflect on the system we have here.  I live in South Africa and most of the laws and policies here are like Nelson Mandela authored.  We put the D in democracy and the humane into human rights, thereotically.  In practice, it doesn’t work that way.

For example, I once “trained” a group of women in a rural area in our country on the beautiful domestic violence act we have.  Thereotically the police can intervene, you can obtain a protection order, and again thereotically, be protected.  In your home.  In your house with your children.  They listened, dilligently took notes and smiled when I paused.  When I found their silence too much I asked why they weren’t talking / participating.  One of the older women stood up and said:  “The closest police station is at least 300 km away for most of us.  The court is even further.  And you’d be lucky if they serviced you on the same day, IF you have transport money to spare / get there.  We have our own act.  If your partner is threatening violence, we hang a certain item of clothing on the line, which means I need help.  The woman who sees it alerts others in the street, and we all come for “tea”.  We stay there, with endless conversation, until the situation is diffused. Sometimes it works and sometimes it doesn’t.  But that’s what really helps us”.

I kept quiet.  I was humbled by what these women went through and how they tried to help each other.  But that didn’t mean that they shouldn’t be helped more, and that resources and attention shouldn’t immediately be directed to make their lives better.  In the context of mental healthcare things are even more ominous.  There are people with chronic mental illness who died because they were dehydrated.  Yes, there were other factors, but dehydration?  Not being fed?  If I consider what it’s like to have mental illness and to die for these or ANY reasons just isn’t ok.  No matter how we try to dissect it.  If you don’t have the money for private health care (it cost me about 800 US Dollars for myself and my children on private medical aid per month) you will find that there aren’t any services that are responsive enough to cater for people with mental illness, no matter how ill they are.

For example, you can’t get into a psychiatric ward without being suicidal.  This based on my own and other people’s experience has meant that you need to have tried to commit suicide and required immediate hospitalisation / care.  Not if you were intending to.  No, preventative is nice.  We don’t (although there are a few attempts) have a sufficient suicide call in number for people who feel suicidal, or their families who are a concerned.  And I will not go onto describe the ambulance service, which as the rural women teacher taught me, is just not realistic in some parts of our country.   There are frequent drug stockouts, a lack of psychiatrists in the public health system and therapy is a luxury.

I have to face the reality of this system now.  I was retrenched and do not have the resources for private healthcare.  My psychiatrist costs $150 per session, my therapist $80 and private psychiatric hospitals (which are funnily still like jails) are thousands and thousands.  The implementation of our far-reaching mental healthcare act, like the domestic violence act is failing the people who it was designed to poetically protect.  And most people with mental illness do not in our country, have communities of support where they can hang the “I need help underpants” on the line.  We need to draw attention to the state of the system (or perhaps the lack of it), the way people with mental illness are treated and the services they are subjected to, and the not so silent genocide of people with mental illness in our country.  I intend to.  Be part of those who support us as opposed to those who don’t.  I am 4 M’s Bipolar Mom.