Monday, January 9, 2012

anecdote of a schizophrenic patient

While working as a behaviour therapist at a rehabilitation centre for chronically mentally ill patients in Bangalore, I met a plesant  schizophrenic guy in his mid forties. He had developed schizophrenia while doing his PhD in mathematics and was living with his older brother and his family(His parents were dead;  In India, typically, a sibling/some close family member take care of an ill sibling as there is no government support for the disabled or mentally ill).
He was a cheerful guy who would speak coherently for the first couple of minutes before rambling off about numbers and formullas! He came in with a severe cold one day and when I asked him how he caught the cold, he said that he had to wait outside his house in the rain. I knew that he did have  keys to the house  and asked him about his keys. He said that he had recently  sold some of  the house's furniture to buy sweets(laddoos!); his sister-in-law had become livid and  seized  his keys; Since that day,   he was to wait outside until the others returned home! He was giving his cheerful toothless grin while telling  this story . I laughed but I could also see how unfunny it was  from his sister-in-law's of view! He had a great liking for sweets but had no money to buy them and his sister-in-law did not prepare sweets often enough at home......... And I could very well imagine his sister-in-law's wrath to discover furniture worth thousands of rupees sold in exchange for a few laddoos!

Earlier to this incident, my schizophrenic client had been  entrusted with the task of baby-sitting his neice who was about  3 years old. This poor guy had no idea of how to care for a 3 year old nor was he trained by the child's parents about it. He was told to care for this baby neice while his brother and his sister-in-law were at work.  His sister-in-law became livid again when she  discovered  this chap  teaching the three year old, mathematics formule (a+b; a-b; etc) instead of A,B, C as she had instructed ! 
Needless to say, she did not let him near her child after that.

I keep thinking of this guy  on and off, though I stopped  working at this centre years and years ago.
I feel really bad about the mentally ill and the lack of vital things for them in India. They need a job to keep them engaged during the day; Having a job in a sheltered place will help in so many ways: They feel useful and productive; they have pride and dignity; they are engaged and in some place safe during the day and will not get into trouble or get into unhealthy activities  like smoking, etc.
 By Sheltered Work Place, I mean a place where they are   allowed to work at their own  pace, the demands made on them are minimal, they do not lose the job for not being productive enough, the employers are 'disabled-friendly' etc.
 Secondly they need social opportunities such as a place where they can meet and mingle with people socially. Apart from their families, many mentally ill, mentally retarded, some disabled people such as the blind, hardly get opportunities to mingle socially with people. They are more often than not,  teased, insulted, yelled at or treated as if they were dangerous. People do not realize they have social needs like need for friendship, affection, companionship and love like the so called normal people. Their social needs are not met and this can lead to a whole lot of other problems. It would be ideal if they could date and find someone to be their partner but that is next to impossible in India, at this point in time! But in Toronto, where I work with the disabled population, I have seen several happy couples..........the way the system works, this happens so naturally! Briefly, it works like this. The developmentally disabled (i.e. those with mental retardation or intellectual deficits) are in special schools or in special classes. These are often co-ed and the kids get opportunities to mingle with classmates of the opposite sex who are of their level of intellectual functioning. They start dating in high school and many end up in the same day programs or classes in colleges or in the work places. The literate intellectually disabled manage to maintain friendships and even make new friends on facebook, chatsites, etc.  A lucky few manage to have a girl friend or boy friend for life or at least many years. And as they are of the same level of functioning, the relationshsip is not likely to breakdown due to intellectual incompatibility at least.

Assuming that the families in India will at least provide food, clothing and shelter to their mentally ill or mentally retarded members, I do not see this as a problem in the middle and upper class families of India. But I do wish, they were a bit more sensitive about  their psychological needs such as need for autonomy, need for independence, need for privacy, etc.

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