If a person suffers from a chronic condition it can completely change the dynamic of their close family members’ lives, particularly in the case of mental illness.
There is no cure for certain mental illnesses such as schizophrenia or dementia and patients tend to deteriorate rather than improve significantly.
In the face of such unfavourable prognoses, the patient’s immediate family or caregiver may struggle to cope with such a difficult reality.
Dr Khawla Ahmed Al Mer, Consultant Psychiatrist at Rashid Hospital, DHA, says that she commonly encounters close family members that are in denial when confronted with such scenarios.
Dr Al Mer also says that the trauma of dealing with a mental illness can have a detrimental effect on the caregiver’s own psychiatric welfare.
“Sometimes relatives and caregivers’ health can suffer because they don’t have time for themselves. They can be very frustrated, disappointed and exhausted. A lot of caregivers may have symptoms of anxiety and depression and they may suffer from sleep problems.”
In the case of dementia, the everyday burdens placed on caregivers can be overwhelming. There’s a very possible chance that a relative — be it a mother or a father — may forget or fail to recognise the caregiver. And, while this alone must be a devastating psychological trauma, some caregivers can fall into even more complicated mental scenarios, where they place liability on themselves or even the patient for the illness.
“Some people are in denial and can blame the patient for their problems. They can believe that the relative is not sick. This can cause problems for the patient if their caregiver doesn’t understand why they have a problem,” says Dr Al Mer.
“Some caregivers will blame themselves, especially if they are the mother. They will believe that it’s their fault the child has a psychiatric illness but this is not true as the causes are still not known. It comes down to awareness about the nature of an illness, the cause, prognosis, treatment, and how to deal with it.”
The power of truth
While denial and an unrealistic sense of hope may be part of the natural process of acceptance for cargivers, Dr Al Mer believes that educating the caregiver is vital to improving the lives of both them and the patient.
“As a psychiatrist at DHA, it is my job to tell family members that schizophrenia is a true illness and what the patient believes is true to them. For example, I try to educate the caregiver that they shouldn’t try to make the patient change their mind.”
The extent of caregiver’s denial can vary with each individual case. While cultural stigmas and outdated superstitions do exist, Dr Al Mer says that awareness of mental health conditions has improved substantially, attributing this to education.
Dubai Health Authority regularly makes efforts to raise awareness about mental illness within the community. Each October, Rashid Hospital’s Psychiatry department holds a Mental Health Campaign, where they visit schools, malls and other institutions in Dubai. They also hold an annual walkathon.
In 2010, DHA launched a community mental health service. “Staff visit patients’ houses to treat them,” says Dr Al Mer. “This helps a lot of caregivers and this also helps chronic mental health patients who do not comply with their medication.
“It also means the patient will not suffer a relapse in their condition. We have 106 patients now and it improves the quality of life for the patients significantly. With schizophrenics that don’t take their medication, they can experience hallucinations, they can withdraw from their families and they can become aggressive and paranoid. When patients take their medication, they tend to be calmer, more cooperative and sleep better.”
Dr Al Mer says that while ensuring patients complying with their medication is important, it’s also essential for caregivers to set aside time for themselves, where they can focus on their own health and well-being. “For chronic illness, the care will be continuous and it will not end in days, months or years. Therefore it is very important that the patient has time for themselves. My advice for everyone is that they should take time for themselves to have fun and enjoy themselves.”