Wendel Abel - I AM WHAT I THINK MENTAL ILLNESSES are disorders characterised by disturbance in mood, behaviour, perception and thinking and generally are due to disturbance in the brain. Common mental disorders include depression, anxiety disorders and schizophrenia.
Most mental disorders manifest themselves in early to mid-adulthood but they may occur in children and in old age. They may cause distressing symptoms. In depression, the individual feels sad, may experience changes in appetite and sleep and in severe cases may have suicidal thoughts; anxiety disorders are associated with bodily symptoms for example, racing heart, sweating, shortness of breath and schizophrenia is associated with disturbance in thinking, hallucinations (hearing voices and seeing strange things). Conditions like schizophrenia are called psychotic disorders and the individual usually lose contact with reality.
CAUSES OF MENTAL DISORDERS
The causes are many. In John's family his mother and a sister had a mental disorder. For John the cause is genetic - it runs in the family. For many persons like Sarah, stressful life events triggered her illness. She became ill after the break up of her marriage. Any stressful life event may lead to mental illness such as financial problems, loss of a job, retirement, marital problems to name a few.
For others, experiences dating back to childhood or problems within the family may trigger an illness. "As a young girl I was abused," reported one person, "I never resolved that and I have been depressed all my life."
Medical conditions for example, thyroid disease, cancer, infections and injury to the brain, may lead to mental disorders. Many persons believe
that mental illness is due to a curse,
demon possession or obeah; there is no
scientific basis to support these theories.
CHEMICAL IMBALANCE
Regardless of the cause or the diagnosis, the underlying disturbance is a chemical imbalance in the brain. A rich juice of chemicals maintains the brain. In depression these chemicals are decreased, in schizophrenia one such chemical, dopamine, is increased.
DRUGS AND MENTAL ILLNESS
Alcohol use and cocaine use may lead to mental illness. The relationship between cannabis (ganja) and mental illness is controversial. Some persons who are mentally ill report reduction in symptoms when they smoke cannabis, for others there is a worsening of symptoms.
TREATING MENTAL ILLNESS
Some disorders are of short duration but unfortunately some conditions last a life-time. With proper treatment however many individuals with mental illness are able to live a productive life. What services are available in Jamaica?
1. Clinics and hospital services outpatient services are available in over 100 health centres in Jamaica. Only a few individuals may need to be admitted to hospitals and persons with mental disorders can be treated in almost any hospital in Jamaica. Jamaica is unique in the world in that we have developed a system in which mental disorders are treated in general hospitals. These services form an important component of the community mental health services.
2. The Bellevue Hospital is a mental hospital. Many countries have closed their mental hospitals and have shifted the care of the mentally ill to community services.
3. Community residential facilities. These are regular homes within the community in which individuals reside and receive treatment. In these facilities individuals lead normal lives and are able to work and attend school. These facilities now exist in Jamaica.
4. Family support group. A family support group, MENSANA exists in Jamaica. This group meets regularly and members share valuable information with each other and provide emotional support to families and persons living with mental illness.
5. Community rehabilitation facilities. These facilities operate as day centres delivering a wide range of rehabilitation services. A number of these facilities exist in Jamaica. These include: The Committee for the Upliftment of the Mentally Ill (CUMI) and the City Spirit Foundation in Montego Bay, The Rainbow Centre - located at the Bellevue Hospital in Kingston and Ferdie's House in Kingston.
6. Facilities for persons who are homeless. Unfortunately some individuals become homeless. A number of agencies provide services for persons living with mental illness who are homeless. These include the Marie Atkins Shelter in Kingston, Clarendon Association for Street People (CLASP), Westmoreland Association for Street People (WASP), CUMI, City Spirit Foundation and the Ebenezer Home in Mandeville.
Contact us for further information.
Dr. Wendel Abel is a Consultant Psychiatrist and Senior Lecturer, University of the West Indies.
