Dear Counsellor:

My brother is schizophrenic and is not compliant with his medication. He gets ill at times and destroys furniture. We have tried to get the mental health nurse to give him the injections on a monthly basis and this has helped us a lot.

- Martha

Dear Martha:

Schizophrenia is a chronic condition with recurrences and relapses. Compliance with medica- tion and office visits is a major concern for any chronic illness. Patients don't like to take medication or visit the doctor unless there is something physically wrong with them.

The hospitals are filled with individuals with complications of chronic illnesses, schizophrenia being one of them. A lot of patients are admitted to psychiatric units because of non-compliance with medication. When individuals are admitted to hospital, they improve and function well, but unfor-tunately will relapse if they are non-compliant.

Normal life

A large percentage of people with schizophrenia take their medications and are able to work, have a family and live a normal life. I workin an outpatient facility and it is encouraging to see the patients coming each month to get their injections and going off to work. It is possible for patients to be motivated to be compliant with office visits and medications. We need to have social workers who act as case managers to help the patients.

In the Jamaican system, we have mental health nurses who visit homes to give the patients injec-tions and medications. We would like more involvement of family members and community members in the care of the mentally ill.

Dear Counsellor:

I have been trying to deal with my weight problem for some time now. I am neither losing weight nor gaining weight.

- Marie

Dear Marie:

Sometimes we reach a plateau in our weight management before we start to lose weight. It is good that you are not gaining weight. Are you following a diet plan? We need a certain amount of calories for normal functions and if we take in more than the required calories, we will gain weight.

When we are at the plateau, we can either take in less calories or exercise some more. Sometimes we eat because we are feeling unhappy, lonely or angry.

Emotional eating is a large component of our diet. We eat to comfort and nurture ourselves.

When we were babies, we were comforted with food, and we tend to carry on the tradition. You need to be aware of the times when you are feeling emotional and observe yourself. Is that the time when you eat a lot of ice cream, chocolate or sweet drinks?

Too many calories cause you to gain weight. When you are angry, lonely or unhappy, you can practise journaling. Journaling is an activity in which you keep a diary and document your feelings and activi-ties on a daily basis. You will be able to see what happens when you are angry or sad.

Our emotions are very important and we should be aware of what is happening to us.