October 2016

Caring for the one in five among us

In our wealthy and stable society, the most dispossessed and vulnerable today are the mentally ill, writes Margaret-Mary Flynn. The ones most needing mercy and care may be sitting in inner despair beside us at Mass, or standing alone at a family barbecue.

BY Margaret-Mary Flynn

Twenty years ago, I stood at the back of a school chapel and watched a family walk behind their daughter’s casket. I saw her father’s eyes. I have never seen such a depth of sadness. She was 18.

Every day in Australia, an average of eight people take their own lives. It is an appalling statistic. The news of such a death leaves us bewildered and stammering. We try to make sense of what we can, our hearts numb, waiting for the pain to settle, knowing it will never really end.

If we had comparable figures for soldiers lost in Australia’s current deployments of troops to war zones, imagine the national response. Despite political willingness and promised funding, however, we don’t seem to be gaining traction.

We know that mental illness is both a cause and a consequence of poverty, homelessness, and abuse. That alone should ring alarm bells. However, not all who live with a mental illness experience these conditions. One in five Australians suffer from mental illnesses at some time in their lives.

We have a mainstream health system to be proud of. But where are the comparable teaching hospitals; the well-funded research centres; the philanthropic bequests; the specialised ambulances and ‘ambos’, emergency wards and triage nurses; and suitable provision for those living with a mental illness similar to that which speeds the recovery and treatment of those with other forms of serious ill health?

A common symptom experienced by those living with mental illness is lack of insight. In the acute stages, a person may not understand how seriously unwell they are, nor be able to grasp properly that their thinking is disordered. Behaviour that seems to them a perfectly reasonable response to what they are perceiving and reacting to may be frightening and dangerous to others. It is generally those who know and love them who are the first to recognise the problem.

But privacy and patient confidentiality issues mean that family – who are often the carers – are not given vital information about the patient’s prognosis, the severity of the attack, the medication and dosages prescribed, potential side-effects or danger signs. The decision to accept or reject treatment generally belongs to the ill person – who, for the time-being, may have impaired decision-making ability.

The pressure on acute beds often means their family must manage somehow to care for a loved one in dire need without access to critical information or survival strategies. The dreadfully sad case recently of the Walsh family tragedy in Adelaide highlights the flaws of this system. In Meredith Walsh’s extraordinarily courageous victim statement, read to the court, she said:

“My heart remains broken.”
“Our daughter is devastated by the loss of her father.
“Our son Cy is also shattered by what has happened, and has to live with the consequences of his illness, an illness that has destroyed our loving family.”

According to an ABC report, Mrs Walsh also said privacy rules in relation to patients who have mental illnesses need to be readdressed. “Because he was an adult the medical profession, as the law allows, didn’t involve any other person with his health care,” she said. Her final words were: “I will continue to love and support our son as his father and I have always done”.

In contrast, the ordinary experience of families of a loved one needing hospital treatment for – say – surgery, sees them able to ask about his condition; the nature of his treatment; his medication; what to expect, and how to look after him. Dozy with painkillers, recovering from surgery, the patient is just relieved that someone else is taking care of things. Necessary information is respectfully shared. He is sent home with a well-informed carer and back-up. As one would expect.

In our wealthy and stable society, I suggest that the most dispossessed and vulnerable today are the mentally ill. The ones most needing mercy and care may be sitting in inner despair beside us at Mass, or standing alone at a family barbecue. They are the one in five of us suffering mental illness.

Imprisoned by anguish and shame, and by the nature of the illness itself, their suffering goes unaddressed, or if noticed, silenced by our fear of its cause. If they seek help, they are often stuck in a system that offers little continuity of care, and in which programs are subject to availability of ongoing funding. The miracle is that so many do find help and healing despite all this, and so many caring people attempt every day to help them to the utmost of their energy and skill.

The scale of the problem seems so big it’s no wonder we find it difficult to face. But history shows us that it can be tackled. The Catholic Church, with all its faults and failings, was in the vanguard of providing what we now take for granted – universal health care, and universal education. One hundred and fifty years ago, in the face of grinding poverty and exclusion, no doubt these problems seemed just as difficult to overcome as addressing mental healthcare seems today.

The Catholic vision of the dignity of human life informs the care offered for all in our existing hospitals and services. Wouldn’t it be wonderful to be able to offer this vision of care on the same scale in the mental health sector as well?

As the Year of Mercy concludes, and we pray for All Souls, we might remember those who died because they saw no hope, and ponder Pope Francis’ advice: “Ask Jesus what he wants from you, and be brave”.

Mental Health Week is a national event held every October to coincide with World Mental Health Day on October 10. For more information visit the National Mental Health Commission, Lifeline, BeyondBlue or Black Dog Institute.

Margaret-Mary Flynn

Margaret-Mary Flynn is a writer and editor with a background in education, teaching English, literature, history and religious education. She has recently graduated with a Master of Arts (Spirituality) from the University of Divinity, specialising in spiritual direction, and early Christian and monastic spirituality. She lives in Bendigo with her husband, has three adult children and three grandchildren, and enjoys reading and writing, the domestic arts, yoga and gardening.

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