Don't deny mental health patients the chance to live normally

Chan Lishan's struggle with schizophrenia in 2008 is recounted in her book A Philosopher's Madness (Ethos Books), published in 2012. She is now a freelance writer with a passion for raising awareness about mental health.
PHOTO: Don't deny mental health patients the chance to live normally

SINGAPORE - I read with some dismay, Dr Andy Ho's article, "Exempt these young men from NS" in The Sunday Times, Think section on April 13.

He said that a key question raised by the death of Private Ganesh Pillay Magindren was whether individuals with schizophrenia should be enlisted for national service. He went on to argue that the answer was "no".

The young man, diagnosed with schizophrenia, was found dead at the foot of his Sengkang condominium last July. Schizophrenia is a mental condition which distorts a person's thoughts and emotions, causing the sufferer to lose touch with reality.

To me, the key question should be how we can better accommodate and support people with mental health problems who are enlisted for national service.

By denying them the chance to serve NS, it prevents them from experiencing something that all our fathers and brothers go through, including personal growth, and the formation of deep friendships.

For, at risk of romanticising the NS experience, denying them the opportunity to serve NS is to exclude them from a chance to contribute to and serve their country.

Dr Ho stated that people with schizophrenia should not do NS because they are on lifelong medication that can have severe side effects. If they stop taking their medication, they are likely to suffer a relapse. And the NS environment is just the place where someone would be likely to stop taking medication, due to stigma or self-stigma.

But it is not clear that the NS setting is exceptional in its stigmatisation of mental illness. Other environments, such as educational and workplace settings, are similarly stressful and unforgiving. But do we wish to exclude people with schizophrenia from all such settings? The answer must necessarily be "no".

Dr Ho said that in addition to lifelong medication, the person with schizophrenia needs lifelong family support and psychosocial support in order to function minimally. In other words, people with schizophrenia cannot live independently or function effectively without plenty of help.

This is not always the case. People with schizophrenia can recover and cope and, in some cases, with advice from their psychiatrist, reduce and even stop taking medication without relapse.

People with schizophrenia can also live independently without constant reminders from family members to take their medication. They can find meaningful work as professionals in full-time jobs. I say this from my understanding of the experiences of people with schizophrenia, including my own.

Dr Ho rightly suggests that society needs to understand and be more accepting of those with schizophrenia. Additionally, society needs to consider how to best include and support those with schizophrenia. What resources can be provided to ensure that those who need help, get help?

While I believe that Dr Ho's intentions are to ensure the safety of people with schizophrenia, removing these individuals from society, whether by exemption from NS or by not giving them a chance to resume or return to their studies or work, is not the solution.

How, then, can we help such people? Here are some ideas that can be put to immediate practice.

If an employee discloses that he has a mental health problem, the employer should discuss with the employee any necessary adjustments, including workload management, and the importance of having access to a quiet spot in order to relieve stress.

There may also be a need to take time off work for therapy or treatment. As schizophrenia is episodic, these accommodations need not be permanent.

The recruitment process should also be fair to potential employees who have disclosed their mental illness. Bosses should develop a work culture of open and honest communication, where people know that it is perfectly fine to talk about mental health. One way of being supportive is to have informal chats to track the progress of someone who has recently returned to work after hospitalisation.

There is no need for everyone to become an expert on mental health. However, it would be good to develop a sense for when someone needs professional or clinical help. Fellow workers should also make it a point not to treat affected colleagues as special or different from anyone else.

Don't ask "How many mg of what drug are you taking?" or "Why do you think you have a mental illness?". Instead, ask "How can we support you to do your work better?".

Err on the side of not being too intrusive or personal, just as you would with any other colleague.

Be aware that an employee with a mental health problem is not more vulnerable than any other employee to workplace stress.

stopinion@sph.com.sg

Chan Lishan's struggle with schizophrenia in 2008 is recounted in her book A Philosopher's Madness (Ethos Books), published in 2012. She is now a freelance writer with a passion for raising awareness about mental health.

Get a copy of The Straits Times or go to straitstimes.com for more stories.