'There's no shame in mental illness'

Dr Radiah Salim’s elder sister is schizophrenic. Two of her close relatives, who also suffered from mental illness, killed themselves. Dr Radiah hopes Club Heal, the support group she set up for those with mental disorders, will one day be run by people with such conditions and their caregivers.

Dr Radiah Salim remembers the old Woodbridge Hospital as a dark and scary place.

The old mental hospital was sited off Yio Chu Kang Road and, as a child, she went there often to visit a patient - her schizophrenic elder sister.

"The corridors were dark and dingy and you would see all these 'gila' people there," she says, using the Malay word for mad. "Some of my sister's attacks were so bad that they had to tie her down and give her electro convulsive therapy."

Her sister is not the only family member living with a mental illness. Her paternal grandmother, more than half a dozen relatives on her father's side, three of her second cousins, and a nephew lived or live with mental disorders too.

Her nephew and a second cousin committed suicide and their deaths shook her. As a doctor, she felt she could have done more to help them.

The tragedies spurred her to set up Club Heal, a charity to raise awareness about mental illness and remove the derision, shame and stigma associated with it.

Set up in 2011, the outfit has three centres and offers rehabilitation services, counselling and house visits for those suffering from schizophrenia, depression, bipolar and other mental disorders.

"There shouldn't be any shame in developing a mental illness. It is an illness like any other. We have very good psychiatrists, psychologists and medical support in Singapore," Dr Radiah says.

But more than access to doctors and medication, she adds, people with mental health issues need the support of those closest to them.

"Family members should stop blaming one another if someone falls sick. The culture of blame and the stigma can hinder a lot of progress," she says.

Vivacious and self-deprecatingly humorous, Dr Radiah, 52, is the seventh of nine children, two of whom died young.

Her father worked as a labourer in the mornings and ran a magazine stall in the evenings; her mother, who died last week from acute liver cancer, was a housewife who made Malay kueh to supplement the family income.

Although illiterate, her mother was adamant that all her children - including six daughters - got an education.

"She used to tell her daughters, 'If you want to be somebody, study hard. If not, just wait to get married and be stuck in the kitchen'," she recalls.

The young Radiah set her heart on becoming a doctor when she was just four years old. That resolve intensified when, at nine, she met and was bowled over by the the charisma and humour of her father's younger brother - a doctor from Indonesia.

A self-starter, she did well in school and went from Telok Kurau West Primary to Raffles Girls' Secondary and National Junior College. But her world crumbled when she did not get into the medical faculty of the National University of Singapore in 1981. She was admitted to study science instead.

"I thought of going into nursing but I was the first to qualify for university and did not want to disappoint my family," she says. With her honours degree in zoology, she went on to teach at Bendemeer Secondary School.

However, a trip to Australia to visit one of her sisters, who had married and settled in Melbourne, reignited her dreams of becoming a doctor. Her sister suggested that she move to Australia. So she applied for and got Australian permanent residence and left for Melbourne at age 25.

Applications to medical schools were quickly dispatched but, just in case, she also applied for a nursing course at the Royal Melbourne School of Nursing.

When Sydney University's medical school offered her a place, she was ecstatic. To support herself through her studies, she worked during weekends as a nursing assistant at a centre caring for intellectually disabled children.

She was 32, in 1995, when she finally got her medical degree. After stints at hospitals in Sydney and Melbourne, she returned to Singapore in 1998.

The decision to come home was prompted by news that her beloved maternal uncle was dying from cancer. "My mother was also getting old and I wanted to look after her," says Dr Radiah, who was married briefly to a businessman after she returned to Singapore. They divorced because of personality differences.

In Singapore, she worked at KK Women's and Children's Hospital and at Tan Tock Seng Hospital's Communicable Disease Centre, where she cared for patients with HIV, before eventually choosing to do locum work as a family physician in Yishun.

Then came the suicides of two people close to her.

The first was her nephew Amman, the son of her schizophrenic sister. A security officer, he was 18 and in national service when he began displaying the symptoms his mother had.

He was 23 when he leapt to his death from the block of flats where he lived with Dr Radiah and her parents.

"He had very strange thoughts and he always said he would like to swim to Indonesia. My theory is that he didn't deliberately jump but thought he was flying to Indonesia to visit his step-siblings," she says.

"I felt very bad when he died. He lived with us. I'm a doctor and I knew he had schizophrenia, so why did I not monitor if he was taking his medication or keeping up with his medical appointments?"

Amman's death so traumatised his mother that her schizophrenic attacks returned with a vengeance.

Six years later, Dr Radiah received a call from a cousin who was worried by her sister's manic behaviour. Dr Radiah suspected that her cousin might have bipolar disorder but the young woman was so upset at the suggestion that she ought to see a psychiatrist that she cut off all ties with the family.

The incident made Dr Radiah realise that Malay Muslims were often at a loss when dealing with mental illness. "The trouble is, many Muslims want to go to only Muslim organisations and shy away from secular organisations which offer help," she says.

It did not help, she adds, that there was only one practising Muslim psychiatrist. The situation prompted her to write to the Institute of Mental Health (IMH) to seek a position as a trainee.

Working there made her realise that mental patients relapse for two reasons: They do not take their medication, and they are under great stress.

She loved working under rehabilitation specialist Joseph Leong, who believed step-down care or convalescence care was crucial in the recovery process.

Unfortunately, she had to resign nine months into the job to care for her old and ailing mother. But she told herself that she had to continue her work in mental health and started thinking about a rehabilitation outfit for Muslims with such issues.

Meanwhile, the cousin who had called about her manic sibling contacted her again, about another sister - a bright business graduate working in finance who had bouts of slipping into a deep funk and had attempted suicide. The young woman had been diagnosed with bipolar disorder previously but suffered a relapse and was admitted to IMH.

Dr Radiah often visited her cousin in hospital and was convinced that the intelligent woman would be the best person to help her set up a rehabilitation centre.

But just as she was planning Club Heal with the help of friends - including a psychiatric nurse, a social activist and Speaker of Parliament Halimah Yacob - her cousin took her own life. She was just 28.

The tragic turn convinced Dr Radiah that her day-care centre must open.

She dipped into her savings, rounded up friends and contacts and started Club Heal with more than 20 members at a classroom in a mosque in Choa Chu Kang in 2012.

After a write-up in the Malay language newspaper Berita Harian, people began calling.

One year later, with the help of Madam Halimah, Club Heal moved to its headquarters in Bukit Batok. Now an Institution of Public Character, it also has centres in Serangoon and Tampines.

From just one administrator at the start, it now has 13 full-time and part-time employees, including counsellors and programme coordinators. Some of the staff - including the publications executive and peer support specialist - are also mental health patients

More than 400 people have benefited from its programmes which include craft and cooking lessons, support group sessions and home visits by counsellors.

To raise funds, the centre last year published Shattered, We HEAL, a book chronicling the stories of 15 people affected by mental illness.

"My hope is that one day Club Heal will be run by people with mental illness and their caregivers," says Dr Radiah.


This article was first published on May 10, 2015.
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