Diary of a Patient, Her Illness, Family, and Friends
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That is their problem, not yours. It is often helpful to talk with others who have had similar experiences, to learn more about the effects of mental illness and what your options are, so that you are in a better position to make decisions. Going along to a group like this helps you to feel less isolated and to realise you are not alone. You will be better prepared for dealing with the health system if you understand how it operates in your local area. Most areas are now covered by regional mental health services, which have their own clinics and hour assessment and treatment teams to help people in their own homes.
People are generally admitted as in-patients to psychiatric wards only when they are severely unwell. There may also be separate services for people under 18 or over As well as a treating psychiatrist, the person may also have a case manager who coordinates and provides some of their mental health care. This may include seeing a psychologist, social worker, occupational therapist or other health professional.
Some services employ a carer consultant to liaise with family and friends.
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After a time, some people only need to see their GP for treatment, and are in contact with the mental health service if they become unwell again. As well as overseeing physical health, a GP can also set up a Mental Health Plan and refer people for treatment to a private psychiatrist or to a psychologist or other appropriately-qualified health professional for psychological treatment.
If someone refuses treatment, and their health and safety, or the health and safety of others, is at risk, then the treating health professional can apply to have them treated involuntarily for their own sake. This may be as an in-patient, or under a Community Treatment Order where they can continue to live at home, but treatment is supervised by a doctor or other health professional.
Building a good relationship with the doctor, case manager or other treating health professional is important for family and friends who are carers, as well as for the person with the illness. If you are able to do this and are well-informed about the situation, they are more likely to listen and be cooperative in providing help. It can help to write down and take along any questions you want to ask, and to note down the answers at the time.
While National and State mental health policies promote inclusion of family and other carers in treatment, be prepared for the fact that some health professionals are not used to communicating and working cooperatively with families.
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Be polite but persistent. If you feel your concerns are not being taken seriously, put them in writing to a higher authority such as the area mental health service manager or the Chief Psychiatrist in your State. If you think this would help, discuss it with the person and their doctor or case manager. This is especially useful for women of child-bearing age, as pregnancy can trigger relapses in many mental illnesses.
These benefits may make the cost worthwhile for those who are able to afford the premiums, although having a pre-existing condition will affect the cost. They may be concerned about side-effects. They may become confused about the number of pills they need to take and what times to take them. People with a mental illness may be in poor physical health if they smoke, have a poor diet or are overweight and physically inactive because of the effects of their illness and sometimes of their medication too.
This is why people with psychotic illnesses such as Schizophrenia have a higher risk of physical health problems, such as diabetes and heart disease. Encourage the person to think about their physical health. A check-up by a GP is a good start, followed by a routine of regular check ups, including blood glucose monitoring, weight and waist measurement, and pap tests and breast checks for women. Regular dental and eye checks can sometimes be arranged at reduced cost or no cost through a case manager or at a community health centre.
Vaccination against Hepatitis B and tetanus are also recommended.
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Ideally the GP will understand mental illness, keep up-to-date with developments in treatment, listen sympathetically, and be aware of services in the local area. It helps if they bulk bill.
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Encourage a healthy lifestyle and diet, emphasising how this improves mental health too. Encourage the person to eat fewer fatty foods and more fresh fruit and vegetables. Too much caffeine in coffee, tea, cola or energy drinks may reduce the effectiveness of antipsychotic medication and should also be gently discouraged — by offering tasty alternatives, for example.
Exercise is important for all of us. A 30 minute walk daily is a big step towards being healthy. If the person smokes, talk to them about quitting. Not smoking is not only healthy, it can help medication work better at lower doses and it also saves money. It is important for the person taking the medication and others to understand that if they stop, or reduce the dose too much, then symptoms are likely to reappear. Being free, or freer, of psychotic symptoms after many years can also be a strange experience.
Having spent so much time and energy coping with symptoms such as hearing voices or paranoia, for example, means that being free of them can be a strange experience. It can be helpful when this happens, therefore, to encourage the person to talk about how they feel, and to become involved in new activities. In this case, encourage the person to attend a rehabilitation program or employment service, to re-familiarise themselves with what has changed.
When talking to support agencies and even some health professionals , it may be necessary to remind them that recovery from mental illness is not simple, and that people continue to need understanding and support when their symptoms have been reduced. This is the time when family and friends can also help the person make small positive steps towards social, recreational and vocational rehabilitation.
Helping Someone with Schizophrenia
They may also need to adjust their own expectations and reassess their caring roles. Helping someone access psychiatric disability support services can make a big difference to their quality of life and ability to live more independently — promoting recovery of social and living skills affected by mental illness.
They are often run by community organisations with funding from State or Territory Health Departments. If the person you care for has a case manager or other key mental health professional, they should arrange referral to support services. Contact 18 or email This email address is being protected from spambots. In some areas, particularly rural or remote regions, there are few or no programs providing accommodation, rehabilitation or other forms of support.
You may wish to join with others to start up such a program and lobby for funding from government. Local politicians, business people and mental health workers may also be willing to help. Not surprisingly this can contribute low self-esteem and make the symptoms of Depression worse. It helps to remind the person you care for that everyone has a unique value and can contribute to society in some way. This may be through part-time work or by helping others — working in a charity shop for example a volunteer coordination centre can help here.
It may be through membership of a rehabilitation program, taking part in activities and helping others, with household tasks for example. Centrelink can refer people affected by mental illness to Job Network agencies, or to specialist DEN Disability Employment Network agencies to find work. We all need to feel valued, appreciated and part of the community we live in. This is just as important for someone who has lived with the effects of a mental illness for many years. Local councils, community colleges, churches and other organisations in local communities have programs and services which everyone, including people with a mental illness, can make use of for example:.
A case manager or other mental health worker should be able to help the person access community services and accompany them if necessary. Personal Helpers and Mentors Program staff and outreach workers from rehabilitation programs may, for example, be able to visit the person, have a walk and a cup of coffee, or go with them to concerts or a football game.
These activities can help overcome isolation and improve connections with the local community. An advantage of the Disability Support Pension is that it is not assessed as taxable income. A Carer Payment is also available with certain conditions.
Pensions can be paid directly into bank or credit union accounts. Talk to them about what the entitlements are for you as well as the person who has a mental illness. Centrelink has a free Financial Information Service which can help with advice on entitlements in general and on making the most of your income. See centrelink or call 13 to make an appointment.
Any extra income encourages more independence. Encourage the person to manage their own money as much as possible. Bank charges can be expensive for people with small accounts, so discuss opening a Credit Union account — similar to a bank account, but cheaper to operate. Centrelink and local councils often have staff to advise on budgeting and may be able to help with managing money.
People with some illnesses, such as Bipolar disorder for example, may spend money irrationally when they become ill — for example, running up excessive credit card debt or giving money away. This means they can handle their own money as usual, but if they become ill the person with power of attorney can manage things.
Discuss this with the person you care for. Ask an understanding solicitor to draw up the document. A stable home helps a person with a mental illness cope better and live more independently in the community. It also helps give them a sense of security and the feeling of being part of a neighbourhood. Living in the same place means the person stays in the same mental health service area and can build a good relationship with their health team.
It reduces the risk of drifting into unsuitable accommodation or becoming homeless. Talk to the person you care for about long-term accommodation.