The Guyana Foundation is continuing its National Mental Health Sensitization and Awareness Program this year, with an emphasis on innovative, grassroots activities to educate and shed insight into the world of mental illness - with the aim of bringing relief to affected Guyanese and their families.
A number of projects have already been completed under this program launched in January 2014, including two suicide workshops, a mental health Facebook ‘selfie’ event, mental health photo exhibitions in West Berbice, the distribution of mental health posters, the publication of mental health ads, and collaborations with two mental health researchers affiliated with universities in Europe and North America.
However, with less than five full-time psychiatrists, less than 300 beds in the National Psychiatric Hospital, no day treatment or community residential facility, and approximately 142,000-179,500 individuals estimated by the Pan-American Health Organization (PAHO) to be in need of mental health services, the local mental health sector remains in a state of crisis.
Today, the few dedicated mental health professionals remain overworked and under-appreciated, and struggle to deal with a patient population that the health sector lacks the capacity to deal with. Despite efforts over the years to train more mental health professionals, important stakeholders remain disengaged, financial, human and infrastructural resources are scarce, and widespread stigma against individuals with mental illness exists – all within an outdated mental health legal framework dating back to 1930.
Because of stigma and a lack of understanding of mental disorders, discrimination remains widespread, and many individuals in need of assistance are shunned by those close to them who are unable to understand their condition.
The Guyana Foundation is extremely grateful, therefore, to the brave individuals living with mental illnesses who have begun stepping forward to share their stories, such as a young man we met recently who has been living with bipolar disorder for 10 years. He and his family members were able to educate themselves and establish support mechanisms to ensure that his symptoms do not spiral out of control. He is now able to work two days per week and strives towards meaningful goals that he believes he can achieve.
The Foundation is thankful to this young man who has shared his story with the hope of bringing encouragement and insight into the unseen struggles of individuals living with various mental health issues. Below is the transcript of a conversation with this individual, that he has given the Foundation permission to release.
1. How old are you now?
I am 30 years old.
2. When were you diagnosed with a mental disorder?
I was diagnosed in in 2004, when I was 20 years old.
3. What were the circumstances leading up to the diagnosis?
I was in the United States on a vacation and was staying with a distant family friend. In NY, I experienced a manic episode in Spring. I began to behave in a hyperactive manner. I started to hallucinate - seeing people watching me, feeling that people were planning and plotting against me, that my life was in danger…I had racing thoughts and became delirious. I called an ambulance and they came and collected me and took me to the hospital. No family member was aware of what had happened. I fell to the ground at the hospital. They placed me in a room. While being examined, I spit on a nurse and they put me in the psychiatric ward. This was at Jamaica Hospital. In the ward, I was given medication that put me to sleep for a long time. I wasn’t conscious of what was going on for about two days. When I became conscious of my surroundings, the doctors questioned me – they asked my name, address, where I’m from – I couldn’t remember the phone number of the place I was staying at so I gave them the number of a friend who contacted my family in Guyana. My sister booked a ticket from Guyana and came to NY and I was released into her care. I was in the hospital for a total of about 4-5 days. There are things from this episode that I don’t remember. After my sister took me out of the hospital, I was brought back to Guyana.
4. What was the diagnosis?
They didn’t diagnose me at Jamaica Hospital. I don’t recall what they said was wrong. I was back to normal and they released me. My diagnosis came when I returned to Guyana and I was working at a large local company and had another manic episode. This happened about 6 months after the first episode. The job was new and I was a little stressed and the episode occurred. I was taken to a private hospital by my mom. She thought that maybe I was using drugs and I was tested. The test revealed that I was clean. A psychiatrist saw me at this private hospital and I was admitted to a private room. I was sedated and don’t recall much after that. The diagnosis was bipolar disorder.
5. Who made the diagnosis?
A local psychiatrist. I saw other psychiatrists in Guyana and also one in France. I went to France because I wanted to use a medication that was not widely used by two of the psychiatrists in Guyana – that is lithium. Lithium is widely used by people with bipolar disorder around the world, but testing for lithium-levels in the body is not done in Guyana. One of the labs has a service where the blood is sent to Fort Lauderdale in the US for the results. However, it takes a week to get the results and is very expensive.
6. How did you feel when you received this diagnosis?
The psychiatrist used the words manic episode – he didn’t exactly say bipolar disorder. I was in denial. I thought that this was a one-off, stress-related illness and that I needed to manage my stress better because both episodes occurred around work. So I was in denial for several years. I had about 10 episodes and in the first few years they were far apart and the recovery was short, so I was under the assumption that it was just stress. These episodes started to get closer and last longer. We saw a different psychiatrist – at the time the first psychiatrist was not available. She told me the same thing the first psychiatrist had said – that I had bipolar disorder. I was confused because I was very young. There were no persons in the family with this diagnosis. A few friends were aware. At the inception, I was very afraid to tell people because of the stigma attached to mental illness in Guyana. As I got more aware, I started to share the diagnosis with friends. My friends were very surprised, because they weren’t aware that I had been hospitalized and they weren’t aware of the toll this condition was taking on me. They were very supportive. Not all of them knew about mental disorders. I was told that the medication I was taking would make me even more sick –that person tried to discourage me from taking the medication.
However, I’ve learned to accept that this is an illness that I have. You can use medication to control the symptoms. I don’t think we’ve reached the stage of mental illness being cured – even with the current medication, I still get ill. I would like to be cured, but I’ve learned to accept my condition.
I put myself under a lot of stress while in the US, trying to work very hard. I was too focused on achieving high goals. I think this was a contributory factor. I didn’t think too hard on why I ended up in this situation.
You take medication day to day, but when the episode comes, it comes. It’s not something you can fight against. You try to live a balanced life.
However, I’m not satisfied because I’m 30 years old, and don’t have a family of my own and didn’t complete studies. This mental disorder has affect the relationships I have had.
7. How did your family feel? How did they react?
They feel concerned but yet supportive. They worry about what my future will be like, because they will not always be there for me. They worry about how I’m going to be taken care of in the future when they are unable to do it. They were always supportive from the inception – been there for me with the doctors, been there for me financially and emotionally. Even when I was in denial, they had accepted that I was ill. They made a conscious decision to be there at every stage. They were educated about mental illness. They learned about it in the inception from local psychiatrists and my sister, who is living overseas and had a friend who is a psychiatrist.
8. Have you taken medication for your illness?
Yes. I’ve also had years of counseling on a wide range of issues. I was very fortunate to meet a very skilled, qualified counselor who kept everything confidential, and that made me open up more to her.
9. If so, what kind of medication?
Lithium, halodon (helps with hallucination) – this has side effects like blurred vision, twitching of eyes – that’s what I’m using now. In the past I’ve used other medication.
10. Do you feel the medication was effective? Why or why not?
I feel the medication was generally effective. However, if not monitored with the lithium, it can become toxic for the body.
11. How would you describe the quality of mental health services you encountered in Guyana?
We’re fortunate to have in Guyana extremely good, qualified psychiatrists. They were very few and I can only speak about my experiences in the private setting, and not in the public setting.
12. Was there any mental health treatment/service, not available in Guyana, that you wish you could have accessed?
I would like for lithium testing to be done locally - for it to be cheaper and more accessible. I wish there were support groups in Guyana – this is lacking. I really wanted to meet people with the same diagnosis like me. I never met someone in Guyana with the same diagnosis as me.
13. What would you say to someone living with mental illness?
I would tell someone with a mental disorder not to be in denial. Accept the medical condition. Seek help. Stay on the medication. Learn to live a balanced life…a balanced life means having social activities like a gym, a walk, studies, works – different activities to keep you occupied. Don’t stay at home and wonder about the illness, because that will make you more depressed. That’s why I even took a job for two days out of town. I’m traveling, I have an income so I can fund other activities. I’m still working towards my goals, I started working and studying again. I believe I can achieve my goals.