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July 5, 2015 www.guardian.co.tt Sunday Guardian
WOW MAGAZINE| 7
By Dr. Makini McGuire
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Many cynics of today try to downplay mental illness, not understanding
that each illness is defined by a specific set of internationally standardised
criteria, as compiled in the Diagnostic and Statistical Manual of Mental
Disorders, which is now in its 5th edition, (DSM- V). Therefore it is com-
pletely possible and fair for someone to be found "not guilty" of first de-
gree murder by reason of insanity. First degree murder has to involve
wilful and pre-meditated killing; one can neither do something wilfully nor
pre-meditate it if one is living in a non-reality.
The DSM V requirements for schizophrenia identifies a series of symp-
toms, including delusions, hallucinations, disorganized speech, disorganized
or catatonic behaviour, negative symptoms of which the patient should
have at least 2, and 1 must include either delusions, hallucinations or disor-
ganised speech, and goes on to define further how to reach to a diagnosis.
Great care is taken to rule out a physical illnesses as a cause of symptoms
before a diagnosis of a mental illness is made.
I explained delusions and hallucinations in Part 1, but in short, delusions are
bizarre beliefs that have no basis in the truth; hallucinations are seeing,
hearing, feeling, tasting, or touching something that in reality is not there.
Disorganised speech can be creating new words, or speaking proper
words but not in any logical sequence. It can be either answering nonsensi-
cally or consistently veering off topic. Disorganised behaviour leads to the
dishevelled appearance and strange behaviour. Negative symptoms refer
to a blank expression, minimal speech or isolation.
What people need to appreciate is that these persons have in every sense
of the phrase, "lost their grip on reality". Aliens attempting to harm them,
the voices in their head, and the need for self-preservation from the
wicked aliens are as real to them as true reality is to us.
Schizophrenia is caused by abnormal chemical activity of the neurotrans-
mitters in our brain, and therefore the treatment involves regulation of
those neurotransmitters. The tendency to become schizophrenic in-
creases in those of low socioeconomic status, family history of mental ill-
ness, use of marijuana and other illicit drugs, and those with poor life
coping skills. When placed on medication and with proper family support,
these people can live normal, productive lives. Herein lies the problem.
With the high level of ignorance and stigma surrounding mental illness, pa-
tients do not get the opportunity to have regular medical attention, the
family support is minimal to non-existent because pride and vanity reign
supreme. Who wants to admit that their relative is a 'madman'? Who
wants to accept a 'madman' back into the community after he has been
treated, rehabilitated and deemed fit to be reintroduced into society? Who
wants to support this 'madman' in this fight against schizophrenia, vouch
for him to get a job, ensure he takes his medication, and gets regular
check-ups? Who wants to be their brother's keeper? No, "Crucify him, cru-
cify him!" There you have it, we've just created a vagrant.
Harry was evaluated by a psychiatrist and found to be schizophrenic as
well as gravely psychotic at the time of the event. Harry was treated suc-
cessfully at Bellevue Hospital and went through great grief and turmoil
when he realised that during his psychotic state he had killed his father.
Harry regained his grip on reality, and even taught Mathematics at the
hospital during his stay. He was maintained on his medication and did not
have another psychotic episode for over ten years. However, when it was
time for a fully functional and productive Harry to return to the society, his
community would not take him back. Without his long-time friend who
had moved out of the ignorant community eons ago, I'm sure you would
have passed Harry on the promenade and heard the chant of a 'madman'.
If society isn't educated on mental illness and internalises the education, if
the government does not put adequate resources into the mental health
sector, and if human beings don't take a minute to look deep inside and
then outside of themselves, there will continue to be many more stories
like Harry's. Mental illness is real; be your brother's keeper.
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