Family Acceptance With Schizophrenia
Schizophrenia is hard to understand, especially when affected loved ones exhibit symptoms such as hallucinations, delusions, disorganised thinking, and withdrawal from social activities. But family support makes all the difference because it provides a sense of stability, understanding, and empathy that can help individuals with schizophrenia feel less isolated and more motivated to manage their symptoms. Family support plays a crucial role in encouraging treatment adherence, connecting loved ones with appropriate mental health resources, and fostering a positive environment that promotes recovery and well-being for all involved. We hear more from A/Prof Swapna Verma , and Margaret Ong , author and caregiver to her husband.
This article is adapted from the transcript of episode 2 of our podcast Mindful Dialogues “Are People with Psychosis Dangerous?” with host medical social worker Lee Kai Yi.
Dr Swapna:
I work in the Early Psychosis Intervention Programme at IMH where we see young people with schizophrenia. It's common for people to have waited so many months or years sometimes before they sought help. One reason could be the lack of awareness or misinformation about mental illness and early symptoms of schizophrenia, because the symptoms are so strange or bizarre to them.
The second reason is also sometimes shame and stigma, as you said, because again, you don't want to let neighbours know or even other family members know. And it's something hidden behind closed doors because mental illness is often thought of as sign of weakness or something attributed to “bad behaviour”. And then there's something shameful about it, and it's to be hidden from other people as opposed to, say, a physical illness.
Margaret:
I feel it’s important to have someone close that you can lean on. My siblings and I are very close. I kept my boys and my siblings abreast of every prognosis each time my husband visited the psychiatrist. We discussed how to cope if he's in psychosis, and so my siblings actually share that with their children as well.
So, when they were together with my husband, they embraced him. Every vacation, I would bring my two boys and my husband to spend time with my siblings in Malaysia. I remember an incident - we were on an extended family vacation to Mulu cave in Sarawak and the taxis were waiting outside at 4.30am. My husband had an episode of psychosis. He locked himself in the room, insisted that my sister and my brother-in-law were not travelling with us. He refused to get changed and leave with us. My brother-in-law had to remove the doorknob before going in to persuade him that he would be going with the rest of the family. He complied. When we were at the airport, my boys were ashamed of what happened because it was such a commotion. My son went to my brother-in-law and said, “Uncle, I'm sorry for what had happened.” My brother-in-law said, “You know Jeremy, we are here. Let’s go and enjoy ourselves,” and gave him a hug. That is very important, to have family acceptance.
Dr Swapna:
That was such a strong message to your son that there's nothing to be ashamed. It's so important to separate the person from the illness. There is a person behind the illness.
Margaret:
Yes, there are lucid moments. You have to treat the person with dignity, right?
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Kai Yi:
I’m very touched by this sharing, because a lot of the patients’ nuclear families are sometimes isolated from the rest of the extended family. They almost have to be in their own world together with the person with mental illness because they're so afraid and ashamed that they won't be accepted. It’s so fortunate to hear this story from you, and to hear that there's so much support from the extended families. I think that's important.
Dr Swapna:
Just to add on to what Margaret said, I think your story of how you rallied your family and your sons around is unique. But not everybody shares that view. There was a study released by IMH in 2015 called Mind Matters. We found that almost half of the people feel that having a mental illness is a sign of weakness and 1 in 7 did not want to work or stay near somebody who had mental illness. So this is the part of the stigma as you know, and we really need to dispel these myths.
Strategies for Mental Health Acceptance and Advocacy
Some actions we can take for a step towards mental health acceptance are:
In closing, let us remember that within the challenges of mental health, the power of acceptance shines as a beacon of hope. As we navigate the complexities of supporting our loved ones, may we strive to emulate the compassion and understanding demonstrated by Margaret and her family. Through acceptance, we can pave the way for healing and build a community where everyone feels supported and valued.
A/Prof Swapna Verma is the Chairman of the Medical Board & Senior Consultant with the Department of Psychosis at IMH.
Margaret Ong is a caregiver and author of the books One Husband, Two Men and Still My Husband.
Kai Yi has been a medical social worker with IMH for over 10 years. She has helped caregivers and patients navigate their journey to wellness with the support of various community resources.