People
living with mental illness have reason for hope and help
Jakarta Globe, Woodwing Importer, Oct 02, 2014
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| A coalition of mental health advocates will hold a series of events to raise awareness for schizophrenia and other disorders, starting on Oct. 10 with a public seminar at @america in Pacific Place, as well as a candle lighting the same evening at Bunderan HI in Central Jakarta. (JG Photo/Sylviana Hamdani) |
Life is
fragile. What we have today — our health, riches and family — may easily be
stripped from us in an instant.
Many have
watched the 2001 Hollywood blockbuster “A Beautiful Mind,” which tells the true
story of John Forbes Nash, a Princeton mathematician whose brilliant career
spirals out of control when he begins to experience hallucinations that worsen
to the point that he attacked a colleague and nearly injured his wife and
child.
Nash was
sent to a psychiatric facility where he was diagnosed with schizophrenia.
Thereafter, the mathematician’s life yielded to a series of struggles between
maintaining his family and career, and giving in to his demons.
Likewise,
chemist Poltak Tua Dorens Ambarita’s life changed when he began seeing visions
in 2005 while working at a packaging firm in Karawang, West Java.
“I thought
[the visions] were a gift from God,” he said.
Poltak
became convinced that God had chosen him to be a prominent national leader and
marry a certain top celebrity.
Poltak
couldn’t stop talking about these thoughts with friends and colleagues. “I
couldn’t concentrate at all,” said the 32 year-old. “All I could think about
was the visions.”
He then
started hearing voices too.
“I went
barefoot on the streets just to follow the voices,” he said.
When
friends began to realize something was wrong, they subdued the heavy-set Poltak
and took him to a mental hospital where nurses restrained him and injected him
with tranquilizers.
“I tried to
break free, because I believed I wasn’t ill [and] didn’t belong at the mental
hospital.”
It took
Poltak many years before he could accept that he has to live with
schizophrenia, psychotherapy, medication and repeated hospitalizations.
Ash Xyle
was a manager at a private company in Jakarta, as well as a loving husband and
father of two children, when he started experiencing paranoid schizophrenia —
seeing things on his computer screen and hearing whispers behind his back at
the office.
“After a
week, it started getting really scary,” Xyle said. He took time off work and
stayed in his room for three weeks straight.
“I couldn’t
sleep, couldn’t talk with anyone,” he said. “I couldn’t make sense of what’s
going on.” His wife then took him to a psychiatrist.
“He asked
me very carefully whether I know what schizophrenia is,” Xyle recalled. “I said
yes, I’ve seen it in the movies. They’re usually killers.”
“[The
psychiatrist] said very gently to me, ‘Well, my friend, you have that,’ ” Xyle
recalled.
‘Not the
end of the world’
“Having
schizophrenia is not the end of the world,” Ayu Agung Kusumawardhani, a doctor
who chairs the Association of Indonesian Psychiatrists’ (PDSKJI) schizophrenia
section, said.
“Schizophrenia
is a [mental] illness. It’s not a curse or caused by santet [black magic]. With
support from families and friends and proper medication, people with
schizophrenia may fully recover and function as normal,” Agung said.
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| (JG Photo/Sylviana Hamdani) |
“Early
detection is the key to treating schizophrenia,” Agung said.
The first
signs of schizophrenia usually happen between the ages of 15 and 25. Early
symptoms vary from depression, withdrawal from friends and families,
hallucinations, delusions to violent agitation.
Some
parents, upon seeing these symptoms, think their child may be possessed and
bring them to a dukun [spiritual healer] where they undergo rituals that jeopardize
their mental and physical health.
“Parents
should immediately bring their children to the psychiatrist [when they
recognize these symptoms] to get proper treatments,” Agung said, adding that it
is important for schizophrenia to be properly diagnosed and treated within the
first two years of its onset.
“With
immediate diagnosis and [adherence to] treatment, patients may recover fully
much sooner,” she said.
Psychiatrists
typically treat schizophrenia with a combination of medicines and behavioral remedies
that give patients the tools they need to anticipate and deal appropriately
with symptoms that remain despite medication.
A
significant problem for people living with schizophrenia is adhering to the
treatment that doctors prescribe, which may involve daily pills or injections
every two or four weeks.
Severe
cases may require hospitalization until symptoms are under control.
Support
from family and friends plays an important role in assisting patients’
recovery. “It’s important that [patients’ family and friends] understand the
disease and accept and love the patient as he or she is,” said Agung.
Part of
that support also entails ensuring patients follow the medication prescribed by
their psychiatrist.
“The most
important thing is hope,” Agung said. “Patients should have the hope that one
day they can recover fully and function normally in the society.”
Hope
arrives in Indonesia
A new hope
is budding for people living with schizophrenia in Indonesia. Earlier this
year, the government passed Law 18 on mental health, which affirms the right of
every Indonesian to receive treatment for mental health problems that is fair,
humane and free of discrimination.
“It’s a
great, positive move by the government,” Eka Viora, director of the Ministry of
Health’s mental health division, said. “Previously, according to our surveys,
about 14 percent of people with serious mental health problems are either
abandoned by their families or shackled at home.”
Often,
families cannot afford treatment for loved ones with mental illness.
“There is
only one mental hospital in each province,” Eka said. “And they’re usually
located in the capital cities.”
Under the
new law, the Ministry of Health will train general practitioners and nurses at
community health clinics ( puskesmas ) in remote areas to recognize and
properly treat early symptoms of mental illnesses.
“This way,
patients and their families won’t have to travel very far and spend a lot of
money to get help,” Eka said.
Currently,
doctors and nurses at community health centers would refuse treatment to
mentally ill patients, partly on the grounds of being under-resourced and
under-trained to deal with such cases.
“They
thought that mental illnesses are none of their business,” Eka said. “This is a
very wrong misconception. Mental health is actually everybody’s business.”
Indonesia’s
new universal health insurance scheme, known as BPJS, also gives new hope for
people living with schizophrenia.
Under BPJS,
people with schizophrenia are nominally entitled to full medication, treatment
and hospitalization for free. Over 127 million people in Indonesia are
currently covered by BPJS, Eka said.
However,
rollout of the program has been rocky. Patients regularly report problems
accessing appropriate care, while doctors complain they have been encumbered by
low reimbursement rates and regulations that limit the amount of medication
they are allowed to prescribe for chronic diseases to just a few days of pills
at a time.
Join the
dialogue
To boost
awareness of schizophrenia, the Ministry of Health, PDSKJI and Care for the
Schizophrenia Community (KPSI) will conduct a series of public campaigns in
October and November 2014, among them a public seminar held at @america, in
Pacific Place Mall, South Jakarta, on Oct. 10 to observe World Mental Health
Day.
The seminar
will feature Byron Good of Harvard University, who will speak about research on
schizophrenia that he conducted in Yogyakarta. Later that evening, KPSI will
conduct a candle lighting ceremony to acknowledge people in Indonesia living
with schizophrenia at the Hotel Indonesia traffic circle in Central Jakarta.
“We hope to
increase people’s care and awareness for schizophrenics in Indonesia,” KPSI
chairman Bagus Utomo said. “We also hope that [people with schizophrenia] will
no longer be treated as second-class citizens in this country.”
The
campaign will also feature the National Games for Mental Health Rehabilitants (
Porkesremen ) in Singkawang, West Kalimantan, held by the Ministry of Health,
from Oct. 29 to Nov. 1. About 400 people, including mental health practitioners
and people in rehabilitation from all over Indonesia, will participate.
“This is
one of our efforts to eliminate the stigma on people with mental health
problems. We want to ensure that when these people are properly treated, they
too can achieve much in their lives,” Eka said.
Taking
control
Poltak now
says his experience proves that schizophrenia can be overcome with treatment,
enabling great achievements. He now takes his medicine daily to control his
schizophrenia, and practices prayer and meditation to help control his
hallucinations.
Poltak says
that after staying for several months in a Bandung hospital for treatment, he
regained his mental and verbal capabilities by teaching chemistry at a his
hometown high school in Medan, North Sumatra.
“Teaching
encouraged me to take control of my mind and speech,” Poltak said.
In 2007,
Poltak took the test to become a civil servant in the Ministry of Industry. He
passed, and was appointed as a chemical analyst in a government-owned
industrial research and standardization agency in Manado, North Sulawesi. In
2012, Poltak won a double-degree scholarship at Bandung’s Institute of
Technology (ITB) and Chang Yuan Christian University in Taiwan. He recently
graduated from his studies with flying colors.
“I would
encourage fellow schizophrenics not to lose hope. “Life doesn’t end with
schizophrenia. With proper medication and treatment, we all can still have a
bright future,” Poltak said.
Ash Xyle
agrees. “Schizophrenia is like a hard-to-tame pet The day you tame it, it’s
yours. But until then, you have to run around to wipe up the pee and the poo.”
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