In the past four columns, we have looked at four core therapeutic approaches to mental illness: psychiatry, psychology, social work, and alternative (non-medical) strategies.
In this last piece in the series, I will resist the urge to summarize; that would be too easy. Instead I will look at the need for advocacy, which is a necessary aspect of the therapeutic process — though not a therapy itself.
For many folks living with mental illness or a mood disorder, treatment opportunities are missed simply because the patient doesn’t know what is available — doesn’t know who to talk to.
I think that many of our mentally ill homeless, and a good proportion of folks who end up in psych units, fall into this category.
This is where an advocate comes in.
This person can be a family member, a friend, a lover, or — preferably — a publicly paid person expert in locating resources for unwell clients. Social workers often play that role, but they have other pressing duties that are performed with inadequate resources.
I truly believe, though, that every person living with an illness has someone nearby to act as his or her advocate.
What follows is a recent and personal example of this, though here I am talking about a friend made terribly vulnerable by advanced old age.
I became worried recently because a fine, and very old friend was acting out of character. In our telephone conversations she seemed confused. And in visits to the care facility where she resided, she was often detached and not her usual feisty and sharp-eyed self.
I asked the physician attending the facility for a quick interview, but was granted none. Seems he alone was responsible for some 120 residents and didn’t have time for meddling friends.
This was just not good enough, so I waited for my acquaintance to enter one of her more lucid moods. I asked her what had changed over the last six months or so.
Seems she had been prescribed four strong psychoactive drugs for symptoms she had hitherto never experienced.
One of these drugs helped her get up and to breakfast on time. She needed this because she had also been taking a sedative to help her fall asleep — a drug that made her woozy in the morning. The other two were an anti-depressant and an anti-psychotic. All of these were, in our view, unnecessary.
Not being family, there was little I could do but recommend she talk to her old GP. She did this, and in short order was being weaned off all four drugs.
Many care facilities are understaffed, and it is commonly known that drugs can be used to keep residents under control. I’m not saying this was true in my friend’s case.
My point is that by observing, investigating, and dialing a few phone numbers, I was able to advocate for my old friend who, I am happy to report, is once again doing the New York Times crossword faster than I ever could.
So, look around you. Maybe there is someone in your circle who could use an advocate: someone to make a few calls, pull a few strings, and get the necessary help to where it’s needed.
Editor’s note: Hugh Macaulay is vice president of the Arrowhead Clubhouse Society board of directord. He writes monthly about mental health issues with a focus on the Sunshine Coast.
