MATTERS OF MIND - Dr. Neha Bhave Salankar

Today I want to elaborate on the importance of the way in which the family's behaviour affects the course of mental illness in the afflicted. Considering the commonality of mental illness in the community (10% of the general population suffers from a major or minor illness), each one of us needs to know the following facts while relating to the mentally ill.

·He is ill, and not evil - The mentally ill commonly get blamed for their undesirable behaviour, with little realisation that they don’t have a control over their actions, and that their behaviour is a ‘symptom’ of their illness.

·Avoid being over protective or over critical - As exemplified in R's case. Either of these attitudes can interfere with clinical improvement, or can precipitate relapses of the mental illness. It is heartening to note that because of our strong family ties and a better acceptance of mentally ill in the family than in the west, India boasts of a better recovery rate of mental illness.

·Keep stress to the minimum. The mentally ill are vulnerable to the day-to-day psychosocial stresses like conflicts in the family or at the workplace. Stress, if it arises, should be resolved at the earliest.

· Regularity in administering the medicines, especially in the more serious mental illnesses, is an absolute must. Medicine should never be stopped even for a day or two, unless the issue is discussed with the doc tor. 

· Identify reasonable goals and reward them - Encourage and recognise progress even if it is less than what was hoped for. Goals for some people may be continuing college education or returning to workplace. For others, getting out of bed or coming to the dining table is an accomplishment. Lethargy, lack of initiative (which is common in some mental illness) should not be dealt with harshly. 

·Avoid relapse by knowing early signs- Early signs of recurrence of a mental illness can be in the form of irritability, social withdrawal, losing interest in daily chores, sleep problems, difficulty in concentration etc. The family should keep its eyes open and discuss any such signs with the doctors at the earliest. To put it briefly, the mentally ill can be best helped by trying to see the world through their eyes, avoiding harsh reactions, and being encouraging and rewarding for every small improvement they show.

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