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Arkansas Catholic
Little Rock, Arkansas
November 18, 1990     Arkansas Catholic
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November 18, 1990

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• ARKANSAS CATHOLIC NOVEMBER 18, 1990 PAGE 9 Bells in the dark night: MeBtai |llness is uncomfortable when you hear a :%ice' threatening you or cursing you or telling you to be careful because i s0raething is going to hurt you. People .With mental illness are often unsure about their surroundings and other general reaction is to avoid stresses and difficult situations. instead of being aggressive, I think ill people generally tend to more." ill person hearing "voices" le to distinguish between a thought, a memory and actually hearing a Voice which isn't there. After being plagued with such "voices," the person Will then try to come up with an expla- nation as to where the voices are .cOming from• Since there are no real- mic explanations, the person begins to fantasize.- /i USome people get used to hearing they accept them and don't pay attention to them," Jones says. :, majority of mental ill- stem from unknown 'q ut some believe what the voices are ying. If the voices are saying some- thing scary like telling them they are ' 0rthless or that the cops are out to g he! them, then they react to that by • emg more defensive or avoiding People. Many times the voices are so tormenting that the patient is afraid to :'leave the house." A diagnosis of mental illness is based A Hermit's Memory By Mark I do not see you, though you are before I cannot perceive your sandals or your long flowing hair. n The difference between your ca "ng look and my closed eyes is what keeps me thinking of another time There were days with cool breezes, There were fields and little flowers on heverge. I t3ut no , i cannot them -- o.ty [the sentences which form behind my closed • Everything I wanted I no longer de- |~. The thoughts are curved inward and ˘1lo~ now. You will leave and I will not know it. Voices are bells in the dark night, Like their roundness is reful, the moon, [ You did not speak; you have shuffled I the ground the way you did, I o m, I• go back to the cave and wait for on direct observations of signs and symptoms. A sign of illness can usually be observed. A symptom of illness is usually what the patient experiences, such as pain, discomfort or reduction in normal functioning. What happens when a patient with mental illness re- fuses to talk? Can a diagnosis be made? "Not very well," says Jones. "I usually rely on what the person says or what the person says about his thoughts. If they don't say anything, that puts me in a position of assuming or trying to guess what is going on, which is real hard to do." At this point, medical science cannot pinpoint the cause of mental illness. There is no effective prevention; like- wise no cure. "Usually, at least with schizophrenia, it is a lifelong problem like diabetes or high blood pressure," Jones says. "But frequently it is under control or it is in remission. With a maniodepressive ill- ness, you have reoccurring episodes of being high or being depressed. "Some- times, the cycles are fairly frequent. Other times there may be long periods of time in between cycles. Just because a person has a maniodepressive illness or schizophrenia doesn't mean they will experience the same patterns of reoc- currences. A person can have a real severe episode or a pretty mild episode." Treatment progress Numerous strides have taken place in the mental health field during the last decade. Advances in non-medica- tion tools such as case management and psychosocial rehabilitation continue to help the mentally ill function at an even greater capacity than before. For the person with mental illness, basics like food and shelter are impor- tant. Generally, the more severe the illness, the less likely people are able to secure jobs, obtain insurance or have financial resources. They become more dependent on society. "When society backs out of its re- sponsibility to the mentally ill," says Jones, patients "have a hard time stay- ing out of the streets." A Trusting Relationship Case management plays a vital role in community support programs. Acting 'as "life coaches," case managers assist clients in establishing and reaching in- dividual goals. A case manager provides clients with ongoing support and edu- cation on a variety of topics ranging from proper use of medications to food preparation. Nancy Kahanuk ia a case manager with the Ozark Guidance Center• "I might meet with a person each week for a half hour, or for an hour every other week, or perhaps just once a month," she says• "It all depends on the individual." After the initial meeting or meetings (in some cases it takes as long as a year) to establish a trusting relationship, Kahanuk determines a client's needs. Once the basics such as finances, food and shelter have been taken care of, Kahanuk di- rects her atten- tion to helping her clients gain independence and self-esteem. "I don't want a client to become dependent on Nancy Kahanuk me, Kahanuk says. "My job is not to rescue someone." Instead, the case manager teaches her clients how to obtain problem- solving skills while learning to set goals for themselves. any given day, we might social- ize for a period of time," Kahanuk says, referring to a session with a client. "I usually have certain questions I ask, but the questions might be posed differently for each individual. I always want to know how they've been sleeping and if they've been taking their medication." A lot of case management occurs outside of Kahanuk's office. She con- ducts sessions in clients' homes and in neutral settings such as restaurants and coffee shops. Recently, she assisted a client in shopping for groceries, showed another how to use a washing machine and taught another how to learn to budget money. "I'm doing better than I think I ever have," a middle-aged client once told Kahanuk. "For the first time, I'm not somebody's kid anymore. I'm indepen- dent." Kahanuk says the terminology lay people use when describing mental ill- ness disturbs her. "Very often I will hear a person say something like, 'Did you know John is a schizophrenic?' John is no more a schizophrenic than he is a heart disease or liver ailment," she says. %Vhat people really should say is that John has schizophrenia. John has the illness, he isn't the illness." Reflections For mentally healthy persons it is im- possible to truly understand what suf- fering and anguish the mentally ill endure each day. " a memory of promise and a realization of disappointment." "For anyone who has been even minimally in a stage of mental illness," says Mark of his schizophrenia, "one of the most devastating happenstances is the change in.attitudes others around you have; the day, the night where you are. "By this I mean there is a certain point at which you seem to be more pinned down; in which things become dense and misted, and your meaning and recognitions fall into new and dif- ferent perceptions." Mark remembers once being admit- ted to a hospital where the clerk who processed his papers began to cry. "The reaction I had to that was one of bewilderment and disorientation," he recalls• "When I found myself on the ward, the doctors and technicians were, for the most part, very different. They seemed analytical, clinical. "It is a diffi- culty to confuse a reaction to illness with who you feel you really are. Somewhat like a memory of promise and realiza- tion of disappointment. One can no longer be trusted in any sense, and so the act of reaching out is replaced with precautions." Intelligent and articulate, Mark re- cently completed a correspondence course in indexing• Although his illness prevents him from working full-time, Mark spends time writing and helping with attendance records for a support program. "Having often thought the prospect of survival grim," he writes, "I admit feeling helpless at the prospect of bet- tering myself. It may be true there is a certain determination or fate to one's life. After all, we can't always be what we want to be. I wish we could. If we play at what we are, is it really true we become? If so, where does one begin?" "To write someone off because he is "crazy' is not only unjust, it is a mis- take," he says. "It is a mistake because every single human being counts just as much as another. There will never be a better world until that fact is ac- counted for." What About Options? Jami Lynch, President of PEOPL (Personal Empowerment of the Psychb atrically Labeled), remembers a time when no one cared to hear what she See "Illneu," page 10