Recently, I have a family friend who is experiencing an acute mania/depression. Helping his family go through it has given me an update about how the system works (in Ontario Canada) and how to effectively help someone who is acutely mentally ill (which applies to all people in general).
So it started a month ago when his mom told us that he had been acting strange lately for 3 months, symptoms of mania for sure. His mom thought that he would eventually snap out of it and get better on his own. It took a while to convince her that he must receive medical intervention. Then, he started to wander on the street for most of the day, she did not know where he had been to or what he was doing. Finally, she asked us to take him to the hospital. That’s when I saw him for the first time since he became ill. Honestly he didn’t look sick, except I could tell he was no longer the soft-spoken and nice guy that he was. His mom said that he had become a different person, really angry and verbally aggressive, which definitely gave me that kind of impression.
But he refused to go to the hospital. So we called 911 on him. When the paramedics showed up he was furious and started to argue with them, some of the stuff he said was nonsense and delusional. He created a scene for sure. The paramedic told me that they had no authority to forcefully take him against his will, only the police officers could. So eventually two cops showed up, he did not resist at all this time. He went on the ambulance with the company of one of the cops.
After arriving at the emergency room, we were waiting for his turn for almost 1.5 hours.The cops were with us until he was admitted into the emergency unit. Cops came out and asked us what we think his illness is, they were not at the scene earlier, apparently they could not tell if there was anything wrong with him except he was talking in a fast speed. I think he was masking his illness in order to “escape” from the hospital. We told the cops about his strange and ill behaviours. The cops warned us by saying that he might be sent home tonight. “We have seen people who look sicker than him, and they got sent home. There was a guy here couple months ago, his wife took him to the hospital, they did not keep him but sent him home, he jumped off the building on that night. The ones who get to stay usually look very ill, they don’t take care of their hygienes, they look like homeless people or people who are reduced to skins and bones. Unfortunately, that is how the system works, we cannot hold someone against their will, unless you go to those law divisions that process traffic violations and ask the judge to sign what’s called Form 1, you can also get that form signed by his family doctor. With this form, it gives others the authority to hospitalize him by indicating that he is not mentally capable of making decisions on his own. That way, he will be kept in the hospital for up to 72 hours. After that, an assessment will be made to decide if he should be kept for a bit longer (up to two weeks, then reassess to decide if longer)“. “ Where can we get this form at this time of the day?” We asked, it was 10pm on a Saturday night. “Unfortunately, he might have to go home tonight and you will have to come back tomorrow with the signed form. He might go home, he might, I don’t know, it depends on the doctor’s decision tonight.” There is no way that we gonna let him go home on that night, especially after hearing what happened to that poor husband and wife. After more pleads, the cops winked and said: “ you gotta tell them how severe he is. And maybe more severe than he actually is.” The cops left after that. We were lucky that the paramedics and the police officers were very patient, compassionate and helpful.
Another 45 minutes went by, a nurse came to speak to us after speaking to my friend. She asked his mom about what happened and what kinda behaviours and symptoms he had lately. Did we exaggerate the situation? Maybe, but honestly after my own struggle with mental illness, I know that a sick person’s outward behaviour only reflects a small part of what they actually have in mind, their minds are probably 10 times darker than their acts. Therefore, we were probably right on about the severity of his problems. We told the same story to the psychiatrist who came 20 minutes later. It helped when I told them how my suicide attempt put me in a wheelchair and how I wish I was locked away at the time. Thank God he was kept in the emergency room that night and for the next few days.
For the next three days, he was staying in the emergency department, having a bed but only separated from others by a curtain. He was not medicated yet, the doctor was trying to confirm what he had and finally came to the conclusion that he was having a manic episode. I learned from the doctor that he had his first episode three years ago when he was at another city. His medical record helped confirm the diagnosis, which is bipolar disorder. His first episode was effectively treated after almost two months in the hospital, but he did not keep on taking his medications, because of severe side effects, though he had been doing well for the last 1.5 years, being off medications was like a ticking bomb, another episode would inevitable occur.
When a bed was free up on the mental health ward, he was then transferred there and he has been staying there for almost 3 weeks, he is responding well to the medication, which is a similar kind of antipsychotic medication that he took before, but it’s reported of having less side effects. His old self is resurfacing. He is about to be discharged.
There are couple important things to keep in mind when attempting to help a loved one who is suicidal
1. Call 911! The chance of a person staying in the hospital is higher if they are brought in by the paramedics and the police.
2. When someone who is sent home right away after being seen by the doctor, it would actually facilitate their determination to commit suicide because they have now lost all hopes that anyone is able to help them, they have lost faith that their condition is treatable. When describing their behaviours, make it sound worse than you have witnessed, chances are there are many troublesome symptoms that you are not aware of. You might not know just exactly how bad they want to die.
3. Keep them in the hospital for as long as they are allowed. Ideally, if someone is on medications and takes them consistently, they don’t necessarily have to be hospitalized. But for any types of psychotropic medications, it takes at least 2 or 3 weeks to kick in. During that period, staying in a hospital is the only way to keep them safe. When a person is mentally ill, they usually don’t sleep at night, therefore it’s impossible for family members to watch them 24/7.
4. Taking medications in most cases is a lifelong commitment. The medication that my friend took during his first episode was very effective during his acute state. However, when he were at the maintenance stage, he should switch to a different medication and he should have a long-term psychiatrist to help him figure out the right meds and the right dosage. Not having anyone to follow up with him regularly was a mistake.
5. Having a mentally ill person in the family is extremely tiresome, therefore patience and unconditional love is really needed. Most importantly, being educated about their condition and monitor them to make sure that they stay on medications. It’s definitely treatable.
To learn more about my journey and insights, read a free PDF of my story at http://xianancy.blogspot.ca