Tina - Interview 18

Age at interview: 59

Brief Outline: Tina cares for her son who suffers from mental health problems and she is also working as a carer for people with mental health problems at an Asian community centre.

Background: Tina is married and has two grown up children. Ethnic background' Asian.

More about me...

Tina is in her 60s and lives in London. She is a carer for her son who suffers from mental health problems and she is also working as a carer for people with mental health problems at an Asian community centre. Originally from India herself, she welcomed the opportunity to serve her own community.

Tina thinks that the health service makes it too easy for patients to avoid taking medication which could make them better. To address this she thinks carers should be more involved so that they can make decisions when the patient may be unable to. However, this can only be done if carers are involved and included in the process. Tina has experienced being excluded from some discussions and given limited information, yet she has been expected to sign papers related to medication or sectioning. On one occasion she was excluded because she wanted to bring along her daughter who would be able to translate medical terms. As a result, her son and the consultant had met without her.

In her work, Tina says it is important to be extra patient when interacting with people with mental health problems. They need to be shown sympathy and support, and it is important to address them in a calm and understanding way. She has experienced that when she does this, they open up to her and she can help them better. She has several times followed a woman at the community centre to the local hospital to get her injections, and Tina says without her gentle approach this woman wouldn't have received her medicine.

Tina thinks that many people have unrealistic views of mental health problems, which sometimes leads them to behave inappropriately towards people with such problems. She believes that with the right medical care, which should involve the family and carers, people can get well. Without the involvement of carers, however, people may lose out on chances of getting better.

Treat people with mental illness with sympathy and understanding (played by an actor).

My advice to them, please be patient, more sympathetic towards them, try to understand them, and they'll need, -the mental people need more love and affection, as much as you give them they come nearer to you and they open up with you that -why they are suffering and how they suffer, and that -if they come to the knowledge that you are more loving [towards] them, more affection, give them affection, they'll open up more and more and they forget their disease and they can tell you how they feel it, and that way you can give the treatment and they come out from that illness.

She thinks medicine should sometimes be hidden in drinks to help people get better (played by an...

Rather than forcing you should give them treatment, if the person doesn't take treatment you should give something in the water or in the food, and that way you can find out the 'cureness'. But if they say that, we should, -the law is very bad for this country. When the person has a mental balance then they don't say or hesitate taking the medication, but this kind of schizophrenia or any mental depression or many mental illness, the doctor should give the treatment in food or any available drink, when they refuse it they should do like that and cure the person. This is my personal opinion.

Tina says the meals in hospitals don't suit a Hindu diet (played by an actor).

One client -he is Hindu religion and the family is also Hindu, but I speak to their mother and say that, 'look, in the hospital they won't get food that they require, but whatever is the availability and if the child wants it, help them'. Because over there they won't get enough food, the food they provide there, the timing is very bad, early morning 7 o'clock, 8 o'clock to 10 o'clock they give the breakfast. Then 12 o'clock they give the food like a lunch break, lunch, and 5 o'clock the dinner. The 5 o'clock dinner, after that they don't have anything only they put, -and after medication, they give the medication 5 o'clock after or about 5. After the medication it's about half an hour or hour the appetite is open up for the client, and those people get hungry like anything, -whatever they can have it they can have it. Because that is the effect of the medication and they put only the bread and butter, or not enough milk or sandwiches.

And what about clients who are vegetarian, they don't eat meat?

No, they don't get any vegetarian food, the only they get is like boiled vegetables, not properly -the vegetarian food at all. So when the client's family they bring the food then he can have it, otherwise they won't. So if they are strong religion minded it's really bad for the religious people there. But funny enough that my client he is a flexi one, the only thing -he doesn't have any beef, otherwise he's having all other food, and funny enough he gets fish and chicken so he can survive that way. But the portion they give is very little, like a little baby's having food, one scoop is not enough for them.

She says the hospital wanted her to sign sectioning papers while 'bluffing' about what was...

Because the doctor said that -unless, -if he, -when they come to the hospital they have to sign certain papers and 'you are bringing him here but you don't sign the paper?', I say 'without my knowledge what kind of medication you are going to him, and if you are not explaining to me, how can I sign the paper?' Then one of the social workers he said, 'OK, I speak to your husband and your husband said yes', I said, 'no, what number did you dial my husband, my husband is not here, how can you do that?' And then we had to take, -we take to the tribunal, -and then they know how it's coming, they are bluffing. Then one day the doctor phoned me in the morning at home and said that, 'Oh, I can't give the treatment because he is not willing to take the medication'. Then I had to fight with the doctor on the phone, not fight-fight, it's a verbal fight, that -if the baby is, little baby is not feeling well and you have to treat them, the patient have to come to you then you have to treat them, you have to find out what was the cause for that, and you have to give the treatment. Similarly when they have a mental problem then you have to find out what's the issue with them and then you have to give the treatment. You can't say denied and say, 'no, I'm not giving the treatment because he's old enough'. 'If their mental state stabilised then they won't have to come here'. And then he have, -agreed with me and then say, 'OK, I will see you so and so in the mornings about half eleven, and we will see you there'. Then we went together, -myself and my daughter- we went together and said that how, then he said, 'no, your daughter, you can't bring your daughter in, because it's just only you'. 'Say if you are using the medical term, certain words, and if I don't understand you can't explain to me properly and something happens I don't know those things. That's why I need somebody with me and only my daughter knows those words, terminology, and if you say no then I won't sign anything'.

Tina thinks people need regular checks if they suffer bad side effects from psychiatric medicines...

The patient has to have a regular check up for the body like a blood test, any routine check up, that they don't have any more kind of disease like the liver disease or any infection in their body. So sugar level, blood level, they should check it regularly like a, -not every month, but at least three months or six months, they should do that.

To make sure that the general health...

The general health is keeping well. 

Why do you think that is particularly important?

Because when they see the side effect, like the put on weight, tiredness means, -with their medication at certain time their body is not coming on -back up, so they should have the check up that so they don't get any illness, what they are suffering from and with the side effect, so they should check up the blood etc.

Tina says when people with mental health problems have wrong perceptions of what is happening,...

One patient, she is a woman, and any man she saw to enter the room (at the community centre) to ask anything and she said, 'Oh, that man is looking at me and why is he coming here, I don't like the man's face here, why is he coming here, what's wrong with me, why are they looking at me?' Actually he doesn't look at that woman or nothing, they never say hello or nothing, but she feels an inferiority complex in her mind that any man who come near -coming in the room means -she is sick of men, and that's the reason -she gets so angry and she gets so angry in her behaviour. So I take her in another room and sit down with her and say, 'Look, she is coming or he is coming here for so and so reason, it's nothing to do with you, don't worry, he won't come to you, he won't harm you, so don't worry'. And then I make her calm down so she's all right after a while. But I think she is having the episode that -after marriage- she doesn't have any family members surrounding her, -her own family member, only husband, and she is not having any baby or anything, and mentally she thinks that, 'No-one loves me'. And that is the problem with her and that's the way.

She thinks most support comes from the home, but more openness can help communities provide...

That's the most important issue, because the people can, the outside people they can watch, see and laugh it on. Very rare you get support from outside. So if you want to support you have to do support from the home, like a charity begins at home.

And what about support from the community?

Well, if the people who understand those problems then they can talk to the community people and say that in -openly, in community members and then say that, 'Look, when this is the type of issues coming in our society, now we can take some action or we can take them, -if you can't look after them, take them to the old people's home or children's home or fostering them, and if you can afford to them to send in a hostel you can do that way'. Otherwise I don't think so, -you can live your life like that because come what may happen, something happens to you who can come and help you? So the community should get together and think about the progress or 'unprogress' or any issue of the health problem -they should take into their hand and give them support.

Tina says the ability housing officers are not giving her clients the support they are paid for ...

The services should listen to carers because carers are more close to the client, and the client, -the carer knows what the client and [his or her] everyday needs, -that way they should help the client. I saw that chap, he is living in ability housing and the [professional] carer who looks after him she doesn't go and look after him at all, neither she cares, -his own client- they don't phone, at least they should phone once in a day that 'how you feel and how you are coping, how do you look after your day to day routine', but it's nothing like that. So when the CPN is visiting and asking 'has the ability housing carer come in to visit you or nothing', that time he says 'no, only my personal carer'.

His relative?

His relative, 'she looks after me, otherwise no-one else, neither she phone or nothing'. And that's why I feel sorry for my client and say that, why the authority doesn't step up into it and find out that you are having the money for nothing, and the girl, -they should take the paper to sign, -the client, -that you are looking after them or not day to day in a routine' It is part of the government services, it's the local authority is in charge of them, and they don't look after that way. I raised those issues with the CPN, but it's -nothing happened because CPN can't do anything because the health authority is a different thing, and that supporting care thing is different thing, they said.

So the -your client is not receiving their...

Any, no, should have to receive that from the authority, he did not have any support from the ability housing office. So that's the one and other bad thing, and the authority doesn't know anything and I think then my voice is heard to the authority, then they should take all the money back from her, because the government is giving the money to look after them, or care for them, and you are having the care for them and getting money and don't do anything.

Tina says information should be available in different languages (played by an actor).

What kind of information do you think should be available to carers?

Well, funny enough the primary care trust person, when I was visiting one of the clients in the hospital and they tried to put that client under the section, and I don't understand those sections, so I asked the chap that what they do this and what they, -how it works, then he explained to me that if you, -and funny enough he is an Asian guy so he speaks my language, and he explained to me very simply that this is the thing that happens in society and they can, if you don't agree they can put under the section.

So information in different languages?

Exactly, because if they simplify then we should not [need to] ask any other people. If the information is available in the local people's language then they can read and they understand what is the problem, how their children or child or the patient are behaving in that manner, so they can find out that what is happening in their family or relative or in [cared for] people. So the language is the most important issue, and it's a barrier to combine the two communities together.

Instead of offering friendliness and support, Tina says, people sometimes act as if mental health...

I think people make a big ho-ha about mental health, it's not a big, big kind of disease that people get infected. Like it's not a, -what do you call it? You don't get the spread of the germs or anything, it's mental stability. 'When they have a mental problem the same way you have to tackle the problem, because once you know that his mental stability is not there then you have to tackle that. And it's not a disease that you can catch easily like a cancer or any other things. People are saying, he's got the cancer and he passed away or he got so and so things, he got asthma or you can, coronary attack, you get, it, jumps you get it but with the mental disease there's nothing like a jump or anything. They need your support, you're more friendliness and more good way approach.