I guess that many people around the world never expected to be worrying about mental health issues, either their own, a family member or a friend. There is no manual to tell people how to deal with it, how to recognized the signs, and/or how to navigate the health care system (when available) to get help for you or your love one. I found myself in a supporting role on the main stage trying to help my 71 years old friend Sherry. And what I found was astounding.
Sherry is 71 years old, a native of Taiwan and has lived in Canada for about 40 years. She and Paul (her husband) worked very hard and retired early in life, their two sons are very successfully one in Finance (Michael) and the other one in Human Kinetics (Steven). I met Sherry and her family in the elevator, her husband Paul and son Michael. Paul was suffering from stomach cancer (he passed away 6 years ago). We all live in the same building but different floors and through the last ten years I have kept in touch with Sherry going out for coffee, going to Chinatown to buy groceries and/or take a stroll around Lost Lagoon in Vancouver, British Columbia, Canada. Michael lives in the same building as his mom and he manages her finances, is married and has three kids. Steven lives in Ontario. When the pandemic hit, we stopped seeing each other physically, but I wanted to make sure that she was able to see a familiar face. I know she likes Tim Hortons Coffee and Boston Cream donut, which is what her and Paul used to have when they would go out for coffee on Sundays. When I started to visit Sherry in August of 2020, the first thing I did was to bring her coffee and a donut, and because I was not able to go into her apartment, I sat outside her apartment and she sat on a stool inside. What a sight! Some of her neighbours gave us dirty looks, while others said “what a great idea, we love it”. At some point our government allowed us to visit others within our household or those who live by themselves to meet each other, but only in small groups. I asked Sherry if she wanted to keep meeting, she was delighted. At some point in our conversation, the topic of learning to read came up and she said she wanted to learn and I offered to help her. We were reading children’s book, and it was all fun, but she didn’t understand the stories we were reading. She was just reading the words, but not really getting into the story to know what was happening within it. She sometimes would hit her head and said “I’m so stupid”. I reinforced her that she was not stupid, etc. and that patient was required, and then she started talking about things happening in her apartment, things like finding oily and sticky areas in her kitchen, the table that she has had for over 15 years was wearing off, “this is not normal and I know who is ruining my things”. The next time was oil and sticky stuff in her clothes, and the next she would tell me that she had taken out all her clothes from the closets and washed everything by hand from midnight until six the next day. She was exhausted, I could see it. She wears the same jeans, the same shirt, underwear, shoes every day, because she says those are the only clothes that are not contaminated.
Our conversations varied from time to time and from topic to topic, one time during our reading time, she started to talk about the things happening in her apartment:
Sherry: I know she came in last night when I was sleeping and took some notes, I left on the kitchen counter
Me: Hmmm sorry what was that? Who came into your apartment?
Sherry: Michael’s wife
Me: And why would she be doing this?
Sherry: She hates me and wants to kill me. She wants to kill Michael too and take the kids and all his money. She is so evil, that one. I know she came into the apartment while I was sleeping
Me: Shall we continue reading?
And so, the conversations were always like that every single time, but the objects taken or moved were different, her dining room table which she has had for 15+ years is all worn out and she believes her daughter-in-law scratched it, she ruined the mirror that is chip in the bathroom, the walls are scratched, pain is falling of the door frames and this is all done by one person. I talked with Michael, he said he knew and has been trying to get help, but has not been successful. At the end of 2020 I told him I would see if I could help, he was grateful and I started reading, watching videos and educating myself as much as possible to help my friend. I felt well armed with knowledge of what to do and how to go about it. The whole process was emotionally charged, I cried on the phone when I called the help line. The person on the other side was very helpful and provided me with some numbers I could call, which I called immediately. They only have voice mail, I called back the help line and told them I wanted to speak to someone and was provided with another number. The number was directed to a Case Manager, I left a detailed message on what I was looking for. The Case Manager called back and I relayed the information I had and she typed Sherry’s name on the computer and voilà: “Yes, your friend has a history of mental health illness.” I was actually not expecting to hear that because they are not supposed to provide this information. I told her “Sherry needs help, she doesn’t know she is sick, please help.” I didn’t hear anything but I kept visiting Sherry and use some “tactics” that one of the book’s described and it worked – I convinced (after 6 months) Sherry to go see the physiatrist…whoop, whoop! I called the Case Manager and told her, “Great news she said, we will be there to visit in a couple of weeks.” I insisted that a couple of weeks was not good enough and that they should seized this opportunity when Sherry was agreeable, but it didn’t happen. Two months later they came and asked Sherry about her health, do you have diabetes, heart disease, high blood pressure, do you get lost, what is today’s date, etc. Do you want to go see the doctor? Sherry said “No, I’m fine. There is nothing wrong with me. It is them that need to take medication and go to the doctor.” They left with nothing and I felt totally defeated.
I called the manager to request an update and I got the following "Well, she needs to call us and ask for help, there is nothing we can do." This upset me beyond belief and I asked "of all the cases they have seen how many people have actually picked up the phone and say I need help, I want to take my medications, I want to see my psychiatrist" - the answer "not many". I begged, “but she needs help” Case Manager “I don’t know what she’s telling you but that’s not what she told us.” Of course, she is not going to tell them, Sherry told me that much. It is beyond me how our healthcare system expects someone with serious mental issues to make this kind of decisions, when they don't even know they are sick. My friend is clearly not able to make this decision and she will never call to ask for help. She has threatened to kill herself, yet this is not taken seriously and I'm told "if you're that worried, you can take her to the ER" but I know she won't go, the Case Manager also knows this. The Case Manager has the power to request for an assessment regardless or what my friend says. They already know she has a history, so why not tell her we will re-asses you. If they are actually communicating with her doctor. Sherry’s family doesn’t know what’s her diagnosis – the Doctor’s don’t want to share this because it’s private information – So how can they help if they don’t have this information. I have kept a diary of all the activities, it is not looking good for sure. I have read so many stories of families that can't get help for their teenage daughter/son because if they don't want to, we can force them, but we could force them by enacting the Mental Health Act that has not been reviewed since 2005 (in British Columbia, Canada).
I saw Sherry for lunch and she became enraged when I asked her about going to see a doctor. "Why do I need to see a doctor, I'm not crazy. You're the one who needs help, not me. I'm fine. You're the one who needs to take medication." She was so enraged she was shaking, picked up stuff and threw it on the floor – this is not the person I know. She calmed down and continue our conversation as if nothing had just happened; and we continued to eat our lunch, I was shaken, her eyes were dark, and there is no hope in sight for her. She moved out last month to a new apartment and cut all communication, except with her online friends, whom she tells them about the things that are happening in her apartment and believe it is true. They are not in the same Province as we are and they don’t visit, they think Michael is a bad son and his wife is an evil person. Sherry told them I had called the Case Manager and I became a bad friend. They reinforced her (Sherry) suspicions and beliefs, but they don’t know the reality.
This is not a unique situation, unfortunately. I recently joined a group that supports families and friends to help their loves one to get help for an eight-week course to learn how to help others, but specifically my friend and heard about “my son died last years of overdose and he had mental health issues.” “My daughter had to be committed but because she is 18, I don’t have any say on her treatment”. “My nephew has schizophrenia and we’ve been trying to ten years to get him into a centre to treat both his mental health and his drug use problem.” These are only a few of the ones I know, but it seems the failure of the system is pervasive. We are overall helpless and literally incapacitated by the healthcare system to help our friend or family member to get help.