When They Need You Most

Something had scrambled Lily’s mind.

Huddled between her mother and me in the minimalist reception at a Child Psychiatric Unit, my daughter jigged one knee like a drummer who couldn’t stop, staring ahead consumed with thoughts she couldn’t articulate.The normal parental assurances had little effect; we were three disorientated people in a strange environment.

Waiting long beyond the scheduled appointment time, we watched the steady passage of staff and young residents through what doubled as a walkway from living quarters to the in-house school – as if part of our induction was to acclimatise to this flow of troubled humanity. Soon Lily would be following the same alien routines.

This was my baptism into the world of mental health. I’d never had to confront the subject, and like those sitting by me I was scared. When had things gone wrong and why hadn’t I noticed? Was it teenage angst, or perhaps something I’d done? The loving relationship with my daughter seemed at risk and I didn’t understand why. I was faced with an intangible problem and wanted tangible information to resolve it – but this would never come.

For six months the Unit for twelve young people into which she’d admitted herself became Lily’s first home – and my second. Tentative visits to her small room, with an occasional game of pool or stroll round the local park. Meetings with care staff, consultants and parent support groups. Tip-toeing forward, stumbling backwards, never sure of the next turn, listening to expert opinion but unable fully to grasp the issues or get an unequivocal diagnosis around which to plan. Such is the nature of mental illness.

This fragile nurturing continued through Lily’s rehabilitation at home and her resumed education at a local school for young people recovering from emotional problems. We listened to whatever diagnostic information was available, no matter if it was vague and inconclusive. We came to accept that Lily had thoughts and feelings she might be unable to bring out, and that guiding her into adulthood would require greater patience and direction. We kept her safe. And we trusted that Lily would make her own contribution to this working partnership and would ultimately value the support offered.

It’s said that one in four people are affected by mental illness, from mild depression to eating disorders, psychosis to dementia. Likely as not, we either have a problem ourselves or know someone who has. But acceptance of this by the other three- quarters is rarely straightforward. Unlike a broken leg or a common cold, mental illness is not a subject everyone can get to grips with. It leaves many people uncomfortable, frightened – like talking about terminal illness. Whereas friends and neighbours may offer practical or emotional support to an amputee, or the public rallies en masse to a physical disaster like flooding, a mentally ill person doesn’t readily attract such attention. Loss of contact and limited community back-up can mean a person’s mental health problems are compounded through isolation – just when they most need a friend.

Lily was not immune. Whilst people were by and large supportive, some who would previously have asked after her with enthusiasm now did so with caution, as if they might themselves become afflicted; the subject was awkward and perhaps best avoided. Irregular silences would creep into conversation and a change of topic sought. It was somehow unsafe to send ‘get well’ messages. And through fear or ignorance, a few even joked openly about mental illness. Ironically, those who had shied away most would nod sagely and express shock at the thought of such social exclusion, failing to recognise their own behaviour or perhaps finding denial the easiest way out.

Mental health is an imprecise science and likely to develop only slowly if government and society, perhaps relieved that by its nature mental illness stays largely hidden, continue to accord it low priority. At one time I too used to avoid the subject – it didn’t affect me and I found its intangible nature inconvenient and worrying. But having tracked my daughter’s experience through a difficult time and listened to many skilled practitioners, I feel a stronger responsibility to engage with mentally ill people – without being expected to understand what’s wrong.

Though I’d not have wished illness on Lily, I’m glad that having to face up to it has at least made me think differently.

Copyright © Paul Costello April 2014

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