A year ago, 503 mentally ill people at the Buddhist-run Longfatang (龍發堂) psychiatric care facility in Kaohsiung were transferred to state-run psychiatric sanatoriums. Some patients’ relatives on Wednesday last week held a news conference, at which they voiced two main complaints.
First, they said that the sanatoriums had been pressing them for treatment fees, while the Ministry of Health and Welfare appeared to be phasing out subsidies, thus increasing the burden on patients’ families.
Second, they said that Longfatang never called them when their relatives were there, but that, since the transfer, the state sanatoriums had been “harassing” families with frequent calls that were making them “depressed.”
The first of the families’ concerns has to do with care resources. Having intervened to dissolve Longfatang, the government must at least provide patients with follow-up care that equals what was received at the facility.
From a humanitarian and legal point of view, the patients’ relatives should not have to bear a heavier financial burden.
Longfatang’s existence was a tragic result of insufficient mental healthcare. Skimping on funding is not a fair solution, because the government owes the patients for several decades of neglect.
As to the sanatoriums’ alleged “harassment” of patients’ families, that is clearly a misunderstanding.
From a psychiatric point of view, the role of the families is to comfort and console patients, which helps significantly to improve their mental condition and functional abilities.
When sanatoriums contact patients’ families, it is to urge them to visit the patients more often or to have a say in treatment decisions.
Family involvement shows patients that they have not been abandoned: that someone still loves them. This is true for the patients from Longfatang, as well as for all psychiatric inpatients as part of the standard treatment that sanatoriums provide.
One relative complained that after being transferred to a mental hospital, a patient had to take medicine every day — so much that they felt dizzy and got swollen feet, and the more medicine they took, the worse it got. The relative said that the patient was not as lively as when they were staying at Longfatang.
This is another misunderstanding.
Psychiatric patients who stop taking their medicine do have temporary relief from any side effects, but their mental condition is like a forest fire, which, if left untreated for a long time, can burn out their brain functions and leave them in a state similar to dementia. In cases where a patient suffers side effects from a psychiatric drug, this can usually be fixed by adjusting the dosage or changing to a different medicine.
The transfer of the Longfatang patients to other institutions was a major event in mental healthcare in the nation. Sanatoriums should regularly assess the mental condition and functional abilities of the transferred patients. If, one year after their initial assessment, the patients’ symptoms are less severe, the sanatoriums should inform the patients’ relatives and the public to ease people’s minds.
Apart from drugs, sanatoriums should also provide non-drug treatments and rehabilitation. Patients’ families would then be convinced that they are much better off receiving orthodox psychiatric treatment than they would have been if they had stayed at Longfatang.
Shen Cheng-nan is a physician.
Translated by Julian Clegg
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