Saturday, September 15, 2007

A day at IMH: Where the daily routine is everything, otherwise...

15 Sep 2007, ST

IT IS Tuesday morning and Bala is off to visit his older sister and her family. He takes the bus and will arrive at her place before lunch.

He likes McDonald's burgers, so that's what she usually gets for him. He also gets on well with his brother-in-law, who 'jokes with me', he said.

These visits have become almost a ritual, carried out faithfully week after week, for more than 20 years. Sometimes he stops on his way home to do some shopping.

But there is one major difference between Bala and other commuters. The 'home' he returns to is Woodbridge Hospital.

Bala, 43, has been living there for more than two decades. He is one of over 900 schizophrenia patients who have made the mental institution their home.

When The Straits Times team visited the ward, Bala and others in his group were discussing what they had read in the morning papers. The discussion that followed could have taken place in the void deck of any Housing Board block.

At first glance, all seems normal. But the truth is that each person in the ward suffers from severe and chronic schizophrenia. Most have had this mental condition for many years.

In the highly regulated environment of this ward, many of the patients lead nearly normal lives. 'Little things can trigger off an attack,' said psychiatrist Swapna Verma.

If they have to cope with life outside, they would very quickly suffer a relapse and have to be warded again.

She explained: 'They don't react well to surprises or conflicting orders. They need things to be consistent and routine. That's why they have a hard time fitting into society. They cannot handle the unpredictable.'

In his 21 years at Woodbridge, Mr Michael Wee, assistant director of nursing, has seen patients 'do things you'd never imagine'.

Several times a year, Bala would get a relapse and refuse to eat or bathe. He would be unkempt and would wake up screaming and shouting in the middle of the night. Others might shout back, telling him to 'Shut up'.

Staff would talk to Bala gently and encourage him to return to a normal routine. Sometimes, that doesn't work. Then his medication has to be adjusted to treat his changed behaviour.

Said Mr Wee: 'They're unpredictable. When they are well, they are really well. But when they are not, they can do the oddest things.'


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