The Dark Secret

He would buy new clothes every day and throw them into the sea.

Rohan Sharma, a civil engineer in Dubai, was slowly unraveling. He would invite people over and then not open the door to them. He heard voices talking to him all the time. He believed people were following him, trying to poison his food. He lost his job and was completely unable to function.

“My mother and the other elders in our family thought that some kalian jihad has been done over him,” recalls his daughter Sheela, who was only 8 years old at that time.

“So we left Dubai in a real crisis and came back to India. My father was taken to fakir babas and tantriks to remove the kala jaadu (black magic). We donated lots of money, gold and silver to temples for his recovery.”

Schizophrenia was the terrible word that nobody was willing to acknowledge even as the family’s life became a living hell. Recalls Sheela, “As a person who witnessed all this, I really felt all the shame and embarrassment as a child, seeing my father’s symptoms. I felt why did God have to make my family like this and was always praying for some miracles.”

Sunita Gupta is only 14, but she’s had enough of life.

She has everything, the best education, a great family, and all the material things and is studying in one of the most prestigious high schools. Yet, she’s attempted suicide twice by cutting herself. Her family was too embarrassed to talk about it and could not understand how their daughter could be depressed and suicidal.

Arif Khan, who is 7, was having serrious problems in school. He was unable to sit in one place and would distract other children. He would not complete his class work and had a hard time doing his homework. His parents were tired of the constant complaints from the school and would blame Arif. They would constantly push him to do more work, call him names and not allow him to play.

Concerned parents, who would normally rush to the doctor if their child had a cough or a cold, stonewall when they suspect the need for a psychiatrist. And so they didn’t even come to know that the problem might be Attention Deficit Disorder, and that it is treatable.

Though their names have been changed to protect their identities, Rohan, Sunita and Arif are all very real people, living in New York.

Mental illness is the big, dark secret that nobody wants to examine in the sunlight. Feeling alone and isolated, families live on the cusp of sadness and despair, not knowing that help is out there for them.

Life changes dramatically when the family faces the truth and seeks treatment.
“Finally we decided to take my aunt’s suggestion and he was shown to a psychiatrist,” says Sheela, Rohan’s daughter. “He was diagnosed with schizophrenia. He was reluctant to take medication, but eventually started doing so. His symptoms reduced drastically, and he was more functioning as an individual.”

After years of turmoil, Rohan was employed again and able to participate in family life. Says Sheela, “Today at 62, he is a grandfather of six children, has three children of his own who are happily settled with their spouses. He works full time as civil engineer, travels, socializes and is happy. But he needs to take his medication every day. After my father started treatment and we saw the improvement I felt why did we wait so long to get him into treatment?”

Mental health problems, along with alcoholism and substance abuse, are the secrets families keep hidden away, but all these are treatable. For those who are wary of venturing out into the mainstream, hospitals and clinics catering specifically to immigrants and physicians who are culturally sensitive and can speak their language are now available.

“A lack of awareness about mental illness and the unwillingness to accept that a family member has a mental health problem prevents many people from accessing services,” says Reshma R. Shah, a social worker at the Asian Outreach Clinic of the Queens Child Guidance Center in Elmhurst, Queens. Mental hFree ,alth services are also provided once a week at the Indo-American Psychiatric Services at Flushing Hospital in Queens, established in 1999 by Dr. Seeth Vivek, Dr. Deenshaw Bamji and Dr. Vinod Dhar.

The Asian Outreach Clinic, established in 1993, offers family therapy, mental health services and alcohol and substance abuse services. The trained staff speaks several South Asian languages including Hindi, Gujarati, Punjabi and Bengali. While there are Chinese, Korean, Filipino and Latino clients, Shah says, “South Asian cases are just increasing every year. We have three full-time South Asian social workers, and each one of us must be having an average caseload of about 35, anytime.”

According to Dr. Agnelo Diaz, a psychiatrist at the clinic, the patients include Chinese, Korean, Filipino and South Asians. “We deal with mental health and substance abuse and we serve both children and adults. We see a variety of problems, starting with behavior problems, truancy, and parent-child conflicts. The immigrant parents come with certain set mind as to how the child is to be raised, and the child struggles with the world at home and the world outside and it’s very hard to draw a balance.”

There are often parental conflicts with children, primarily teenagers, who may sometimes run away from home or get into the wrong company and parents are not willing to compromise or understand the child’s needs.

“We also see a lot of influx in terms of domestic violence, both the victims as well as the perpetuators,” says Diaz. “It’s a positive sign. It’s a step forward because in the past domestic abuse stayed in the closet. Now we are getting hreferrals from courts for the batterers and the victims. People are now coming into the open and somehow they now have the courage to take that first step of reporting.”

Often alcohol or substance abuse is interlinked with depression and other mental problems. Young Gurmeet was always sad and depressed. He confided to the caseworkers that he had nightmares and flashbacks of scenes from the past, of his alcoholic father drinking and fighting with his mother. Although his father has an order of protection against him and was currently out of the house, he was never out of mind for Gurmeet who had visions of his father drinking, beating up his mother and also beating him. Counseling for him and his family have got them into the process of healing.

The clinic serves clients with mental problems such as schizophrenia, depression and bipolar disorders. The troubled Sunita and Arif were bothreferred to the Asian Outreach Clinic by their schools and were finally able to get treatment. Sunita was stabilized first with ongoing therapy and medication. She was seen twice a week for close monitoring. Eventually her suicidal tendencies declined and she started taking more interest in herself. She was started with home instruction and enrolled in a support group for girls.

“The family still had a hard time accepting her mental illness and kept minimizing it,” says Shah.

“We explained that they need not feel guilty about it and the more they verbalized their concerns it would be helpful in treating her. The parents started responding more, attended therapy with her, were compliant with medication and Sunita’s depression started getting better.”

Now 17, Sunita is still in treatment, but has contact with friends and is no longer suicidal and is very much aware of her symptoms. She is currently facing new issues with her parents about adjustment to the mainstream culture and her South Asian culture, However she is able to deal with the conflicts better now and no longer thinks suicide as an option. As for Arif, things are looking up for him too.

At the clinic, he was diagnosed with Attention Deficit Disorder or ADD. Says Shah, “We asked the parents to have him psychiatrically evaluated. They were hesitant about it and said that their child was not mad. We explained to them that ADD did not mean he was mad; he just had a problem focusing due to some functioning in the brain.”

His parents were reluctant to put him on medication, thinking he would get addicted and that it would be harmful. But after the school continued to complain, so finally, the parents relented and got him to see the doctor and start medication.

Says Shah, “The child responded beautifully. Also we used behavior modification techniques with him, and he was responsive to them. The complaints from the school stopped and the parents were relieved of the pressure at home and this child scored very well in school.”

For families under stress, the first step to a solution is picking up the telephone