Photo of Institute of Mental Health (Credit - IMH)

Rehabilitation and reintegrating of long-term stayers at IMH into society

by Apolitical

Finally! I am really happy someone is addressing the issue of Long-term Stayers: reintegrating them into society. They are so out of touch with reality!

Dr Alex Su, vice-chairman of the medical board at the Institute of Mental Health said some have been staying for 10, 20 years or longer. He said these stayers lead very simple lifestyle during their long-stay: sleep, wake up, eat, sleep, wake up, eat and so on.

This effort to reintegrate them into society is part of a broad initiative started to help suitable long-stayers regain independence, improve their ability to care for themselves, learn new skills and eventually be useful members of society.

Goh, a senior, said some of them believe they will continue to enjoy staying for the longest time, or even forever. These people may, therefore, be listless, unmotivated or have poor self-confidence.

Dr Su added that although long-stayers have been well cared for over the years, the side effect is they become “institutionalised”: “Everything is done for them such that they lose independence in their daily tasks”.

It is truly a beautiful day when someone with much to lose does a bit of self-reflection. I never believed for one moment I will ever hear them saying reintegrating long-term stayers into society will help boost their self-worth and dignity: “It can be quite sad to have to live the rest of their lives inside. If they are competent and stable, why not try to re-integrate (them back into society)?”

Still, there is cause for skepticism. Especially, when the strategy, to achieve reintegration into society, is to ask for volunteers to undergo “slow stream” rehabilitation. It is worrying when Dr Su expectation managed: “As hospitals, we are always a bit risk-averse.”

Tan, Su’s colleague, also didn’t inspire confidence chiming there is “an added layer of complexity” in assimilating stayers who have been institutionalised. It is noted challenges include potential discrimination, self-stigmatisation and finding employment and retaining it. The biggest bugbear is, “All these require the community’s support, without which it will be an uphill task.”

These long-term stayers were interviewed to determine their personal goals or wishes. Some said they wanted to work. It would seem not all of them were loafers. There are inexplicable forces at work preventing anyone from doing any real work: forces designed to prevent boat rocking. Probably, the risk of capsizing is too great: being on an unstable boat is dizzy enough without someone rocking it further.

One long-stayer admitted he only has a simple wish of going to his own church. Even this is difficult. I reckon religion is a sensitive issue and it is important for long-stayers to be on the same page.

Several would like to break away from the status quo. Personally, I think it is a long shot for Long-term stayers to give up their comfortable lives in search of the unknown. They have too much to lose.

Even if they were all diehard Star-Trek fans – watching the series like watching a performance of Vexations, a musical work by Erik Satie, 840 times – their instinct will never be to seek out the final frontier, to explore strange new worlds, to seek out new life and new civilizations, to boldly go where no man has gone before.

I find it hard to believe those deemed suitable for rehabilitation is willing to work and receive training so they can take on simple jobs and be taught skills aligned with their goals. It is laughable they even wish to take public transport or go cycling, not to mention they even understand the meaning of safety.

It is a sick joke – pun intended – to suggest that these Long-stayers need to get help in setting up a bank account. They can teach you a thing or two about banking that experienced bankers will be dazzled with amazement. Why bother with ez-link card when the intricacy of Swiss banking will be more their cup of tea and also an inducement to greater participation!

The bit about Long-term stayers being very motivated and they work very hard because they know this is a good chance to get out, and get back to reality, must be taken with a tablespoon of salt.

The admittance that it is not always easy to make the transition and some wanted to return to their old way of life, and a few did, says it all: “They found it was too much of a change. Some were stressed and a couple of them relapsed.”

The good doctor said we have to be realistic – after so long, it may take a couple of readmissions before they can adapt.

Perhaps the story of Mr H, whose full name cannot be revealed, is instructive. He said he likes his current lifestyle now. He is stoic even though he has been diagnosed with lung cancer. When asked what if he dies before he gets a shot at a new life “outside”? With a dismissive wave, he said, “No need to be sad.”

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