How To Help the Mentally Ill in Public Spaces
And helpful tips to be more empathetic to their stories
I walked into the Edmonton Milner Library, got a book, and sat down.
I was paranoid and delusional. I was also hallucinating that my thoughts were being broadcast and dialogue was going on in my head of things I thought people were saying about me and thinking about me as I went near them. I had schizoaffective disorder, a combination of bipolar and schizophrenia that is categorized by mood swings, and a ‘split’ from reality known as psychosis.
Because of my mental illness, I was imagining that everyone in there was watching me closely. In reality, around me all was fine. But inside my head, a worsening storm was raging. Delusional thoughts. Hallucinations. And fear that my life was in grave danger. I stood up, leaving behind my jacket and hat, and walked away.
I thought I could lose the people following me if I ducked into the underground pedway. Alone in the parkade, I shouted nonsense. I was severely mentally ill and an intervention by my family to get me help didn’t happen for days.
That was more than twenty years ago.
Today I had to go to my clinic to get bloodwork done and the bus ride home was crowded. Behind me there was the sound of a wireless speaker blasting gangster rap, many people on the bus weren’t wearing masks, and a young man standing near me was saying what sounded like threats.
I can handle situations like this now, after being homeless and later spending large amounts of time in a psychiatric hospital. Once you have lived with and dealt with a place like a psychiatric hospital, nothing bothers you much.
But the young man worried me. He saw me look at him and walked to another part of the bus, continuing to talk to himself. A few minutes after he sat down, the people around him moved to different seats.
I knew what was going on. This guy spoke with a heavy accent, he was likely an immigrant, possibly an African refugee. I had seen enough psychosis to know this young man was having what is known as a psychotic break. I wanted to help but my back was in pain and I was weak from fasting for my blood test. It can be very difficult to approach people like this and try and help them. Part of illnesses like schizophrenia can be that a person, while in psychosis, doesn’t realize that anything is wrong.
Another time, while riding a late-night bus a troubled-sounding young person got on and asked the bus driver if he knew of a church that was open. I saw a connection. I realized I could help him. I talked him down from his fears, I befriended him. I told him that he was hearing and seeing things that were most likely not true and that there was help, there was hope.
On this day I did nothing. I had become jaded because of what it was like living in the part of town I was in, where the poor, addicted and mentally ill mostly end up in Edmonton.
It is hard to know what to do when you come across someone in psychosis. In my work with the Schizophrenia Society, we tell people in our presentations to speak slowly and clearly, reduce distractions, don’t argue about what they see and hear.
What they see and hear is very real to them, it is better to speak to emotions and behavior.
If I had today to do over, I would have thought more about where this young man had come from. He could have come from some war-torn country, fleeing a place that had no government or police and was governed by warlords. Guns, violence, assaults. He really could have used a friend.
To those who experience something like this, the first thing you should know is that people in psychosis are rarely violent; they are actually more often victims of violence and self-harm. It is important to reassure the person they are safe. Not all people with psychosis have been to war zones, but paranoia can still exist.
If you want to help, look up the number to call when someone is in trouble but it is a non-emergency. Use it when you see people struggling. Program the number on your phone. Use it when you are worried about someone. Talk to them if possible, don’t confront their delusions and hallucinations, but speak to emotions and behavior. If the person may be a danger to themselves or others, call 911.
Because of all of the wars and disasters happening in our world, the Canadian and US governments are preparing to welcome masses of refugees, and many have come already from past wars and unstable countries. These are people fleeing carnage, destruction, and sometimes even the targeting of civilians with mortars, artillery, and airstrikes.
A lot of them will have problems processing the turmoil they have been through, and many of them will have Post-Traumatic Stress Disorder, which can be a gateway to psychosis and a host of other problems. This is in addition to the current strain on the mental health system from the Pandemic and the one in five of us who in regular times have needed treatment.
Do what you can, even if it just means calling for help.
Consider volunteering with welcoming agencies, or private mental health charities like The Schizophrenia Society. Donating to a charity that helps refugees like the Red Cross can also make a difference. Regarding the current crisis in Ukraine, you can learn more about how to help, volunteer, and donate through the website.
