“RAYMOND ANTHONY FERNANDO” is a name that is well associated with issues concerning the mentally ill and their caregivers. This name has been appearing in letters to the media, including The Straits Times, TODAY and CatholicNews, and on radio and television programmes.
Raymond has also written to Members of Parliament, doctors, and directors of various organizations to highlight the plight faced by the mentally ill and their caregivers, and made suggestions to help them.
In addition to the cost of treatment and medication, persons with severe cases of mental illness require constant home supervision. Raymond knows.
He is one such caregiver who had to give up his job in broadcasting seven years ago to care full-time for his schizophrenic wife, Doris. (Her mobility has also been impaired in recent months because of severe arthritis.)
He was 51 then, and had not received his pension. He soon found himself in great financial diffi culty and had to survive substantially on assistance from the Society of St. Vincent de Paul. That was when he started writing “Loving A Schizophrenic”, in which he told the story of loving his wife of 30 years then (33 years now), who, at that time, had suffered 11 relapses.
Churchgoers might find Raymond familiar as he has been around parishes promoting his books, which are his main source of income these days. Along the way, he began advocating for the mentally ill and their caregivers.
Raymond's journey as an advocate for the mentally ill has garnered him several commendations: from letters including one from a 16-yearold girl who was inspired by his book to pursue her interest in psychiatry, to YMCA Singapore's testimonial of Raymond's monthly volunteering, teaching poetry to youth with cerebral palsy.
In September 2007, Raymond won the Asian Women's Welfare Association's Model Caregiver Award for being a “role model to inspire others in the giving of time and effort to bring about a higher level of caregiving in our community”.
Raymond admits that he has his fair share of critics, as any outspoken person would encounter. He often meets priests who refuse to let him promote his books at their churches, and doctors who believe that he is trying to make money from his wife's illness. But not all whom he meets are unhelpful or cynical.
Father Andrew Wong, parish priest of Church of the Holy Spirit, has been a source of strength for Raymond. It was through Father Andrew's support and encouragement in Raymond's time of greatest need that brought Raymond back to the Catholic faith after a 15-year absence.
Father Andrew shared with CatholicNews the reason for his support for Raymond's work. “Raymond does not want to stretch out his hands for free meals,” he explained.
“He is asking for an equal footing and stands on his own two feet supporting his wife. “I don't think he started out writing, but out of necessity and when you are 'desperate', you try anything, and from there comes his fl air to tell the world about living with a mentally sick wife.
“This is truly a genuine, touching story of 'for better, for worse, for good times and bad times, in sickness and in health'. He is a witness to the world of his love for his wife.”
Considering all the difficulties related to caring for Doris at home, it seems reasonable that people have asked Raymond why he doesn't put Doris in an institution, where she will presumably receive good treatment and companionship.
“I will never put Doris in a home for as long as I live, because I believe very much in what the Catholic religion says about the sanctity of marriage. I will always be with her,” Raymond emphasizes.
One of Doris' main worries, and Raymond's too, is what would happen to her if he dies fi rst? Would she be left in the Institute of Mental Health (IMH) until her death? Raymond believes this would happen, and it is this prospect that gives him the will to live, especially in those moments when suicide crosses his mind.
A longing for family support
Over the Lunar New Year period this year, Doris suffered her 12th relapse and is undergoing Electroconvulsive Therapy (ECT) during her hospitalization at the Institute of Mental Health (IMH).
Although her condition prevents her from having visitors, Raymond shared with CatholicNews that in her disoriented and depressed state, Doris had said, “My wish is that I will be able to be reunited with my family and yours.”
A perception of a lack of family support is major cause of sadness and feelings of abandonment for Raymond and Doris.
“I've never asked money from my relatives; all I ask is that they come and see us once in a while,” he told CatholicNews.
Interviews with the relatives painted another side of the story. Raymond's fourth brother, Frank, knows Doris' condition and for him to hear the same issue repeatedly at every visit to his brother's has been depressing for him, and is not something he believes a weekend visit to a family member should be about. Hence he has stopped visiting.
Doris' second sister, Jenny, shared that what prevents her family from visiting in recent years is the fear that their visits might cause Doris more psychological harm than good. She used to visit them regularly during holiday periods such as Lunar New Year and Christmas, and had even brought both of them for holidays. Jenny has also helped Raymond to transport his books to sell at parishes. Another relative says he has family and other obligations.
Other relatives say they do not visit because Raymond is overly fussy and demanding when they visit, or he places restrictions, which is an additional strain on the family ties.
Perhaps it is true that Raymond is a demanding person, and perhaps it is also true that people not involved with caring for the mentally ill do not really understand the specialized care that the mentally ill need, or the unremitting emotional wear and tear that caregivers have to endure practically every hour of every day.
“Raymond is behaving the way he is because of his extremely difficult circumstances,” one observer noted. “He is in survival mode.”
While Raymond believes that isolation is a key contributing factor in the psychological stress that has led to Doris' latest relapse, Dr Eu Pui Wai, a Senior Consultant (General Psychiatry) at IMH clarified that reasons for her relapse are multi-factorial.
“Essentially when a person faces greater psychological stress, that places additional risk for relapse,” said Dr Eu in a telephone interview. “There are many other causes that could be psychological stresses, so basically whenever any event doesn't go well, [it] can bring about psychological stress. It just so happens that around Chinese New Year, with the reunion dinners and people visiting, Doris feels more lonely around this time.”
The "love hug" they need
So what do persons with mental illness and their caregivers need? Dr Eu believes that what can help the mentally ill and their caregivers would be if they can have a supportive community to replace their immediate family.
Raymond believes that 'befrienders' will be of great help to Doris. “Doris needs people in her life, other than me,” he added. But no befriender has visited on a regular basis yet.
Some parishes already have ministries dedicated to the elderly and homebound. An expansion to include visits to the mentally ill will be doubtlessly appreciated.
A second area of help would be “affordable home delivery meals” which are nutritious and tasty, said Raymond. He described the food from one such service arranged by a charity organization, at his request, as “terrible” and terminated the service. We, like others who heard about it, thought that Raymond was being unreasonably demanding. That was, until we found out that they were being catered sardine curry four times a week. He has approached some Catholic charity organizations for support in this form but they don't provide such a service.
Raymond believes that Catholic charities, like the Catholic and Social Community Council and the Society of St Vincent de Paul, should make funds available for the mentally ill and their caregivers.
Funds can perhaps be raised in collaboration with parishes by setting aside one Sunday in a year to raise money for them. Raymond has already “made his rounds” to various parishes to sell his books, and have drawn the support of a number of Catholic priests and parishioners, including Fathers Thomas Lim, Andrew Wong, John Lau, Eugene Chong, Henry Siew, Edmund Chong, Francis Lee, Augustine Joseph, John Sim, and Lawrence Yeo, all of whom he is grateful to. He prays that someone would help transport Doris to Sunday Mass.
Another area of help that would be greatly appreciated would be funding to print his books. When Raymond published “Loving A Schizophrenic”, he did so with the help of an arts grant of $6,000 from the Central Singapore Community Development Council. The reprint was sponsored by the Lee Foundation with the support of the Singapore Association for Mental Health.
Such grants are useful for persons with mental illness and their caregivers, because they are able to maintain their dignity by using the grants to make a living.
On a national level, Raymond hopes that the following measures can be taken:
1. Stop discrimination of the mentally ill. Those who openly discriminate against the mentally ill should be taken to task and counselled.
2. Raise funds for the mentally ill on a national level.
3. Remove the clause on job application forms asking the applicant to declare if she or he has a history of mental illness as this in itself is stigmatization and discrimination.
4. Provide structural support for both the mentally ill and their caregivers.
5. Provide a caregivers' allowance for caregivers of the mentally ill, as this task is round-the-clock.
6. Advise SBS to re-route an existing feeder bus or trunk bus service to enter the IMH grounds, so that the 400-metre route out to the main road does not wear out both the patient and the caregiver. Major transport companies must play a supporting role to help the mentally ill.
7. Award grants and opportunities that facilitate caregivers and patients to work from home.
There are some local organizations that provide some form of support for the mentally ill and their caregivers.
|Singapore Association for Mental Health (SAMH)||http://www.samhealth.org.sg/||6255 3222|
|Singapore Anglican Community Services (SACS)||http://www.sacs.org.sg/||Hougang Care Centre: 6386 3911 Simei Care Centre: 6781 8133|
|Action Group for Mental Illness||http://www.agmi.org.sg/||6386 9338|
|Asian Welfare Women’s Association||http://www.awwa.org.sg||6511 5318|
|Institute of Mental Health||http://imh.com.sg||1800-3864541|
|Caregivers Association for the Mentally Ill (CAMI)||6782 9371|
|Family Service Centre Hotline||1800-838 0100|
But a fear of stigmatization or lack of support could still prevent many sufferers from coming forward to receive the help they need, leaving the primary caregiver as the sole care provider for the mentally ill and without any support for himself.
At the XIV World Day of the Sick Mass held on Feb 11, 2006, Pope Benedict XVI called to mind “families with a mentally ill member who are experiencing the weariness and the various problems that this entails”.
The pope said, “We feel close to all these situations... These are forms of poverty which attract the charity of Christ, the Good Samaritan, and of the church, indissolubly united with him in her service to suffering humanity.”
It is time that Catholic organizations in Singapore, and Catholic individuals, take a closer look at the tough situation that the mentally ill and their caregivers face on a daily basis, and offer our neighbours something more to meet their financial, physical, emotional and spiritual needs.
Get to know Raymond and Doris Fernando on TV
MEDIACORP TV has produced a new TV series of a one-hour women's talk show similar to the Oprah Winfrey Talk Show, titled, “Rouge”. This local talk show will be hosted by NMP Eunice Olsen.
In the second episode of this series, which is scheduled to be telecast on Sunday Mar 16, 2008 at 10pm on Channel 5, Raymond and Doris are featured as one of the couples in this real-life issue series. This particular episode touches on relationships/marriages.
Raymond will speak of his 33-year marriage to his beloved Doris and the many challenges he faces in providing a safe haven for his wife who has schizophrenia. -By Daniel Tay and Joyce Gan