Residents and shop workers in a southern Jeddah district are accustomed to seeing Muhammad Sultan running around in the streets scratching his body. His elderly mother blames herself for her only child's condition. “For 16 years he has suffered from mental illness. I noticed his silence and introversion but I thought it would go away, until he was fired from his job because he had been absent. Maybe my failure to take him to doctors when it first occurred made his suffering worse,” she said. She said that his condition has worsened recently, to the point where he often “ate the leaves of trees. But he doesn't hurt anybody”, the mother added. She said Muhammad spends his days sitting in front of nearby shops and only comes home to eat or sleep. Umm Muhammad says she took her son to the psychiatric hospital on the advice of some of her neighbors. He was given medication but she could not get him hospitalized because the hospital told her there was no bed for him. He could only come to the hospital for predetermined check-ups. “I committed to the appointments and he was given medication but showed no improvement,” she said. “I am an old woman and I cannot even take care of myself let alone taking care of a patient. I fear his condition will worsen and that he will start hurting himself and others.” Wandering the streets Nasir wanders aimlessly and sleeps under bridges and among parked trucks and cars in Jeddah's downtown Al-Balad area. Nasir does not talk to anybody, and those who have seen him around, say that he has been living near SAPTCO bus station for years. Nasir, a heavy smoker, screams if someone gets closer to him. Some of the shops provide him with food and water. Another wandering, mentally disabled person is the “rich man” as he calls himself. He sits on a pavement in a street in central Jeddah, shouting about “the people who stole my money,” and often frightening the passersby. When approached, the man was silent at first, but then became agitated. Ahmad, 35, who lives in the Al-Zarqa village of Dhamad region, showed signs of mental illness when he was only five years old. His uncle tied him and then locked him up in an isolated one-window room outside their house because of his hostility. The family hands him food and drink through the window. “He won't wear any clothes. He rips apart whatever we give him,” the uncle said about his nephew. He said he has taken him to several hospitals, without any success. He had to pay for his medication out of his own pocket, despite his financial problems, the uncle said. The stories above are a fraction of the people living with mental illness in the Kingdom. While some wander the streets, others are placed by their families into rehabilitation centers or hospitals, and some of them are tied up or locked up in rooms at their families' houses because of the danger they pose to themselves and others. Some families have isolated their relatives with psychological disorders because of the stigma attached to the illness. This has led to many of these people become even more ill. Psychiatric health law A Shoura Council member said recently that the Council has taken major steps toward drafting a psychiatric health law presented by the Health Affairs and Environment Committee. The law has been written taking into account the experience of a number of countries and the conditions in the Kingdom. The law involves penalties of a maximum of two years in prison and fines of up to SR200,000 for those who break it. It also proposes the establishment of a supreme council to oversee psychiatric health issues, with councils in every region. The law, he added, specifies that only certain bodies will be allowed to deal with psychiatric patients. It will include clear clauses on the rights of patients and the medical personnel who treat them. This will ensure that decisions on treatment are not done on the basis of “personal judgment”, he said. The most important goal of the new system is to protect the rights of psychiatric patients and to treat them with respect. It will require psychiatric establishments to document all treatment plans. A member of the Council's Health Affairs and Environment Committee Dr.Abdulrahman Bin Abdulaziz Al-Suwailem, said that in the coming days the committee will hold meetings with officials from the Ministry of Health, universities and other relevant bodies to discuss the draft law. The Ministry of Health's Director of Psychological and Social Health, Dr. Abdulhameed Habeeb, said he did not expect the Shoura Council to take a long time to study the law. When issued, the law will make the ministry's duties more clear in dealing with psychiatric patients. “The service is good now but we hope it improves and develops and that it will be clear to everyone.” Forgotten patients A total of 300 patients out of 630 at the Taif Mental Hospital seem to have been forgotten by their families. Statistics show that patients are transferred to the hospital from all over the Kingdom. The Western Region tops the list having sent 97 patients, the Riyadh region is second with 69 patients, with the oldest having been admitted in 1962. There are 13 patients from Qassim, with the oldest held there for 32 years without visits. One male patient, of a total of 13 patients from the southern region, has been in the hospital for about 36 years, while another from the Eastern Province was hospitalized 28 years ago. One patient from Al-Baha has been in hospital for 28 years. Dr. Hussein Al-Shareef, Supervisor of the Human Rights Commission (HRC) in Makkah, said the HRC visited the hospital a few years ago and found there were several patients who have shown improvement but have continued to live inside for years. They were supposed to have been released to provide an opportunity for others to get hospitalization. However, some families have refused to take them back claiming that they are not able to constantly monitor their relative's condition. Others use “social justifications”. Some patients have no family or relatives, he said. Dr. Suhail Abdulhameed Khan, a psychiatry consultant and Medical Director at Jeddah's Psychiatric Hospital, said medical services, especially the ones introduced to psychiatric patients, have developed significantly in recent years. He said that many who roam the streets suffer mostly from schizophrenia, which is an illness that affects one percent of every society. He said the hospital receives 100 to 120 cases daily, either referred, brought in by their families or who come in on their own. “If the patient's analysis and tests shows he needs hospitalization he will be admitted immediately,” he said. He said the hospital is facing a lot of pressure, with many families ignoring their members who have improved. “When we call them we find the numbers have changed,” he said. This results in beds being occupied which are sorely needed for more urgent cases. He warned families about giving up on their ill relatives. He said the hospital has now launched a program to follow up with patients once they are discharged and are back with their families. Psychiatry consultant at Makkah's Annoor Specialist Hospital, Dr. Sami Bin Ahmad Al-Humaida, said that despite many patients recovering and their symptoms disappearing, many are being treated as if they are “infected” and are therefore shunned. “The stigma issue exists all over the world in varying degrees, but it has metaphysical dimensions in our society, because some people link psychiatric illnesses to sorcery – a patient being a victim of sorcery.” Psychiatric consultant, Ahmad Al-Harbi of Jeddah Medical Center, said psychiatric patients represent more than 20 percent of every society, according to the World Health Organization's studies. This “is a high percentage that requires us to change our attitude toward this segment of patients and to improve cultural and health awareness”, he said. - Okaz/SG – Abrahim Al-Qirbi, Abdul Aziz Al-Rabi'i and Abdul Aziz Ma'afa also contributed to the report __
