THOSE with mental illness are sometimes so difficult to care for that their family members give up on them.

These patients end up abandoned in mental hospitals and nursing homes, with no one to pick up the tab.

But for caregivers who stay by their mentally-ill family members, the emotional strain can take its toll.

It is telling when even the man who founded the first and only national association here for caregivers of the mentally ill declined to have his photograph published for this report.

His deputy in the association declined to be interviewed.

Mr Michael Pang, 58, head of the Caregivers Association of the Mentally Ill (Cami), said: 'None of my colleagues and bosses knows of my involvement in Cami and my family members do not want too many people to know.

'It's not that we want to feel different, but people view the mentally ill differently.'

GROWING NEED FOR HELP

Such is the reality faced by a small group of caregivers here, and the numbers appear to be growing.

Starting with fewer than 10 members three years ago, Cami now has more than 80 members who are caregivers.

Cami, which has not had funding for the past three years, provides support and refers these caregivers to the various community services available here.

The association holds weekly support group meetings at the Simei Care Centre.

Last year, it started a hotline (6782-9371) that will refer caregivers to the relevant service providers.

Cami became a member of the National Council of Social Service on 1 Apr.

Providing support for those who care for their mentally-ill loved ones is a cause that Mr Pang, a civil servant, believes is worth fighting for.

He said: 'People used to suffer in silence, but now, they are more willing to come forward and seek help.

'And it is important because, without proper resources and guidance, caregivers, too, can snap.'

Mr Pang understands this strain well because he has a 31-year-old daughter with schizophrenia.

He said: 'It's hard. You first go through guilt, questioning whether you are to blame for your child's ailment.

'Then you hope against hope that your child's tantrums, and delusional and suicidal episodes will go away.

'As years go by, you never stop worrying about how your child will cope when you are gone.'

Mr Pang, who also has a 29-year-old daughter who is normal, did not realise his elder daughter was mentally ill until she was 18.

'When she was in primary school, teachers said she was slow in her learning. She was also extremely quiet and had very few friends.'

Mr Pang thought his daughter was just shy.

Teachers recommended that she see a psychologist as they suspected that she had a learning disorder, but specialists failed to detect anything.

In Secondary 2, she failed her exams and had to repeat the curriculum for the next two years.

At 16, she left school and took attended night classes to try and take the O levels as a private candidate, but stopped her studies after a year.

She then enrolled in an Institute of Technical Education, but dropped out after a week.

Mr Pang said: 'She was supposed to learn how to operate certain machines, but the instructor said she would just stare and appeared very afraid to go near the machines.'

He decided to let her stop school completely.

Later, she appeared depressed and withdrawn and had trouble sleeping.

Mr Pang said: 'One night, she gave me a fright when she came to me, quite hysterical, and said someone was telling her to kill herself.

'She kept saying that she couldn't take it anymore and that she had to jump.

'She wouldn't calm down and kept saying, 'I can hear voices telling me to jump,' he recalled.

Desperate, he took her to the emergency department of the National University Hospital (NUH), where she was hospitalised.

SEDATED AND TIED

That night, medical staff members had to sedate her and tie her down to the bed.

She spent the next month in hospital, where she was diagnosed with schizophrenia.

She was then in a rehabilitation centre for nine months.

A few months after she left rehab, she had a relapse, suffered bouts of depression and was hospitalised.

Since her discharge, she has been having monthly checkups at NUH, where she is given medication to control her illness.

And since 2005, she has been attending a day-care service at the Simei Care Centre, where she is taught simple working skills.

The centre has recommended her for jobs at fast-food outlets, but Mr Pang said: 'The last time she tried was two years ago. She lasted only about two weeks.

'The supervisor there told us that they found her too slow.'

She now helps to man a kiosk selling accessories at the centre.

It was during the time his daughter joined the Simei Care Centre that the idea of Cami was born.

Mr Pang said: 'The centre had a caregiver's network, but there were fewer than 10 of us. We realised that there was no organisation here catering to the needs of caregivers of the mentally ill.'

Mr Pang, who earns about $4,000 a month, pays Simei Care Centre $200 and spends another $80 on his daughter's medication, said: 'A major worry of caregivers is how our children will cope when we are dead.'

A government-backed trust fund for disabled children, where parents are allowed to set aside money that will go to their children after they die, is expected to be put in place later this year.

Mr Pang wants something similar for the mentally ill.

He said: 'We don't want our children to end up in a nursing home, and a burden to the state.'

Caregivers who need help can call Cami's hotline at 6782-9371.

This story was first published in The New Paper on Apr 15, 2008.