Stalking: Its never your fault. A 15 yr old volunteering for a hospice and reading to an elderly person with Dementia is stalked by the son of the very person she was helping. What made the stalker pursue her is unclear and is truly unclear in MOST cases. Your normal helpful, courteous behavior, your pleasantness, cheerfulness, anything can trigger a chain reaction in the stalker’s mind which is fertile (read unwell) for such inaccurate and unreasonable beliefs. 2. Stalker: You are unwell but you do not realise it. For you, your emotions are strong and your thoughts stronger, they carry you onto an unreal world where the person you feel for is actually hurt by your actions, you feel hurt because she is hurt, but your mind is not ready to give up. Hope becomes a belief which grows so dark that it overwhelms you into a state where nothing else matters except the other person being with you, yours, and nobody else’s. Seek help from a Psychiatrist and change will occur, you will be back in control, able to rationally decide and judge how far is appropriate and when it is not.
Victim: Talk about it to your family, friends and well-wishers. Let them know you are being stalked. Tell them who it is and what you feel about that person. Hate, anger, frustration, even being violent (!) are emotions that you are entitled to feel! Do not let the stalker get away with minor transgressions, if any. There has to be a negative repercussion each time. In the west, the law and the police are much more sensitive to stalking as a crime than in India, but nevertheless write to the Police each time a stalking incident happens. If possible, let your community of friends and well-wishers know what to write and whom to write it to (send them a template). Seek help from a Psychiatrist. I can help you cope with the problem, support you emotionally without being judgemental, and suggest steps that I know (from experience and learning of mental health practice) will help.
Psychologist/Mental Health Professional: Listen to your client/subject carefully. Not everyone with suicidal thought needs admission, even if it is voluntary! Be open about the possibility, if need be discuss the pros and cons, but leave it to the individual to decide. Soon, mental health care will be covered by Health Insurance even in India, but we must be wary of selling our souls to hospitals for higher financial incentives in return for higher admissions. The interaction with the psychologist in this movie was so depressing and unnerving, that it will turn off people from consulting a mental health professional. However, people please understand that counselling sessions are much more interesting and relieving than what has been caricatured in the movie. I can vouch for myself, I keep hospitalisation as the last resort and the one which I wish to prevent at all costs.
Psychiatrist: Your being busy is no excuse for not listening to your patient, (AND stop those phone calls while with a patient!) Unfortunately, institutional Psychiatrists AND other mental Health professionals become ‘immune’ and ‘insensitive’ to the patients’ emotions and will often miss relevant and reasonable concerns because of their high ability to dismiss patients who are ‘unwell’. I found this an unfortunate occurrence in many hospitals that I worked at in the NHS England. In one instance, when I refused to detain (involuntary admission) a person who had a history of mental illness but was not demonstrating any unreasonable behaviour except anger, a staff member sarcastically remarked “You would prefer him to stay unwell at home than to bring him to hospital” and I replied, “I would prefer that an unreasonable man stay at home, rather than unreasonably deprive him of his freedom!”
Psychiatrist: In Unsane, when the Psychiatrist quotes how an assault on a staff and another patient makes it likely that the patient is a risk to others, and thus should be kept in hospital for another 7 days, it should be a red flag sign to all doctors that such ‘signs’ should not be seen in isolation but should be assessed together with the clinical diagnosis and the overall demeanour and presentation of the person whose freedom and liberty is being deprived. In this case, a person who was supposedly being voluntarily admitted for a risk to self has then been kept involuntarily for another 7 days for suddenly being a risk to others! That should get all clinicians thinking.
Psychiatric Hospitals: There is a lot to learn for those involved in managing and running a Psychiatric Hospital. Just because you manage to treat a lot of patients and send them healthier than when they were admitted, doesn’t mean you can’t make a mistake. Further, if a mistake has happened, it is best to admit it and to focus on finding solutions and changing the systems rather than hiding failures and hoping that your positive work will make those faults go away. A good hospital manager fosters a transparent and positive working attitude rather than a secretive, hush hush atmosphere.
Psychiatric Hospitals: I haven’t come across mixed sex wards in any Psychiatric Indoor Unit in India, BUT disappointingly in 2007 in Belfast there were still mixed sex wards. Staff tried their best to get all the female residents on to one side of the ward and males on the other, but the risks were still there. Hopefully, NHS has grown, developed and matured over the years to invest into at least getting different genders on different wards. The plight of a female in a mixed sex ward is clearly shown where a sexual assault by a male patient on our female protagonist is left unchallenged and uninvestigated. On the other hand her reasonable action in self-defence is highlighted as a ‘risk to others’. On a progressive note, the Mental Health Care Act 2017 (India) notified in 2018, provides for separate wards for children from those of adults.
On a summarising note, the entire movie highlights how a string of errors can lead to a Sane individual becoming Unsane and yet at the end we are left with the question of whether the lead is sane or unsane?!