There are often many misconceptions about schizophrenia and having worked with several clients impacted, it has become clear to me how much they suffer from negative perceptions in society. That is why is important to raise awareness, help to reduce the stigma and discrimination faced by those with this diagnosis.
The WHO (World Health Organisation) reports that:
24 million people around the world are schizophrenics (approximately 1 in 300 people)
Schizophrenia is perceived as less common than other mental health disorders and does experience a lot more discrimination than other mental health disorders because of the many erroneous beliefs given if you’re a schizophrenic.
Schizophrenia is more common in men than women and for men it begins between adolescence and young adulthood whereas for women usually the onset is from 20 to their early 30’s. It is unusual for someone to develop schizophrenia under the age of 12 or after the age of 40.
The most common symptoms are disorganised thoughts, hallucination and delusional experiences (often referred to as hearing voices or seeing things that are not real). Other symptoms are poor concentration, memory problems, becoming overly excited, behaving inappropriately, emotionally withdrawn, entering a catatonic state which is disassociating starring continuously at a particular thing and uncommunicative. Another common feature is looking dishevelled, poor hygiene and diet.
There are many theories as to what triggers the onset of schizophrenia: is it hereditary; or could it be the environment: or does it relate to adolescent hormonal changes: or could it be due to the development of the frontal cortex of the brain in adolescence?
In my experience, working at psychiatric hospitals, reading about the condition and listening to patient’s histories I feel that they are all influential factors. I also came across incidences of trauma at different times in their life. Examples traumas described were witnessing and/ experiencing violence or psychological abuse using fear through coercive control (to influence the person thinking and responses) which for some patients led to having PTSD.
In addition, the use of hallucinogenic or dissociative hallucinogenic drugs like cannabis, LSD, PCP, ketamine can exacerbate schizophrenia developing into paranoia. The substances mentioned cause an over stimulation of delusions and hallucinations so that they readily believe what they’re seeing also hearing are real even when presented with evidence to the contrary. The hallucinatory voices become more frequent and much louder, filling the person’s mind with statements of self-criticism, urging them to do harm to themselves or others. Their thinking and behaviours become increasingly chaotic
also unpredictable hence the propensity for forensic behaviours that involve committing violent crimes especially against people. Here is where the stigmatisation along with the stereotyping assertion that all schizophrenics are dangerous and ought to be locked away occurs. This non-factual thinking stems from fears that exist in society, the misrepresentation that are often reported in mainstream media and leads to discrimination Schizophrenic can experience. The discrimination experienced by a schizophrenic denies them access to services within their community, possibly leading to homelessness, they can struggle to access appropriate medication for their condition, leaving them isolated a sense of worthlessness and hopelessness.
Due to the unsympathetic stigmatising or ostracising a schizophrenic will encounter the WHO reports that many endure human rights violations in mental health institutions and frequently end up in prisons ultimately becoming institutionalised. The last psychiatric hospital I worked at being part of a multi-disciplinary team I was asked for input from a therapy opinion to assist with deciding if a schizophrenic patient needed to be detained under the mental health act. There had to be a careful deliberation involving the patient to decide and be sure detaining them was not affecting their human rights.
Having worked within medical settings involving clinical and therapy services the approach used to support a patient with schizophrenia required a treatment plan combining several strategies medication to manage their symptoms, therapy using approaches such as:
Dialectic Behavioural Therapy (DBT)
Cognitive Behaviour Therapy (CBT)
Mindfulness
Acceptance and commitment therapy (ACT).
If it was an option and possible care in the community was available to refer clients onto so they could access peer support groups, community drop in services which were for socialising, fun activities and an opportunity to interrupt their isolation.
At PBH working with case management, coaching and a clinical lead has replicated the approaches I’ve worked under confirming the importance of operating as a multi-disciplinary team. Creating a robust treatment plan together with the client’s involvement, they’ve formed a strong alliance with all involved helps the client to find stability allowing them to try to live a fulfilling and happy life.
