What is the role of the schizophrenia patient's support system?
cont. from
Support for someone with a mental disorder can come from family, a
professional residential or day program caregiver, shelter operators, friends or
roommates, professional case managers, or anyone else in their community or
place of worship that is concerned for their welfare. There are many situations
in which people with schizophrenia will need help from other people.
Getting Treatment. People with schizophrenia often resist treatment,
believing that their delusions or hallucinations are real and psychiatric help
is not required. If a crisis occurs, family and friends may need to take action
to keep their loved one safe.
The issue of civil rights enters into any attempt to provide treatment. Laws
protecting patients from involuntary commitment have become very strict, and
trying to get help for someone who is mentally ill can be frustrating. These
laws vary from state to state, but generally, if a person is dangerous to
himself or others because of mental illness and refuses to seek treatment,
family members or friends may have to call the police to transport the person to
the hospital if he/she will not go of his own accord. In the emergency room, a
mental health professional will assess the patient and determine whether a
voluntary or involuntary admission is needed.
People with mental illnesses who do not want treatment may hide their strange
behavior or ideas from a professional, so family members and friends should ask
to speak privately with the person conducting the patient's examination and
explain what has been happening at home. The professional will then be able to
question the patient and hear the patient's distorted thinking for themselves.
Professionals must personally witness bizarre behavior and hear delusional
thoughts before they can legally recommend commitment, and family and friends
can give them the information they need to do so.
Care giving. Ensuring that people with schizophrenia continue to get
treatment and take their medication after they leave the hospital is also
important. If patients stop taking their medication or stop going for follow-up
appointments, their psychotic symptoms will return. If these symptoms become
severe enough, they can become unable to care for their own basic needs for
food, clothing, and shelter; neglect personal hygiene; and end up on the street
or in jail, where they rarely receive the kind of help they need.
Family and friends can also help patients set realistic goals and regain
their ability to function in the world. Each step towards these goals should be
small enough to be attainable, and the patient should pursue them in an
atmosphere of support. People with a mental illness who are pressured and
criticized usually regress and their symptoms worsen. Telling them what they are
doing right is the best way to help them move forward.
How should you respond when someone with schizophrenia makes statements that
are strange or clearly false? Since these bizarre beliefs or hallucinations are
very real to the patient, it will not be useful to say they are wrong or
imaginary. Going along with the delusions will not be helpful, either. It is
best to calmly say that you see things differently than the patient does, but
acknowledge that everyone has the right to see things in their own way. Being
respectful, supportive, and kind without tolerating dangerous or inappropriate
behavior is the most helpful way to approach people with this disorder.
What is the outlook for the future?
The outlook for people with schizophrenia has improved over the last 30 years
or so. Although we still do not have a cure, effective treatments have been
developed, and many people with schizophrenia improve enough to lead
independent, satisfying lives.
This is a very exciting time for schizophrenia research. The explosion of
knowledge in genetics, neuroscience, and behavioral research are all being used
to understand the causes of the disorder, how to prevent it, and how to develop
better treatments to allow those with schizophrenia achieve their full
potential.
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Hospitalization and Out-Patient
Treatment
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Reviewed: 03/2006
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