A person's support system may come from
several sources, including the family, a professional residential or day program provider,
shelter operators, friends or roommates, professional case managers, churches and
synagogues, and others. Because many people with schizophrenia live with their families, the following
discussion frequently uses the term "family." However, this should not be taken
to imply that families ought to be the primary support system.
There are numerous situations in which individuals with schizophrenia may need help from
people in their family or community. Often, a person with schizophrenia will resist
treatment, believing that delusions or hallucinations are real and that psychiatric help
is not required. At times, family or friends may need to take an active role in having
them seen and evaluated by a professional. The issue of civil rights enters into any
attempts to provide treatment. Laws protecting patients from involuntary commitment have
become very strict, and families and community organizations may be frustrated in their
efforts to see that a severely mentally ill individual gets needed help. These laws vary
from State to State; but generally, when people are dangerous to themselves or others due
to a mental disorder, the police can assist in getting them an emergency psychiatric
evaluation and, if necessary, hospitalization. In some places, staff from a local
community mental health center can evaluate an individual's illness at home if he or she
will not voluntarily go in for treatment.
Sometimes only the family or others close to the person with schizophrenia will be aware
of strange behavior or ideas that the person has expressed. Since individuals may not always
volunteer such information during an examination, family members or friends should ask to
speak with the person evaluating the individual so that all relevant information can be taken
into account.
Ensuring that a person with schizophrenia continues to get treatment after hospitalization
is also important. A patient may discontinue medications or stop going for follow-up
treatment, often leading to a return of psychotic symptoms. Encouraging the patient to
continue treatment and assisting him or her in the treatment process can positively
influence recovery. Without treatment, some people with schizophrenia become so psychotic
and disorganized that they cannot care for their basic needs, such as food, clothing, and
shelter. All too often, people with severe mental illnesses such as schizophrenia end up
on the streets or in jails, where they rarely receive the kinds of treatment they need.
Those close to people with schizophrenia are often unsure of how to respond when patients
make statements that seem strange or are clearly false. For the individual with
schizophrenia, the bizarre beliefs or hallucinations seem quite real they are not
just "imaginary fantasies." Instead of going along with a person's
delusions, family members or friends can tell the person that they do not see things the
same way or do not agree with his or her conclusions, while acknowledging that things may
appear otherwise to the patient.
It may also be useful for those who know the person with schizophrenia well to keep a
record of what types of symptoms have appeared, what medications (including dosage) have
been taken, and what effects various treatments have had. By knowing what symptoms have
been present before, family members may know better what to look for in the future.
Families may even be able to identify some "early warning signs" of potential
relapses, such as increased withdrawal or changes in sleep patterns, even better and
earlier than the patients themselves. Thus, return of psychosis may be detected early and
treatment may prevent a full-blown relapse. Also, by knowing which medications have helped
and which have caused troublesome side effects in the past, the family can help those
treating the patient to find the best treatment more quickly.
In addition to involvement in seeking help, family, friends, and peer groups can provide
support and encourage the person with schizophrenia to regain his or her abilities. It is
important that goals be attainable, since a patient who feels pressured and/or repeatedly
criticized by others will probably experience stress that may lead to a worsening of
symptoms. Like anyone else, people with schizophrenia need to know when they are doing
things right. A positive approach may be helpful and perhaps more effective in the long
run than criticism. This advice applies to everyone who interacts with the person.
Schizophrenia Table of Contents