As someone who has worked with individuals dealing with severe and persistent mental illness, schizophrenia and schizoaffective disorders in particular for many years, I have seen the struggles of those diagnosed, and the struggles that exist within the healthcare system. An incredibly frustrating situation for all involved, and one that is now becoming more dangerous, it is time to make changes that will improve the likelihood of safety for all, and offer proper care for the mentally ill. I like this recent NY Times article by Paul Steinberg because it clarifies a few long-held misunderstandings about schizophrenia:
1. “Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior.”
2. “Schizophrenia has nothing to do with multiple personality disorder,” making this often misused joke (shown on the post-it note) false and completely irrelevant.
3. “Schizophrenia causes miscommunications between the prefrontal cortex and the language area in the temporal cortex may result in auditory hallucinations, as well as disorganized thoughts.”
4. These thoughts and hallucinations are often ‘heard’ as ‘voices’ and those voices can be experienced as commands. “The commands might insist, for example, that a person jump out of a window, even if he has no intention of dying, or grab a set of guns and kill people, without any sense that he is wreaking havoc. Additional symptoms include other distorted thinking, like the notion that something — even a spaceship, or a comic book character — is controlling one’s thoughts and actions.” In my experience, the commands often demand that the individual engage in humiliating acts, acts of self-harm, or attempt to convince the individual (often successfully) that they are ‘chosen’ or special in some way, more frequently known as delusions of grandeur.
5. “Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care.” In Western North Carolina, these hospital stays are typically five days or less. This is a fraction of the amount of time needed to reach a therapeutic level of care.
The article also highlights a few areas that are in great need of change, which include:
1. “Reasonable controls on semiautomatic weapons.”
2. “Criminal penalties for those who sell weapons to people with clear signs of psychosis.”
3. “Greater insurance coverage and capacity at private and public hospitals for lengthier care for patients with schizophrenia.”
5. “Greater willingness to seek involuntary commitment of those who pose a threat to themselves or others.” For more information on how to involuntary commit someone that is in danger of hurting themselves or someone else in the state of North Carolina: http://www.ncdhhs.gov/mhddsas/services/IVC/index.htm In states other than NC, I suggest researching your local Involuntary Commitment process. This is typically done through the magistrate’s office.
6. “Greater incentives for psychiatrists (and other mental health professionals) to treat the disorder, rather than less dangerous conditions.”
Do you know someone with schizophrenia, or have you been diagnosed with this illness? Are there misunderstandings about schizophrenia that you’d like to clarify for the general public? What do you think would help to effect positive change for this population? Leave your comments below.