Why are relatively few schizophrenics treated?

In our society, the disease of schizophrenia is shrouded in fear, isolation and ignorance.

The initial symptoms, which include hearing voices, mental delusions and paranoia, may at first be attributed to a bad day, an odd drug reaction, or any other number of conditions. Someone having these experiences does not suspect that a journey is beginning that may change their life and the lives of those they love.

I remember when my close friend, whom we will call Chris, began to experience the debilitating indications of the disease. As a supporter and embracer of the sixties’ culture, he had experimented with numerous and varied hallucinogenic drugs. While he didn’t seem affected at that time, several years later we all began to notice disturbing changes in his once amiable and warm personality. Odd behaviors such as furtive looks, false accusations concerning our motives, talking to himself or to figments of his imagination started intermittently, but soon began to control his actions and destroy his relationships with others.

The victims of this disease rarely wake up one day with a full-blown case of firmly established schizophrenia. It is a gradual descent into an increasing level of confusion and delusion. Normality whirls and reels and there seems to be no solid ground. In spite of this, the warning signs may get swept under the rug or minimized and each ‘good day’ brings tenuous hope.

The victim, whose world has been indescribably altered, is confused and focused on simply making it through each moment. To them, finding treatment might feel more threatening than helpful. Victims of the disease hope that it will just go away; they don’t know where to go for assistance or feel treatment will be too expensive

Early and sustained treatment of the disease is one of the primary aids in success with schizophrenic patients. Seeking help for our friend at this early stage may have made a difference in his long-term wellness. I’m sad to say, however, that we did not seek help when we should have. For us, a lack of understanding, shame, and not wanting to face the reality that was happening in our lives slammed the door to outside assistance. But when we finally faced up to the reality of what was going on, finding reliable information about the disease and treatment was extraordinarily difficult.

If it is to fall to family or close friends to intervene in a loved one’s life when the symptoms of schizophrenia become evident, readily available information about the disease, the symptoms, and access to treatment is imperative.

Although schizophrenia cannot be cured, early treatment can make all the difference in the ability to lead a productive and fulfilling life. New anti-psychotic medications are being developed and tested toward the goal of an increasingly effective treatment plan. Personal therapy has been shown to improve behavior and help the patient recognize and control triggers that might begin or escalate a psychotic episode.

In the face of these medical facts, it is deeply disturbing that less than 50% of those suffering with this illness actually receive treatment. It’s been said that a nation is only as healthy as its individual members. Providing access to the wide range of health care available for those suffering from schizophrenia should be a priority for our society.

Because schizophrenia only affects about 1% of the general population, it is not prioritized over more prevalent conditions such as substance abuse or bipolar disorder, affecting about 9% and 5% of people, respectively.  It is known that pre-emptive health care and education can significantly reduce the societal burden, medically and financially, but resources can only be allocated so far before they are stretched thin.  The long-term inpatient and outpatient care required to treat schizophrenics justifies an increased portion of our health care budget towards schizophrenia. Advertising campaigns are needed, which could provide educational materials that can increase the awareness of the associated symptoms so that intervention can occur earlier. Immediate access to services such as hotlines could help remove the complexity of the process and direct the individual on the proper steps towards receiving treatment.

Of course there remains a societal stigma surrounding schizophrenia.  Popular media reinforces these negative views. In addition, then, we need to educate the public in about mental illnesses, and especially episodes of psychosis.  The general attitude must shift from a shunning stance to an accepting embrace and a willingness to help those we can’t understand. The shame of a schizophrenia diagnosis cannot be stronger than the suffering of the schizophrenic. This can be reversed by teaching understanding and compassion to the masses with educational campaigns similar to those teaching about more prevalent disorders, such as the DARE program for substance abuse.

It has been approximately 10 years since we knew that ‘something’ was wrong with Chris. We have watched the debilitating effects of the disease steal the delightful, fun-loving personality from him. He currently lives in a care home and receives the needed medication to quiet the voices in his head and suppress the delusions that rise to the surface of his thoughts. We are grateful that he has peace now. Yet the years when his diagnosis was unclear, our information was limited and access to care not adequate can never be regained. This is partially our own fault for not seeking the information and help as diligently as we should have, but when we did look for help we faced enormous difficulty in gaining information and access.

Helping people with schizophrenia get early treatment will require both policy and personal changes. Even if health agencies improve information and access, families still must confront stigma, fear and misunderstanding. Yes, it will be difficult for you or your loved one to express a need for during these acute episodes. Yes, the available information is full of medical jargon and other complexities. But do all that you can as soon as you can.  If you or a friend or loved one is experiencing schizophrenia or has in the past, please take it upon yourself to help spread the information and make it easily accessible to as many people as possible.

Jared Hobbs is a writer at Schiz Life, a community website providing information about schizophrenia and schizophreniform disorder. Follow Jared on Twitter @SchizLife

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  1. Leigh Neegaham

    I’ve been searching online to find information about schizophrenia. I stumbled upon this website and I’m glad I did. I have a close relative who I believe is going through the same as you mentioned about your friend Chris. It has made me realize I need to push more to make sure they get the treatment that deserve.

    Thanks again, I’ll be sure to check out your website to.

  2. Lisa Feldstein (@lisafeldstein)

    Thank you for writing this article and highlighting the role of the family. Mental illness does not just affect the individual, but that person’s network of family and friends as well. As a mental health lawyer, I have seen families who know a loved one needs help, but are uncertain whether and how they might be able to seek treatment or other forms of assistance. Glad to see these issues are getting some attention.

  3. Mark762

    This article does not accurately answer the question the title asks, " Why are relatively few schizophrenics treated?" Look, as someone who has spent his career working with people with mental illness including schizophrenia I can tell you quite honestly that it is not lack of awareness and education, societal stigma, or access to helping resources that is the barrier to treatment.

    In fact, the real answer is twofold:

    1. Schizophrenia is a nasty neurobiological disease that, among other things, robs people of their insight. This includes the self awareness that they are ill and in need of medical treatment. In my experience, most people with schizophrenia reject treatment.

    2. Our laws are such that we cannot legally force people, even ill people, to obtain treatment against their will unless they meet certain narrow criteria. In many ways this is a good thing and avoids abuses. But, most people with acute decompensated schizophrenia are not competent to truly understand their illness and the implications of accepting or rejecting treatment. Most health professionals on the other hand are reluctant to deem a person incompetent (and therefore incapable of making their own medical treatment decisions) because then means forcing medication into someone against their will. As our society becomes more litigious, medical practitioners are less and less willing to stick their neck out and force treatment on someone at the risk of facing a lawsuit. Anti-psychiatry groups such as Scientology and their public misinformation efforts have not helped matters by claiming that illnesses like schizophrenia do not exist and that psychiatrists and their drugs are evil. Some patient advocacy/"psychiatric survivor groups" also discourage the use of mainstream evidence based treatments and advocate the patients' right to refuse treatment.

    So we can go ahead and educate until the cows come home but I guarantee you it will not result in a significantly larger number of schizophrenics getting the treatment that actually helps them. Schizophrenia is a neurochemical disorder caused by a series of faulty genes and the best technology we have at present for reversing the main symptoms is medication. Find a way to consistently get more of the right medication into schizophrenics and you will see substantial numbers of these people doing considerably better.

  4. Chinook

    This is a meaningful and well written article. I am a health care professional myself, and my father a physician. When my brother began to show clear signs of paranoia and delusional thoughts, it was near impossible to access care for him because he was a. unwilling to be considered unwell (significant lack of insight) and b. over 18. I watched my parents crumble, even with their “network” and I cannot underline the need to obtain EARLY intervention in this condition. In my view, my brother (and his family) has essentially suffered unduly and is fairly dependent on his family to keep the threads together. I had possibly one of the worst experiences of my life when I had to take my brother to the emergency room to have him committed. An emergency room is not an appropriate place to take someone in a psychotic state- from the perspective of the afflicted individual, the family or friend, or the other people waiting in an emergency room. We need a much better triage system, in a safe and non judgemental venue, to accept people in mental distress. This is not difficult, but requires the will to introduce this with expedience.

  5. Amber Scurvey

    I’ve been schitzophrenic for 15 year’s. I alway’s had help. From my family or even friend’s. Because, I want to help people. That’s why I was schitzophrenic. From: Amber Scurvey

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