Brian Smith originally published this
article in psych central journal as a guide for family members having
someone with schizophrenia. The article is useful, especially in our
situation where there is poor social welfare scheme and poorly developed
community-based mental health services.
Family members often try to cope with
someone, who has schizophrenia for a period. But once there seems to be
lack of progress in treatment or dropping out of treatment, the family’s
emotional support may wane, resulting in some family members cutting
off all contact with their schizophrenic
sibling.
Friends may also lose interest
in supporting a person with schizophrenia, as they cannot understand
how to continue to give long-term support to such a person.
People with schizophrenia may need help
from people in their family or community in numerous situations. They
may often resist treatment, believing that delusion or hallucination is
real and that psychiatric help is not required. Certain long-held
beliefs and practices concerning mental illness in a particular
community may frustrate efforts of some family members in getting
relevant orthodox intervention for their relatives. The following hints
may be useful for such family members and friends.
The closest family member or friend
should be the advocate. Sometimes, only the family or others close to
the person with schizophrenia will be aware of strange behaviour or
ideas that the person has expressed. Since patients may not volunteer
such information during an examination, family members or friends should
volunteer to offer all relevant information.
Ensure ongoing compliance with treatment
Ensuring that a person with
schizophrenia continues to get treatment after hospitalisation is also
important. Discontinuing medication or not going for follow-up
treatment, often lead to a return of psychotic symptoms.
Offer strong emotional encouragement
Encouraging the person to continue
treatment and assisting him or her in the treatment process can
positively influence recovery. Without treatment, some people with
schizophrenia become so disorganised that they cannot care for their
basic needs, such as food, clothing and shelter. Such patients may end
up on the streets or in jail.
Know how to respond to bizarre comments
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 hallucination seems quite real —
they are not just “imaginary fantasies.” Instead of “going along with” a
person’s delusion, family members or friends can tell the victim that
they do not see things the same way, while acknowledging that things may
appear otherwise to the patient.
It is very important not to challenge
the person’s beliefs or delusion. They are very “real” to the person who
experiences them, and there is no point arguing with them about the
delusion or false beliefs. Instead, move the conversation along to areas
or topics where you both will agree.
Keep a record
It may also be useful for those who know
the person with schizophrenia well to keep a record of types of
symptoms, medication (including dosage), and effects of various
treatments. By having this knowledge, 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.
Thus, return of illness may be detected
early and treatment may prevent a full-blown relapse. Also, by knowing
which medication that have helped and which have caused troublesome side
effects in the past, the family can help those treating the patient to
seek better treatment more quickly.
Support the person
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
or repeatedly criticised 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.
Source: Punch