What is the role of the patient's support system?
Support for someone with a mental disorder can come from family, a professional residential or day programme 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 behaviour 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 behaviour and hear delusional thoughts before they can legally recommend commitment, and family and friends can give them the information they need to do so.
Caregiving. 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 behaviour is the most helpful way to approach people with this disorder.
