What does a schizophrenia diagnosis mean?
It seems that schizophrenia is all too often the diagnosis given to a person experiencing severe mental health issues Clare Allan The Guardian,
Severe mental illness needs to be given the priority it deserves. Photograph: Alamy
Imagine, if you will, a young man of 18. It is not, perhaps, the best time to be 18, but, despite the government's seeming determination to make his life as insecure and challenging as possible, our young man has pulled through. His mother is enormously proud of him, and it's not hard to see why. He is kind, thoughtful, popular, hard-working and has an enviable ability to laugh off life's injustices – being stopped and searched, for example, apparently for no other reason than the colour of his skin. He has set his sights on becoming a dentist. He's wanted to be a dentist since the age of 12 when he lost two teeth playing football and was treated by a highly skilled and charismatic fellow Tottenham supporter.
Our young man has worked hard and recently received a very good offer from Cardiff dental school. He went out with friends to celebrate and, unusually for him, accepted a joint. This may or may not have affected him. Anyway, since then, or round about then, he hasn't been himself. Normally gregarious, he's become increasingly withdrawn. He spends all evening alone in his room and misses school, too, unbeknown to his mother, who is usually out at work. Things come to a head when she swaps shifts and arrives home to find her son watching television. Her anger quickly changes to concern as he tells her that presenter Phillip Schofield has been talking about him. She goes to open the curtains and he leaps up to stop her. The man in the flats across the road is watching him, he says.
Our young man is lucky in some respects. His mother works as a healthcare assistant and is aware of the early intervention in psychosis (EIP) services. EIP has been one of the most successful innovations in mental health treatment in the last 10 years. By bringing together professionals from a range of disciplines – medical, psychological and social – to provide intensive age-appropriate support to young people experiencing their first psychotic episode, EIP has been shown to improve long-term outcomes, reduce the need for hospital admissions, and lower suicide risk.
Our young man's mother calls his GP and requests an immediate referral. Sadly, due to government cuts, EIP services in his area have been drastically scaled back (all that talking is expensive) and are unable to offer the level of support he needs. There is a 12-bed crisis house, a better option for him than hospital, everyone agrees, but it is full. He is placed on the waiting list, but within two weeks his health deteriorates so badly that he ends up being admitted to hospital. Terrified, he tries to discharge himself and is placed on a 28-day section.
The doctor diagnoses schizophrenia, which terrifies him still further. His mother tries to reassure him. It doesn't mean anything, she says. But, of course, she knows it does. It means stigma, if not outright bigotry; it means an 8% chance of him finding employment and a life expectancy 15-20 years shorter than that of his school friends. What it means in medical terms is far less clear.
He is placed on high doses of antipsychotics, which dampen the worst of his symptoms but leave him bloated and depressed. He is not allowed to leave the ward. There is nothing to do and nobody to talk to. At an age when life's possibilities should be opening up to him, his world is shrinking further every day. Desperate, his mother demands to speak to the doctor in charge of the ward. "I don't understand," she says. "How is this helping him?"
It's hard not to sympathise with the doctor. What, after all, can he say? I don't doubt he's doing the best he can with the resources he has available, but, as shown in the recent report from the Schizophrenia Commission, such resources are grossly inadequate. For the sake of patients, carers and the professionals trying to help, it is high time the treatment of severe mental illness was given the priority it deserves. Meanwhile, our young man is sitting on the ward.
Our young man has worked hard and recently received a very good offer from Cardiff dental school. He went out with friends to celebrate and, unusually for him, accepted a joint. This may or may not have affected him. Anyway, since then, or round about then, he hasn't been himself. Normally gregarious, he's become increasingly withdrawn. He spends all evening alone in his room and misses school, too, unbeknown to his mother, who is usually out at work. Things come to a head when she swaps shifts and arrives home to find her son watching television. Her anger quickly changes to concern as he tells her that presenter Phillip Schofield has been talking about him. She goes to open the curtains and he leaps up to stop her. The man in the flats across the road is watching him, he says.
Our young man is lucky in some respects. His mother works as a healthcare assistant and is aware of the early intervention in psychosis (EIP) services. EIP has been one of the most successful innovations in mental health treatment in the last 10 years. By bringing together professionals from a range of disciplines – medical, psychological and social – to provide intensive age-appropriate support to young people experiencing their first psychotic episode, EIP has been shown to improve long-term outcomes, reduce the need for hospital admissions, and lower suicide risk.
Our young man's mother calls his GP and requests an immediate referral. Sadly, due to government cuts, EIP services in his area have been drastically scaled back (all that talking is expensive) and are unable to offer the level of support he needs. There is a 12-bed crisis house, a better option for him than hospital, everyone agrees, but it is full. He is placed on the waiting list, but within two weeks his health deteriorates so badly that he ends up being admitted to hospital. Terrified, he tries to discharge himself and is placed on a 28-day section.
The doctor diagnoses schizophrenia, which terrifies him still further. His mother tries to reassure him. It doesn't mean anything, she says. But, of course, she knows it does. It means stigma, if not outright bigotry; it means an 8% chance of him finding employment and a life expectancy 15-20 years shorter than that of his school friends. What it means in medical terms is far less clear.
He is placed on high doses of antipsychotics, which dampen the worst of his symptoms but leave him bloated and depressed. He is not allowed to leave the ward. There is nothing to do and nobody to talk to. At an age when life's possibilities should be opening up to him, his world is shrinking further every day. Desperate, his mother demands to speak to the doctor in charge of the ward. "I don't understand," she says. "How is this helping him?"
It's hard not to sympathise with the doctor. What, after all, can he say? I don't doubt he's doing the best he can with the resources he has available, but, as shown in the recent report from the Schizophrenia Commission, such resources are grossly inadequate. For the sake of patients, carers and the professionals trying to help, it is high time the treatment of severe mental illness was given the priority it deserves. Meanwhile, our young man is sitting on the ward.
No comments:
Post a Comment