While the understanding of schizophrenia as a brain disorder has grown significantly within the last 40 years, most people living with this illness do not choose to disclose it. Many family members are hesitant to talk publicly or with other relatives and friends about their loved one’s struggle with this illness. This is primarily due to the general public’s misconceptions about psychosis and schizophrenia.
One of the dominant, prevailing myths is that people with schizophrenia are dangerous. The vast majority of people living with schizophrenia are neither violent nor a danger to others. Yet, high-profile media cases of violence by some people with schizophrenia perpetuate this myth.
Another misconception is that people with schizophrenia can’t be helped and recovery is impossible. While long-term treatment may be required, the outlook for schizophrenia is not hopeless. When treated with “person-centered care,” many people with schizophrenia are able to enjoy life and function within their families and communities.
Yes, schizophrenia is a challenging disorder. As a form of psychosis, it can affect the way a person behaves, thinks and sees the world. People with schizophrenia often have an altered perception of reality due to hallucinations and/or delusions. They may see or hear things that don’t exist, speak in strange or confusing ways and believe that others are trying to harm them. Many feel like they’re being constantly watched. This can make it difficult to navigate the activities of daily life. Without help, they may withdraw from the outside world or live life in confusion and fear.
The good news is that schizophrenia can be successfully managed. The first step is to identify the signs and symptoms. The second step is to seek help without delay. With support, medication, and therapy, most people with schizophrenia are able to function independently and live fulfilling lives. But it takes the support of a caring community that addresses stigma, prejudice, and discrimination. These three devastating and demoralizing factors always result in social exclusion, which many people living with schizophrenia say is harder than living with the illness itself.
Stigma is the number one reason why most people struggling with a mental illness delay seeking help. The fear of being socially isolated also hinders this. Then, some refuse help due to the severity of the psychosis, which robs them of insight as to how sick they are.
Helping people to live life beyond the limitations of a mental illness with a sense of dignity, purpose, hope and meaning is called recovery. The hope of recovery changes everything: how we view the person, how we address stigma and discrimination and how we make mental health services accessible and available.
One example of mental health support is helping people with schizophrenia understand the role and importance of medication in assisting their recovery. While recovery is much more than this, medication adherence is particularly challenging for many with a psychotic disorder like schizophrenia. Health Canada recently approved a long-acting injectable antipsychotic that only has to be administered four times a year. This makes adherence easier and more convenient. Many people taking some form of medication for any medical condition would welcome “just four times a year.” Families are often supportive of any therapeutic means that promotes medication adherence and the hope of recovery.
We still have much work to do as a society in debunking the myths, misunderstandings and misconceptions about mental illness. Many service providers, family members, peer support workers and advocates are working to transform our mental health systems and services to be recovery-oriented. Mere symptom reduction should not be the single goal of any mental health system, but promoting a quality of life for those living with a mental illness in a non-discriminating society where it is acceptable to disclose and talk about any mental illness or challenge.
And yes, it is even possible for people living with a mental illness to have positive mental health. That’s part of recovery. But most of society does not even realize this reality. Still, hope changes everything and that’s a good place to start!
Chris Summerville is the CEO of the Schizophrenia Society of Canada, a family member and a certified psychosocial rehabilitation practitioner.