Current concerns about the illness of Schizophrenia
Jane Burpee, Public Education Coordinator and Chris Summerville, Executive Director - Manitoba Schizophrenia Society
World wide, and in Canada, schizophrenia affects 1% of the population. One in 100 will have some form of schizophrenia in their lifetime. Though rare, one in 5,000 children can experience early-onset schizophrenia between the ages of 7 – 12 years of age. Over 10,000 people in Manitoba are affected or will be affected in their lifetime, in a given generation.
The scientific world does not know what causes schizophrenia. The three strongest theories are: genetic predisposition, viral infection, and birth trauma. However, external or/and internals stressors trigger onset of initial signs and symptoms.
There is a 10-15% inherited risk of developing the illness if a sibling or one parent has schizophrenia. When both parents have schizophrenia, the inherited risk rises to 40-50%.Thus, there may be a genetic factor involved. But it is not entirely genetic or else both identical twins would have schizophrenia where one develops it. The chance of an identical twin developing schizophrenia if one develops it is around 40%.
The response to schizophrenia is a holistic one involving 1) medical treatment with anti-psychotic medications, 2) psychosocial rehabilitation to redevelop lost life skills and learn how to live with the illness. 3) recovery philosophy to regain purpose, meaning and hope for the present and future. 4) empowerment awareness in making choices as to present decisions and to future goals, and 5) the appropriate community supports and services so as to live of quality in the community and in reducing the possibility of relapse.
Studies show that 50 – 70% of those who develop schizophrenia, recover to the degree that they can function independently with few or no positive symptoms. (Positive symptoms include hallucinations, delusions, disorganized thoughts) Approximately 25% manifest poorer outcomes indefinitely.
Approximately one third of the nation’s homeless have a treatable mental illness.
Criminal Justice System:
More than 16% of the prison population have a severe mental illness such as schizophrenia. The penal institution is the largest mental illness institution in North America. Prisons and jail are not equipped with how to work with inmates who have a mental illness. Often they do not receive medical intervention. Inmates with mental illness are abused by other inmates due to the stigma.
The regular court system is unequipped and unprepared to deal with offenders who have a mental illness. Thus, some provinces (2) and States (approx. 32) have developed mental health courts. They are diversion courts. The judge, the crown and the defense have a working knowledge of mental illness. There is a community mental health team attached to the court to assist with the terms of probabtion.
Quality of life issues:
Approximately 85% of persons with treatable mental illness are unemployed. Most do not marry. Most don’t have children. Most are on income assistance. The BIG ISSUE is STIGMA and DISCRIMINATION. Much of society still holds to unfortunate myths and misconception.
40% of people with schizophrenia will attempt suicide. 10% will die from suicide. Risk assessment and intervention plans must be regularly reviewed.
Alcohol and drugs:
Up to 70% of those with serious persistent schizophrenia will, at some point, have a co-occurring disorder of alcohol and/or substance use/abuse/addiction. Both must be seen as of primary concern in treatment. The mental illness and substance use must be addresses at the same time as one exacerbates the other.
Myths and misconception:
“Schizophrenia is a split personality.” False. Person has difficulty determining what is real and what is not real. It is a thought disorder.
“Schizophrenia is caused by poverty or poor parenting.” False. There is no evidence for this. It has a biochemical aspect to it.
“People with schizophrenia are violent.” False. The vast majority are capable citizens. Take away all those with schizophrenia and the crime rate would not be reduced by even 1%. For the few that act out in violence, the three prior indicators are: 1) Serious mental illness and not adherent to medication. 2) Use of alcohol and/or substance. 3) History of volatility or violent personality.
“There is no hope of recovery. Once ‘schizophrenic,’ always ‘schizophrenic.’” False. People do and can recover significantly with early intervention, appropriate treatment, community supports and services, and with a mental health system that is recovery-oriented.
“Schizophrenia is not costly.” Yes it is. Health care costs in Canada for the illness are around $3 billion a year. Loss productivity is another $2 million. The illness that consumes more hospital beds and days in the hospital is SCHIZOPHRENIA. Not cancer or heart disease.
What more could be done:
Reduce and eradicate stigma and discrimination through increased public awareness and education. Increase early intervention and treatment. Provide adequate community supports and services: reduced caseloads for community mental health workers, more Programs for Assertive Community Treatment (PACT), improved housing stock, increased income assistance, effective vocational rehabilitation for those with mentally illness, and access to psychological supports and services, etc.
Service providers needs to encourage recovery and hope as opposed to hopelessness (Wrong to say: “You will always be schizophrenic. You will always have to take medication. You may as well as give up your goal and dreams.”) Anyone who lives with and works with those with schizophrenia: Ask more often: What do you want? The system should be consumer driven.
Manitoba Health and the Regional Health Authorities should plan and develop a recovery-oriented mental health system. MSS calls for the establishment of a Mental Health Court in Winnipeg.
Each of us should be an advocate to this marginalized group in our population. Support and donate to organizations such as the Manitoba Schizophrenia Society (204-786-1616 or donate online)