The Challenge of Adequate Treatment

Schizophrenia is a treatable illness. In fact most mental illnesses are treatable, with the notable exception of Alzheimer's. Depression is one of the most treatable, and 80% of people who seek medical attention for depression will recover with the treatments available, primarily antidepressant medication. Almost everyone has heard of Prozac, an SSRI antidepressant.

The prognosis for someone with schizophrenia treated in the first year of symptoms, usually a first psychotic episode, is also very good. With repeated relapses and delays in treatment, the medication becomes less effective, and the degree of disability caused by schizophrenia increases. The challenge of many mental illnesses is simply one of adequate treatment, and that is especially true for schizophrenia. A recent national US study, the PORT study, "http://www.nami.org/pressroom/9803241027..." found that more than half of the individuals with schizophrenia are not receiving adequate treatment. There are a significant number who are not receiving any treatment at all.

With one-third of the homeless believed to be experiencing an untreated schizophrenia, and more people in jail than in hospital with schizophrenia, the number of people not receiving adequate treatment mushrooms to a very significant number of people. For many years there has been a revolving door syndrome in schizophrenia. People are discharged from a psychiatric hospital only to go off their medication and relapse and be readmitted to hospital, if they are lucky, and don't end up homeless or in jail instead. That cycle of admission, discharge, noncompliance and readmission has historically been a common pattern across North America.

Part of the problem is that people with schizophrenia are usually the last ones to realize they have a treatable illness. And when they are feeling better on medication they have trouble believing they still need to take it. The older conventional medication had frightening side effects that were more unpleasant than the illness for many people, and relapse rates were sometimes as high as 70% in the first year of discharge. Noncompliance was the major cause.

Because of a civil liberties philosophy involuntary hospitalization was a last resort. To force someone to take medication was even more unthinkable. The right of people to make their own choices was considered sacred. With schizophrenia, though, the illness compromises the individual's mental functioning. They can no longer make good choices and most governments have had to step in and make involuntary treatment a last resort option for individuals who have become incompetent in making choices for themselves.

Go To Page: 1 2 3