Effective Treatment of Schizophrenia - What Needs to Happen?

I have had schizophrenia for the last 25 years. I've been on medication for the last 10, and on one of the newer atypicals for the last 3. I had an insidious onset which is a gradual increase in symptoms over the course of several years. By the time it was obvious I needed help there was no one who could help me because I had lost all my human relationships. I had been kicked out of university, I had alienated my parents, I had lost all my friends.

I was psychotic for ten years. I was homeless, I attempted suicide, and I spent a couple of nights in jail before I was court ordered to see a psychiatrist as a condition of my probation. I often wonder why I had to lose 10 years of my life to an untreated psychosis. In fact I wonder why didn't I receive help in the first five years as I became psychotic.

I think the first step in effective treatment for schizophrenia is a provincial strategy by the Ministry of Health to minimize the destructiveness of this disease. Currently the Ministry is implementing a generic strategy called "Mental Health Reform", reallocating hospital funding for community services. It has had the opposite effect of increasing homelessness and incaceration of people with schizophrenia in jail, because people were not rehospitalized when they relapsed.

Most researchers agree that psychoses are bad for your health. Delays in treating the first psychotic episode and subsequent episodes essentially cause irreparable brain damage leaving people increasingly so disabled they can only live in the community with a lot of expensive services, including housing, financial benefits, case managers and ACT teams.

The best prognosis at the moment is where treatment is initiated within the first six months of the first psychotic episode, with adequate followup to prevent any relapse for the rest of their lives. In fact you can teach most people to manage their own illness and prevent relapses on their own.

I think everyone will agree that even without this long term brain damage psychotic episodes are very destructive. When people with schizophrenia don't take their medication they relapse and become homeless and/or end up in jail, if they are not rehospitalized.

Mental Health Reform resulted in more people with schizophrenia becoming homeless and/or ending up in jail because of noncompliance. That is probably my biggest concern about effective treatment of schizophrenia. The drug companies are investing billions of dollars developing more effective medications with fewer side effects. These new medications would be much more effective if people in the Ministry of Health understood the dynamics of schizophrenia, if the Ministry developed a strategy to minimize the destructiveness of this disease.

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