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Entries for June 2015

FDA OK's First Quarterly Schizophrenia Drug

 

Selina McKee

 

FDA OKs first quarterly schizophrenia drug

US regulators have issued a green light for the first schizophrenia medicine dosed just four times a year, which could potentially help patients better stick to treatment and thus improve symptom control.

 

 

Following a priority review, the US Food and Drug Administration has approved Johnson & Johnson group Janssen’s atypical antipsychotic Invega Trinza - a three-month injectable formulation of paliperidone palmitate - for the treatment of the condition.

 

 

Clearance came on the back of data from a Phase III, long-term maintenance trial, published in by JAMA Psychiatry, in which 93% of patients treated with Invega Trinza did not experience a significant return of schizophrenia symptoms. Clinical data also show that the drug’s safety profile is consistent with that of its once-monthly predecessor Invega Sustenna (paliperidone palmitate), approved by FDA back in 2009.

 

It is hoped that the new three-month version will go even further in boosting treatment adherence rates. As Janssen notes, patients with acute illness often do not have insight about their disease, which contributes their not taking medication or using treatment services, potentially leading to relapse.

“With a dosing interval that can be measured in seasons, not days, people living with schizophrenia and their treatment teams can focus on recovery goals beyond short-term symptom control,” commented trial investigator Joseph Kwentus, Precise Research Centers. “Recovery looks different for everyone, and the long-term symptom control offered by Invega Trinza can help patients work toward their own personal goals.

 

Janssen said the drug should be available in the US mid-June.
Read more at: http://www.pharmatimes.com/Article/15-05-19/FDA_OKs_first_quarterly_schizophrenia_drug.aspx#ixzz3e1IpQmY7
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Depression In Teens

It’s not unusual for young people to experience "the blues" or feel "down in the dumps" occasionally. Adolescence is always an unsettling time, with the many physical, emotional, psychological and social changes that accompany this stage of life.

Unrealistic academic, social, or family expectations can create a strong sense of rejection and can lead to deep disappointment. When things go wrong at school or at home, teens often overreact. Many young people feel that life is not fair or that things "never go their way." They feel "stressed out" and confused. To make matters worse, teens are bombarded by conflicting messages from parents, friends and society. Today’s teens see more of what life has to offer — both good and bad — on television, at school, in magazines and on the Internet. They are also forced to learn about the threat of AIDS, even if they are not sexually active or using drugs.

Teens need adult guidance more than ever to understand all the emotional and physical changes they are experiencing. When teens’ moods disrupt their ability to function on a day-to-day basis, it may indicate a serious emotional or mental disorder that needs attention — adolescent depression. Parents or caregivers must take action.

Dealing With Adolescent Pressures

When teens feel down, there are ways they can cope with these feelings to avoid serious depression. All of these suggestions help develop a sense of acceptance and belonging that is so important to adolescents.

  • Try to make new friends. Healthy relationships with peers are central to teens’ self-esteem and provide an important social outlet.
  • Participate in sports, job, school activities or hobbies. Staying busy helps teens focus on positive activities rather than negative feelings or behaviors.
  • Join organizations that offer programs for young people. Special programs geared to the needs of adolescents help develop additional interests.
  • Ask a trusted adult for help. When problems are too much to handle alone, teens should not be afraid to ask for help.

But sometimes, despite everyone’s best efforts, teens become depressed. Many factors can contribute to depression. Studies show that some depressed people have too much or too little of certain brain chemicals. Also, a family history of depression may increase the risk for developing depression. Other factors that can contribute to depression are difficult life events (such as death or divorce), side-effects from some medications and negative thought patterns.

Recognizing Adolescent Depression

Adolescent depression is increasing at an alarming rate. Recent surveys indicate that as many as one in five teens suffers from clinical depression. This is a serious problem that calls for prompt, appropriate treatment. Depression can take several forms, including bipolar disorder (formally called manic-depression), which is a condition that alternates between periods of euphoria and depression.

Depression can be difficult to diagnose in teens because adults may expect teens to act moody. Also, adolescents do not always understand or express their feelings very well. They may not be aware of the symptoms of depression and may not seek help.

These symptoms may indicate depression, particularly when they last for more than two weeks:

  • Poor performance in school
  • Withdrawal from friends and activities
  • Sadness and hopelessness
  • Lack of enthusiasm, energy or motivation
  • Anger and rage
  • Overreaction to criticism
  • Feelings of being unable to satisfy ideals
  • Poor self-esteem or guilt
  • Indecision, lack of concentration or forgetfulness
  • Restlessness and agitation
  • Changes in eating or sleeping patterns
  • Substance abuse
  • Problems with authority
  • Suicidal thoughts or actions

Teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. Teens also may express their depression through hostile, aggressive, risk-taking behavior. But such behaviors only lead to new problems, deeper levels of depression and destroyed relationships with friends, family, law enforcement or school officials.

Treating Adolescent Depression

It is extremely important that depressed teens receive prompt, professional treatment.

Depression is serious and, if left untreated, can worsen to the point of becoming life-threatening. If depressed teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice.

Therapy can help teens understand why they are depressed and learn how to cope with stressful situations. Depending on the situation, treatment may consist of individual, group or family counseling. Medications that can be prescribed by a psychiatrist may be necessary to help teens feel better.

Some of the most common and effective ways to treat depression in adolescents are:

  • Psychotherapy provides teens an opportunity to explore events and feelings that are painful or troubling to them. Psychotherapy also teaches them coping skills.
  • Cognitive-behavioral therapy helps teens change negative patterns of thinking and behaving.
  • Interpersonal therapy focuses on how to develop healthier relationships at home and at school.
  • Medication relieves some symptoms of depression and is often prescribed along with therapy.

When depressed adolescents recognize the need for help, they have taken a major step toward recovery. However, remember that few adolescents seek help on their own. They may need encouragement from their friends and support from concerned adults to seek help and follow treatment recommendations.

Facing the Danger Of Teen Suicide

Sometimes teens feel so depressed that they consider ending their lives. Each year, almost 5,000 young people, ages 15 to 24, kill themselves. The rate of suicide for this age group has nearly tripled since 1960, making it the third leading cause of death in adolescents and the second leading cause of death among college-age youth.

Studies show that suicide attempts among young people may be based on long-standing problems triggered by a specific event. Suicidal adolescents may view a temporary situation as a permanent condition. Feelings of anger and resentment combined with exaggerated guilt can lead to impulsive, self-destructive acts.

Recognizing the Warning Signs

Four out of five teens who attempt suicide have given clear warnings. Pay attention to these warning signs:

  • Suicide threats, direct and indirect
  • Obsession with death
  • Poems, essays and drawings that refer to death
  • Giving away belongings
  • Dramatic change in personality or appearance
  • Irrational, bizarre behavior
  • Overwhelming sense of guilt, shame or rejection
  • Changed eating or sleeping patterns
  • Severe drop in school performance

REMEMBER!!! These warning signs should be taken seriously. Obtain help immediately. Caring and support can save a young life.

Helping Suicidal Teens

  • Offer help and listen. Encourage depressed teens to talk about their feelings. Listen, don’t lecture.
  • Trust your instincts. If it seems that the situation may be serious, seek prompt help. Break a confidence if necessary, in order to save a life.
  • Pay attention to talk about suicide. Ask direct questions and don’t be afraid of frank discussions. Silence is deadly!
  • Seek professional help. It is essential to seek expert advice from a mental health professional who has experience helping depressed teens. Also, alert key adults in the teen’s life — family, friends and teachers.

Looking To The Future

When adolescents are depressed, they have a tough time believing that their outlook can improve. But professional treatment can have a dramatic impact on their lives. It can put them back on track and bring them hope for the future.

If you or someone you know is contemplating suicide, call 1-800-273-TALK (1-800-273-8255).

Other Resources

The Boys Town National Hotline. (800)-448-3000.

American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Ave., N.W.
Washington, D.C.  20016-3007
Phone Number: (202) 966-7300
Email Address: clinical@aacap.org 
Website URL: www.aacap.org  
American Association of Suicidology
4201 Connecticut Avenue NW; Suite 310
Washington, DC 20008
Phone: 202-237-2280

Suicide Awareness/Voices of Prevention

The Jed Foundation. Suicide prevention for college students.

The Nine Line. (800) 999-9999. Covenant Hous crisis counseling for homeless and at-risk children.


Tobacco Cessation

People with mental illnesses and addictions can die decades earlier than the general population — and smoking is a major contributor.

  • About 50% of people with mental illnesses and addictions smoke, compared to 23% of the general population.
  • People with mental illnesses and addictions smoke half of all cigarettes produced, and are only half as likely as other smokers to quit.
  • Smoking-related illnesses cause half of all deaths among people with behavioral health disorders.
  • 30-35% of the behavioral healthcare workforce smokes (versus only 1.7% of primary care physicians)

What Can You Do to Decrease or Prevent Tobacco Use Among People with Mental Illnesses and Addictions?


Trauma Informed Behavioral Healthcare

Home > Consulting & Best Practices > Areas of Consulting Expertise > Trauma-informed behavioral health care

trauma_informed_care_2

“Trauma-informed approaches suggests clinicians, organizations and whole systems of care are in an active and reflective process of engaging consumers with histories of trauma. Trauma-informed transcends the isolated, “in session,” application of specific clinical interventions that are designed to “treat” the symptoms and sequelae of trauma.

Rather, trauma–informed care implies individual and collective systems recognize that trauma can have broad and penetrating effects on a client’s personhood. These effects can range from sensory sensitivities, (to harsh noise, light for example) stemming from a sensitized nervous system, to more existential challenges, like distrust of others, despair, a damaged sense self or powerlessness.

In the active acknowledgment of these broad and varied effects, clinicians, organizations and systems of care actively work to cultivate physical environments that are healing and soothing. Also, we are working to create a “behavioral environment,” where staff (clinical and non-clinical) convey dignity, respect, hopefulness, the opportunity for choices and empowerment among consumers. This seems to be a never ending, ongoing process, involving exchange and dialogue with those we serve.”

-Bharati Acharya, MA, LPCC, Diplomat Narrative Therapy, Trauma Informed Therapist/Mental Health Professional

Trauma-Informed Care in a Nutshell

CONSULTANTS

 

Cheryl Sharp
Senior Advisor for Trauma Informed Services
Cheryl Sharp holds the unique perspective of a person who has recovered from significant mental health challenges, a trauma survivor, a family member of a [...] Read More

 

 

Linda Ligenza, MSW
Clinical Services Director
Linda Ligenza supports national behavioral health quality improvement initiatives, with focus on helping organizations become trauma-informed. She was formerly with SAMHSA as the disaster trauma [...] Read More

 

 

Johnson Karen
Director, Trauma-Informed Services
Karen Johnson, MSW, LCSW, director of Trauma-Informed Services, brings to the National Council over 19 years of clinical and administrative experience in child welfare and [...] Read More

 

Request consulting services in trauma-informed care.

NEED FOR TRAUMA-INFORMED CARE

Trauma is a near universal experience of individuals with behavioral health problems. According to the U.S. Department of Health and Human Services’ Office on Women’s Health, 55% – 99% of women in substance use treatment and 85% – 95% of women in the public mental health system report a history of trauma, with the abuse most commonly having occurred in childhood. The Adverse Childhood Experiences (ACE) study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente is one of the largest investigations ever conducted to assess associations between childhood maltreatment and later-life health and well-being. Almost two-thirds of the study participants reported at least one adverse childhood experience of physical or sexual abuse, neglect, or family dysfunction, and more than one of five reported three or more such experiences.

An individual’s experience of trauma impacts every area of human functioning — physical, mental, behavioral, social, spiritual. The ACE study revealed the economic costs of untreated trauma-related alcohol and drug abuse alone were estimated at $161 billion in 2000. The human costs are incalculable.

Trauma is shrouded in secrecy and denial and is often ignored. When we don’t ask about trauma in behavioral health care, harm is done or abuse is unintentionally recreated by the use of forced medication, seclusion, or restraints.

The good news is trauma is treatable — there are many evidence-based models and promising practices designed for specific populations, types of trauma, and behavioral health manifestations.

CONSULTING SERVICES IN TRAUMA-INFORMED CARE

Addressing trauma is now the expectation, not the exception, in behavioral health systems. Every day, behavioral health organizations are asking the National Council how they can be better prepared to offer trauma-informed care.

The National Council’s trauma-informed care initiatives have helped hundreds of organizations across the country map out and operationalize a plan for delivering trauma-informed care. National Council trauma experts can help you devise and implement a complete A-Z trauma-informed care plan for your organization. They help you address board and leadership buy-in, workforce training, practice changes and guidelines, community awareness, and outcomes measurement. Our experts are available for short-term and long-term consulting and training engagements at your site and can work hands on with your core implementation team.

Addressing trauma helps your organization improve the quality and impact of your behavioral health services, increase safety for all, reduce no-shows, enhance client engagement, and avoid staff burnout and turnover.

Start today with one or more of the three key trauma-informed care consulting and training packages that the National Council offers:

Organizational Self-Assessment and Follow-up

The National Council’s Trauma-informed Care Organizational Self-Assessment is designed to increase your awareness and readiness to adopt the key components of a trauma-informed care organization and to identify what you need to keep doing and reinforcing, stop doing, or start doing the right thing. Our consulting package is designed to help you complete the assessment, review results, and develop strategies for improvement. We meet face to face with your leadership and core implementation teams, offer in-person site visits and phone consultations, schedule monthly calls to track and discuss progress, and give your team access to key resources.

Introduction to Trauma-informed Care

A day-long training at your site for all your staff provides an overview of trauma across the lifespan, discusses its impact, explains what it takes to be trauma-informed, offers helpful tools (i.e., trauma-focused therapy, alternative healing such as WRAP), and explores proven models of trauma-informed care.

Seven Domains of Trauma-informed Care

The seven domains of trauma-informed care are early screening and assessment, consumer-driven care and services, nurturing a trauma-informed and responsive workforce, evidence-based and emerging best practices, creating safe environments, community outreach and partnership building, and ongoing performance improvement and evaluation. In each of these areas, the National Council offers a half-day education workshop followed by 1-day onsite consulting on the implementation process. We help you set up performance indicators and provide essential tools and resources.

And More…

The National Council also provides consulting and technical assistance to help you

  • Address compassion fatigue
  • Use the Wellness Recovery Action Plan (WRAP) as a tool to heal trauma
  • Nurture trauma-informed peers
  • Rebuild organizational culture in the context of trauma
  • Examine issues related to gender and trauma
  • Practice trauma-informed supervision of staff
  • Build trauma-informed communities
  • Understand trauma-informed evidence-based practices
RESOURCES FOR TRAUMA-INFORMED BEHAVIORAL HEALTHCARE

National Council Magazine
An entire issue of National Council Magazine is dedicated to Trauma-Informed Behavioral Healthcare. The magazine contains more than 20 cutting edge articles from leading researchers, policy specialists, administrators, clinicians, and peer representatives as well as interviews and case studies from organizations and communities seeking to make the transition to a trauma-informed culture of care.

Manage Trauma Infographic
The National Council’s popular infographic “How to Manage Trauma” presents key facts and stats on trauma in behavioral health and outlines the symptoms and coping strategies. View and share this infographic.

Trauma Survivors Bill of Rights
Thomas Maguire’s Recovery Bill of Rights for Trauma Survivors is presented in a National Council infographic to help persons who’ve experienced trauma cope and manage their rights.

Trauma-Informed Care Learning Community
The National Council’s 2015 Trauma-informed Care Learning Community connects you with trauma experts and agencies like yours to make sure you are offering quality trauma-informed practices. The year-long learning community includes a series of coaching calls, webinars, two in-person summits, access to tools and resources, as well as lifetime membership to an exclusive listserv. Applications are not currently being accepted.


National Council Webinars

Helping Children Recover From Trauma
Bruce Perry

Does Your Organization Measure Up: Are You Really Trauma-informed?
Cheryl Sharp and Linda Ligenza, October 18, 2012

Mobilizing a Community to Address the Impact of Childhood Trauma
Teri Barila and Mark Brown, September 17, 2012

Trauma from Adverse Childhood Experiences: The Hidden Epidemic
Vincent Felitti, August 27, 2012

Engaging Women in Trauma-Informed Peer Support
Cheryl Sharp, Cathy Cave, July 9, 2012

Stories from Survivors: A Primer on Suicide Prevention
David Covington, Cheryl Sharp, Kevin Hines, and Major General Mark Graham, September 12, 2012

Addressing Trauma through Mental Health First Aid
Cheryl Sharp, February 22, 2012

Mitigating Disaster Trauma: Lessons from Sandy
Linda Ligenza, Christian Burgess, Vicky Mieseler, November 14, 2012


HELPING A PERSON WITH SCHIZOPHRENIA

Helping a Person with Schizophrenia

Overcoming Challenges While Taking Care of Yourself

Emotional and Psychological Trauma In This Article

The love and support of family plays an important role in schizophrenia treatment and recovery. If someone close to you has schizophrenia, you can make a huge difference by helping that person find the right treatment, cope with symptoms, and navigate the long road to recovery. Dealing with a family member's schizophrenia can be tough, but you don't have to do it alone. You can draw on others, and take advantage of services in your community–but you will also need to take care of yourself.

Schizophrenia and the family: How to help your loved one

If a family member or someone close to you has schizophrenia, you may be struggling with any number of difficult emotions, including fear, guilt, anger, frustration, and hopelessness. The illness may be difficult for you to accept. You may feel helpless in the face of your loved one’s symptoms. Or you may be worried about the stigma of schizophrenia, or confused and embarrassed by strange behaviors you don’t understand. You may even be tempted to hide your loved one’s illness from others.

In order to deal successfully with schizophrenia and help your family member, it’s important to:

  • accept the illness and its difficulties
  • be realistic in what you expect of the person with schizophrenia and of yourself
  • maintain a sense of humor

Do your best to help your family member feel better and enjoy life, pay the same attention to your own needs, and remain hopeful.

Tips for helping a family member with schizophrenia

  • Educate yourself. Learning about schizophrenia and its treatment will allow you to make informed decisions about how best to manage the illness, work toward recovery, and handle setbacks.
  • Reduce stress. Stress can cause schizophrenia symptoms to flare up, so it’s important to create a structured and supportive environment for your family member. Avoid putting pressure on your loved one or criticizing perceived shortcomings.
  • Set realistic expectations. It’s important to be realistic about the challenges and limitations of schizophrenia. Help your loved one set and achieve manageable goals, and be patient with the pace of recovery.
  • Empower your loved one. Be careful that you’re not taking over and doing things for your family member that he or she is capable of doing. Try to support your loved one while still encouraging as much independence as possible.

Helping people with schizophrenia tip 1: Take care of yourself

In order to successfully deal with schizophrenia in a family member, you need to take care of your own needs and find healthy ways of coping with the challenges you and your loved one face.

Put on your own "oxygen mask" first

Keeping a positive outlook is much easier when you have others you can turn to for support. Like your loved one with schizophrenia, you too need help, encouragement, and understanding. When you feel supported and cared for, you, in turn, will be better able to support and care for your loved one.

  • Join a support group. One of the best ways to cope with schizophrenia is by joining a family support group. Meeting others who know first-hand what you’re going through can help reduce feelings of isolation and fear. Support groups provide an invaluable venue for the relatives of people with schizophrenia to share experiences, advice, and information.
  • Make time for yourself. Schedule time into your day for things you enjoy, whether it be spending time in nature, visiting with friends, or reading a good book. Taking breaks from caregiving will help you stay positive and avoid burnout.
  • Look after your health. Neglecting your health only adds to the stress in your life. Maintain your physical well-being by getting enough sleep, exercising regularly, eating a balanced diet, and staying on top of any medical conditions.
  • Cultivate other relationships. It’s important to maintain other supportive, fulfilling relationships. Don’t feel guilty for looking after your social needs. You need support, too. These relationships will help buoy you in difficult times.

The importance of managing stress

Schizophrenia places an incredible amount of stress on family members. If you’re not careful, it can take over your life and quickly burn you out. And if you’re stressed out and overwhelmed, you will make the person with schizophrenia stressed. That’s why keeping your own stress levels under control is one of the most important things you can do for a family member with schizophrenia.

  • Practice acceptance. The “why me?” mindset is destructive. Instead of dwelling on the unfairness or life, accept your feelings (even the negative ones). Your burdens don’t have to define your life unless you obsess about them.
  • Seek out joy. Making time for fun isn’t frivolous or indulgent—it’s necessary. It isn’t the people who have the least problems who are the happiest, it’s the people who learn to find joy in life despite adversity.
  • Recognize your own limits. Be realistic about the level of support and care you can provide. You can’t do it all, and you won’t be much help to a loved one if you’re run down and emotionally exhausted.
  • Avoid blame. In order to cope with schizophrenia in a family member, it’s important to understand that although you can make a positive difference, you aren’t to blame for the illness or responsible for your loved one’s recovery.

Tips for keeping stress in check—no matter the challenges in your life

Dealing with schizophrenia in a family member can be stressful, but you can keep your stress levels in check by learning and practicing a variety of stress management techniques.

Helping people with schizophrenia tip 2: Encourage and support treatment

The best way to assist the recovery of a family member with schizophrenia is to get them into treatment and help them stick with it. Often, the first challenge of treatment is convincing the ill relative to see a doctor. To people experiencing delusions, hallucinations, and paranoia, there is no need for medical intervention because the voices and conspiracy theories are real.

If a family member with schizophrenia is reluctant to see a doctor, the following strategies might help:

  • Provide options – Your loved one may be more willing to see a doctor if he or she can control the situation somewhat. If your relative appears suspicious of you, suggest another person to accompany him or her to the appointment. You can also give your family member a choice of doctors.
  • Focus on a particular symptom – A person with schizophrenia may resist seeing a doctor out of fear of being judged or labeled “crazy.” You can make the doctor less threatening by suggesting a visit in order to deal with a specific symptom such as insomnia or a lack of energy.

Tips for supporting a family member’s schizophrenia treatment

  • Seek help right away. Early intervention makes a difference in the course of schizophrenia, so don’t wait to get professional help. You family member will need assistance finding a good doctor and other effective treatments.
  • Encourage independence. Rather than doing everything for your family member, encourage self-care and self-confidence. Help your loved one develop or relearn skills that will allow for greater independence of functioning.
  • Be collaborative. It’s important that your loved one have a voice in his or her treatment. When your family member feels respected and acknowledged, he or she will be more motivated to follow through with treatment and work toward recovery.

Helping people with schizophrenia tip 3: Monitor medication

Once your family member is in treatment, careful monitoring can ensure that he or she is staying on track and getting the most out of medication. You can help out in the following ways.

  • Take side effects seriously. Many people stop taking their schizophrenia medication because of side effects, so pay attention to your loved one’s drug complaints. Bring any distressing side effects to the attention of the doctor. The doctor may be able to reduce adverse effects by reducing the dose, switching to another antipsychotic, or adding another medication that targets the troublesome side effect.
  • Encourage your loved one to take medication regularly. Even with side effects under control, some people with schizophrenia refuse medication or take it irregularly. This may be due to a lack of insight into their illness and the importance of medication, or they may simply have trouble remembering their daily dose. Medication calendars, weekly pillboxes, and timers can help people who are forgetful. Two typical antipsychotics, Haldol and Prolixin, are also available in a long-acting injectable form, given as shots every 2 to 4 weeks, eliminating the need for a daily pill.
  • Be careful to avoid drug interactions. Antipsychotic medications can cause unpleasant and dangerous side effects when combined with other substances, including certain prescription drugs, over-the-counter medications, vitamins, and herbs. Help your family member avoid any problems by giving the doctor a complete list of the drugs and supplements he or she is taking. Mixing alcohol or illegal drugs with schizophrenia medication is also harmful, so talk to the doctor if your relative has a substance abuse problem.
  • Track your family member’s progress. You can help the doctor track treatment progress by documenting changes in your family member’s behavior, mood, and other symptoms in response to medication. A journal or diary is a good way to record medication history, side effects, and everyday details that might otherwise be forgotten.

Helping people with schizophrenia tip 4: Watch for signs of relapse

Stopping medication is the most frequent cause of relapse in schizophrenia, so it’s extremely important that your family member continues to take all medication as directed. Many people whose schizophrenia is stabilized or in remission still require medication to maintain their treatment gains and keep symptoms at bay.

Unfortunately, even if a person is taking medication as prescribed, relapse into an acute psychotic episode of schizophrenia can occur. But if you learn to recognize the early warning signs of relapse and take immediate steps to deal with them, you may be able to prevent a full-blown crisis. The warning signs of relapse are often similar to the symptoms and behaviors that led up to the person’s first psychotic episode.

Common warning signs of schizophrenia relapse:

  • Insomnia
  • Social withdrawal
  • Deterioration of personal hygiene
  • Increasing paranoia
  • Hostility
  • Confusing or nonsensical speech
  • Strange disappearances
  • Hallucinations

If you notice any warning signs of relapse or other indications that your family member’s symptoms of schizophrenia are getting worse, call the doctor right away.

Helping people with schizophrenia tip 5: Prepare for crisis situations

Despite your best efforts to prevent relapse, there may be times when your family member’s condition deteriorates rapidly and drastically. During a schizophrenia crisis, you must get help for your family member as soon as possible. Hospitalization may be required to keep your loved one safe.

Emergency planning

It’s important for the family members of people with schizophrenia to prepare for such crisis situations. Having an emergency plan ready for an acute psychotic episode will help you handle the crisis safely and quickly. A good emergency plan for a family member with schizophrenia includes:

  • A list of emergency contact information for your loved one’s doctor, therapists, and the police.
  • The address and phone number of the hospital you will go to in case of emergency for psychiatric admission.
  • Friends or relatives who will take care of other children or dependents while you deal with the crisis.

It’s also wise to go over the emergency plan with your family member. The crisis situation may be less frightening and upsetting to your loved one If he or she knows what to expect during an emergency.

10 Tips for Handling a Schizophrenia Crisis

  • Remember that you cannot reason with acute psychosis
  • Remember that the person may be terrified by his/her own feelings of loss of control
  • Do not express irritation or anger
  • Do not shout
  • Do not use sarcasm as a weapon
  • Decrease distractions (turn off the TV, radio, fluorescent lights that hum, etc.)
  • Ask any casual visitors to leave—the fewer people the better
  • Avoid direct continuous eye contact
  • Avoid touching the person
  • Sit down and ask the person to sit down also

Source: World Fellowship for Schizophrenia and Allied Disorders

 

Helping people with schizophrenia tip 6: Explore housing options

Treatment for schizophrenia cannot succeed if your family member doesn’t have a stable, supportive place to live. But finding the right living situation for a person with schizophrenia can be challenging. When considering housing options, think about the individual needs of the person with schizophrenia:

  • Can your family member care for him or herself?
  • How much support does he or she need with daily activities?
  • Does your family member have a drug or alcohol problem?
  • How much treatment supervision does he or she require?

Living with family

For many families, the most difficult choice involves whether or not the relative with schizophrenia should live at home. Living with family can be a good option for people with schizophrenia if their family members understand the illness well, have a strong support system of their own, and are willing and able to provide whatever assistance is needed.

At-home arrangements are less likely to be successful if the person with schizophrenia uses drugs or alcohol, resists taking medication, or is aggressive or uncooperative.

Choosing the Right Housing Option for a Person with Schizophrenia

Adapted from : Schizophrenia: A Handbook For Families, Health Canada

Living with family works best if:
  • The person with schizophrenia functions at a fairly high level, has friendships, and is involved in activities outside the home.
  • The interaction among family members is relaxed.
  • The person with schizophrenia intends to take advantage of available support services.
  • The living situation does not negatively impact the lives of any young children in the home.
Living with family is not advised if:
  • The main support person is single, ill, or elderly.
  • The person with schizophrenia is so ill that there is little or no chance to lead a normal family life.
  • The situation causes stress in the marriage or leaves children in the home feeling frightened and resentful.
  • Most family events and concerns revolve around the person with schizophrenia.
  • Support services are not used or are unavailable.

Try not to feel guilty if you are unequipped to house a family member with schizophrenia. If you can’t look after your own needs or those of others in the family while caring for your ill relative, he or she will be better off somewhere else.

Residential options outside the family home

If an at-home living arrangement isn’t the right fit, make contact with local mental health facilities, social service agencies, support groups, and public housing authorities. These organizations can help you explore the residential facilities in your community and put your family member’s name on the appropriate waiting lists.

Options in your area may include:

  • Residential treatment facilities or 24-hour care homes – A more structured living environment for those who require greater assistance with medications and daily living tasks or for those going through an acute psychotic episode.
  • Transitional group home – An intensive program that helps individuals transition back into society and avoid relapse after a crisis or hospitalization. Includes skills training and rehabilitation services.
  • Foster or boarding homes – A group living situation for people with schizophrenia who are able to function relatively well on their own. Foster and boarding homes offer a certain degree of independence, while providing meals and other basic necessities.
  • Supervised apartments – An option for those whose condition is less severe or well-managed with medication. Residents live alone or share an apartment, with staff members available on-site to provide assistance and support.

More help for schizophrenia

Resources and references

Schizophrenia help for families

Information for Families: Schizophrenia (PDF) – Tips on how communicate and interact with a schizophrenic person and how to look after your own well-being. (World Fellowship for Schizophrenia and Allied Disorders)

Schizophrenia: The Journey to Recovery (PDF) – A consumer and family guide to schizophrenia assessment and treatment. (Schizophrenia Society of Canada)

Dealing with Unusual Thoughts and Behaviors (PDF) – Fact sheet from the U.K.-based National Schizophrenia Fellowship on coping with the symptoms and behaviors of schizophrenia in a loved one. (Rethink)

Finding schizophrenia services and support in the U.S.

Find Your State and Local NAMI – Locate the nearest branch of the National Alliance on Mental Illness, an organization that offers support, education, and referrals for people coping with mental illness. You can also call the toll free HelpLine at 1-800-950-NAMI (6264).

State and Local Programs for Families, Young Families, and Providers – Directory of education, training, and support programs for the caregivers of people with mental illness. (National Alliance on Mental Illness)

Finding schizophrenia services and support in other countries

Rethink: Schizophrenia offers a helpline (0300 5000 927) and information on support and services in the UK.

Sane Australia offers a helpline (1800 18 7263) and online advice and referrals to support agencies in Australia.

Schizophrenia Society of Canada offers links to regional societies in Canada that offer helplines and local programs and services.

Medical coverage for schizophrenia

Social Security Benefits – Describes the process of applying for social security benefits and what can be done if benefits are turned down initially. (National Alliance on Mental Illness)

Health Insurance and Mental Health Services – Learn about mental health coverage under the Affordable Care Act. (MentalHealth.gov)

Medicare and Your Mental Health Benefits (PDF) – A guide to the mental health services that are covered under Medicare. (Medicare.gov)

Housing options for people with schizophrenia

Finding a Good Residential Option for Someone with Severe Mental Illness – Provides suggestions for choosing the right living arrangement for a family member with schizophrenia. (Schizophrenia.com)

Moving On: Federal Programs to Assist Transition-Age Youth with Serious Mental Health Conditions (PDF) – A collection of fact sheets on U.S. government programs available to help young people with mental illness. (Bazelon Center for Mental Health Law)

Authors: Melinda Smith, M.A., and Jeanne Segal, Ph.D.  Last updated: February 2015.


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