It’s World Mental Health Day 2014 and BMC Psychiatry discusses why we should all be thinking about “living with schizophrenia”.
You may not know it yet, but you have been living with schizophrenia. So has the person sitting next to you, and the person next to them (you see where I’m going with this). In fact, the global population are all living with schizophrenia, from those with the disorder and their caregivers, to clinicians or members of society as a whole. We are all part of an attitude change taking place towards severe mental disorders, which is why the World Federation of Mental Health have chosen “living with schizophrenia” as the theme of this year’s World Mental Health Day.
We are proud to have published a broad range of research on this important topic. Below is a selection of Editor’s picks from BMC Psychiatry that cover a variety of perspectives on living with schizophrenia.
The World Health Organisation reports that for people with schizophrenia, mortality rates are up to 2.5 times higher than the general population. Studies have shown that this can be linked to a number of factors including socioeconomic status and suicide as well as co-morbid disorders such as cardiovascular disease and diabetes.
An interesting insight from the patient perspective published earlier this year comes from Dan Lubman and colleagues at Monash University. Individuals with schizophrenia were interviewed about how they depend on caffeine to counteract the drowsiness that some medications can cause. By interviewing people in this way, the authors were able to shed light on motivations behind certain health risk behaviours that go beyond just wanting to stay alert.
The families, friends and caregivers
Caring for someone with schizophrenia can cause varying amounts of psychological and emotional distress. Because families and carers play a integral role in the management of the disorder, it is essential that the burden of care is understood in order to prevent further mental illness as well as offering more targeted forms of support for caregivers.
A recent study noted that caregiver burden seemed to be linked, not to severity of the illness, but to cultural backgrounds and their understanding of the disorder. Other research highlights the importance of targeting family members with high emotional involvement, as these individuals tend to report a greater burden of care, which can then lead to reduced well-being for both and increased likelihood of relapse.
Schizophrenia is a complex illness to treat, with relapses occurring regularly and sometimes without warning. A recent study in a Tanzanian out-patient population showed that risk of relapse was linked to non-adherence to medication, poor family support and stressful life events. Protective factors included employment, medication adherence and religion.
Understanding the risk factors linked to relapse is key for prevention strategies, particularly in regions where mental health support is limited or non-existent.
Despite the advances in research, there remains a stubborn stigma around schizophrenia and around mental illness as a whole. There continues to be a widespread lack of knowledge, leading to prejudiced attitudes and discriminative behaviours.
It is a global problem, as shown this year by Prof Graham Thornicroft and colleagues in a study based in Guangzhou, China. They showed that even in a healthcare setting, discrimination still takes place amongst community mental healthcare staff. Likewise in a study based in South Africa, importance is placed on providing families and service users with appropriate counselling to help deal with stigma alongside preventative campaigns.
Stigma towards mental illness is driven by ignorance and misconception. Psycho-educational interventions and anti-stigma programmes try to combat this, and have been shown to have positive effects. For example, a group from Sweden recently tested the effectiveness of an anti-stigma intervention incorporated into basic police officer training. They found that it was successful in changing attitudes and improving mental health literacy in the workplace. Another useful intervention more widely applicable comes from Anthony Jorm and Colleagues with their Mental Health First Aid courses for members of the public.
BMC Psychiatry is continually amazed by the research emerging from this area, and we hope this small collection of work gives an insight into this year’s World Mental Health Day topic. For further reading, you can find lots more articles in BMC Psychiatry.
There is also a collection of BioMed Central and Springer articles on schizophrenia at springer.com/schizophrenia
Want to get involved? You can get ideas for raising awareness by visiting the Mental Health Foundation website.