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In Schizophrenia

What should mental health providers do for patients with Schizophrenia

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They need to be accurate in their observations to prescribe effective medications.

The behaviours of a person experiencing schizophrenia can be distressing for family members and friends to observe.  It can also be difficult for onlookers to describe specific behaviours, so consulting professional help is most beneficial.  A mental health provider can determine the specific types of behaviours displayed, thereby diagnosing a person correctly.  An accurate diagnosis helps them to prescribe the correct class(es) of medication to address symptomatic behaviours.

The presence of psychosis is perhaps the prime characteristic symptom of schizophrenia.  There are different aspects to psychosis, including:

  • Delusions: Fixed beliefs that are not grounded in reality, which cannot be changed or challenged.
  • Hallucinations: Sensory experiences that are not real, such as hearing voices or seeing things that are not there.
  • Disordered thinking: Non-linear thinking patterns that result in incoherent speech.
  • Disordered behaviours: Strange behaviours that call for concern.

The following is a list of other behaviours that can indicate the presence of schizophrenia or any related psychotic disorder.  Note that some symptoms below may not be directly affiliated with schizophrenia, but may indicate an overall decline in functioning:

  • Preoccupation with a specific subject or concept to a distracting degree.
  • Restricted speech, causing one to talk less.
  • Impaired ability to concentrate/limited attention span.
  • Limited ability to recall memories.
  • Heightened sensitivity to sensory stimuli, such as light and/or loud noises.
  • Lack of interest in previous hobbies.
  • Withdrawing from friendships.
  • A paranoia that can lead to anger, irritability and suspiciousness
  • Disturbed sleep patterns
  • Impulsive behaviour with strong consequences such as maxing out credit cards
  • Strange reactions, such as overly crying or laughing, or else unable to emotionally respond or experience feelings.
  • Lack of proper hygiene
  • Sadness
  • Anxiety
  • Flat affect

A clinician should observe the patient with schizophrenia over the long-term to monitor their behaviours, thereby getting an understanding of a person’s baseline of functioning.  In the event that the patient has only experienced the behaviours for a short period of time, more time is needed to observe whether he or she is experiencing an overall functional decline.  The diagnosis can change as well.

The clinician should be aware of resources in the community that assist the patient with schizophrenia.  They can then refer patients to these places to receive additional support.  Such resources include day programs where people can go to attend rehabilitative groups while socialising with others.  They can also recommend doctors and specialists who take their patient’s health insurance, which may have a limited list of in-network providers.

In crisis situations, mental health clinicians should know of local hospitals that have excellent inpatient psychiatric facilities.  Inpatient hospitalisations often result in sudden changes in a patient’s medication regimen, warranting close supervision.  Prescribers must be accurate in their observations, so as to prescribe effective medications.  A courteous staff also allows for the patient with schizophrenia to feel safer and more comfortable in a facility.  Given that the patient lives in a unit for an extended period of time, ranging from a week to several months, it is important that a facility is comfortable.

Clinicians should remain current in their practice by being up-to-date on recent research and new medications.  Newfound awareness of the long-term effects of pre-existing medications also can influence how a clinician prescribes in the future.  When prescribing, it is ideal for the clinician to consider both their professional observations, as well as the patient’s reporting of how the medication affects them.  Long-term rehabilitation is the goal.


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