There were some news reports last week in the French-language media of Quebec that discussed the dangerosity of those suffering from Schizophrenia. It was specifically referring to the killing of a couple by their mentally ill son. One cannot deny that there are tragic events related to schizophrenia such as this one. However, they remain very rare and they have the effect of slanting an already unfair portrait of psychiatric patients.
One percent of the population suffers from Schizophrenia. That means 70,000 in Quebec alone. Although there is an increase in their likelihood of killing someone (they are three times more likely to kill someone than the rest of us are), the biggest danger by far is to themselves (suicide rates are 100 times higher in this population in comparison to those without the disease).
In my column this week, I did not want to minimize the seriousness of the potential danger to others of an untreated individual with schizophrenia, but I did want to put the question in proper perspective.
I decided to put the emphasis on stigma and public perception – a major barrier to the proper treatment and follow-up necessary to minimize such events.
Good research shows that the best way to reduce stigma is to interact with the mentally ill. This creates a more balanced public perception and makes it more likely that we will establish relationships of trust with them. When we have a good relationship with a mentally ill person, we are more likely to be aware when they are becoming unstable, going off their medication, or becoming a threat to themselves or others. And if they trust us, they are more likely to accept advice or tell us what’s going on.
THE RESPECT THEY DESERVE
Camillo Zacchia, Ph.D., Psychologist – Douglas Institute (source: Journal Métro, January 15, 2008: Le respect qu’ils méritent)Every once in a while, there is a story in the news about schizophrenia that gets under my skin. This time it involved a report about a couple killed by a schizophrenic child.
Why does it bother me? It bothers me because the general public has so little contact with individuals who suffer from schizophrenia or other serious mental illnesses that these stories paint an unfair picture: a picture of psychiatric patients as a menace to society. And this is at a time when we are trying to help psychiatric patients normalize their lives, and to integrate them into the community.
The effect of segregation
When you know a group well, you tend to see them as a whole. Any aberrant behaviour will be seen as an exception. When you don’t know much about a group, any well-publicized event gives the impression that “they’re all the same.”Therein lies the problem. Just like with any other form of segregation, lack of interaction with another group begets fear, intolerance and mistrust. We have isolated the mentally ill for so long that the public has very little to base their judgment on except the occasional sensational story.
The picture of psychosis
Let’s not kid ourselves. Serious psychiatric disorders, such as schizophrenia, are not always pretty diseases. Sufferers often may have poor hygiene, they may have trouble interacting with others, and they may accuse us of persecuting them. They cannot look into a camera and touch our hearts like a loved one with Multiple Sclerosis can. They elicit fear instead of compassion. Yet they are no more deserving of their medical fates than the rest of us. Their best hope is for us to treat them with the respect they deserve, regardless of how we feel.Reduce stigma, reduce danger
It is true that some patients are not treated optimally, and they may, at times, represent a danger to themselves (often) or others (rarely). Lack of resources and problems in health care administration are important problems that need to be addressed, but as barriers to optimal treatment, they pale in comparison to stigma.Dangerous outcomes rarely occur when someone is monitored properly, but ironically the biggest obstacle to monitoring is our exaggerated fear of these outcomes. Instead of talking to the mentally ill, working with them, and getting to know them, our own discomfort and fear keeps them isolated.
It is this isolation that prevents relationships of trust from forming. Without these relationships, there is less monitoring, a reduced chance of consultation, and less treatment compliance. This isolation is what leads to the occasional tragedy that makes the headlines.
Tagged as Schizophrenia, stigmatization.
Posted in Mental health.
Posted on 15 Jan 2008
