People with complex mental health conditions are usually entered into a treatment process known as a care programme approach (CPA). A CPA is essentially a way of ensuring you receive the right treatment for your needs.
There are four stages to a CPA:
Not everyone uses the CPA. Some people may be cared for by their GP, while others may be under the care of a specialist.
You'll work together with your healthcare team to develop a care plan. The care plan may involve an advance statement or crisis plan, which can be followed in an emergency.
Your care plan should includea combined healthy eating and physical activity programme andsupportfor giving up smoking, if you smoke.
Your care co-ordinator will be responsible for making sure all members of your healthcare team, including your GP, have a copy of your care plan.
People who have serious psychotic symptoms asthe result of an acute schizophrenic episode may require a more intensive level of care than a CMHT can provide.
These episodes are usually dealt with by antipsychotic medication and special care.
One treatment option is to contact a home treatment or crisis resolution team (CRT). CRTs treat people with serious mental health conditions who are currently experiencing an acute and severe psychiatric crisis.
Without the involvement of the CRT, these people would require treatment in hospital.
The CRT aims to treat people in the least restrictive environment possible, ideally in or near their home. This can be in your own home, in a dedicated crisis residential home or hostel, or in a day care centre.
CRTs are also responsible for planning aftercare once the crisis has passed to prevent a further crisis occurring.
Your care co-ordinator should be able to provide you and your friends or family with contact information in the event of a crisis.
More serious acute schizophrenic episodes may require admission to a psychiatric ward at a hospital or clinic. You can admit yourself voluntarily to hospital if your psychiatrist agrees it's necessary.
People can also be compulsorily detained at a hospital under the Mental Health Act (2007), but this is rare.
It's only possible for someone to be compulsorily detained at a hospital if they have a severe mental disorder and if detention is necessary:
People with schizophrenia who are compulsorily detained may need to be kept in locked wards.
All people being treated in hospital will stay only as long as is absolutely necessaryfor them toreceive appropriate treatment and arrange aftercare.
An independent panel will regularly review your case and progress. Once they feel you're no longer a danger to yourself and others, you'll be discharged from hospital. However, your care team may recommendyou remain in hospital voluntarily.
If it's felt there's a significant risk of future acute schizophrenic episodes occurring, you may want to write an advance statement.
An advance statement is a series of written instructions about what you would like your family or friends to do in case you experience another acute schizophrenic episode. You may also want to includecontact details for your care co-ordinator.
If you want to make an advance statement, talk to your care co-ordinator, psychiatrist or GP.
Antipsychotics are usually recommended as the initial treatment forthe symptoms of an acute schizophrenic episode. They work by blocking the effectof the chemical dopamineon the brain.
Antipsychotics can usually reduce feelings of anxiety or aggression within a few hours of use, butmay take several days or weeks to reduce other symptoms, such as hallucinations or delusional thoughts.
It's important that your doctor gives you a thorough physical examination before you start taking antipsychotics, and that you work together to find the right one for you.
Antipsychotics can be taken orally as a pill, or begiven as an injection known as a depot. Several slow-release antipsychotics are available.These require you to haveone injection every two to four weeks.
You may only needantipsychotics until your acute schizophrenic episode has passed.
However, most people take medication for one or two years after their first psychotic episode to prevent further acute schizophrenic episodes occurring, and for longer if the illness is recurrent.
There are two main types of antipsychotics:
The choice of antipsychotic should be made following a discussion between you and your psychiatrist about the likely benefits and side effects.
Both typical and atypical antipsychotics can cause side effects, although not everyone will experience them and the severity will differ from person to person.
The side effects of typical antipsychotics include:
Side effects of both typical and atypical antipsychotics include:
Tell your care co-ordinator, psychiatristor GP if your side effects become severe. There may be an alternative antipsychotic you can take or additional medicinesthat will help you deal with the side effects.
If you don't benefit from one antipsychotic medication after taking it regularly for several weeks, an alternative can be tried. It's important to work with your treatment team to find the right one for you.
Don't stop taking your antipsychotics without first consulting your care co-ordinator, psychiatrist or GP.If you stop taking them,you couldhave a relapse of symptoms.
Your medication should be reviewed at least once a year.
Psychological treatment can help people with schizophrenia cope with the symptoms of hallucinations or delusions better.
They can also help treat some of the negative symptoms of schizophrenia, such as apathy or a lack of enjoyment.
Psychological treatments for schizophrenia work best when they're combined with antipsychotic medication.
Common psychological treatments include:
Cognitive behavioural therapy (CBT) aims to help you identify the thinking patterns that are causing you to have unwanted feelings and behaviour, and learn to replace this thinking with more realistic and useful thoughts.
For example, you may be taught to recognise examples of delusional thinking. You may then receive help and advice about how to avoid acting on these thoughts.
Most people requirebetween 8 and 20 sessions of CBT over the space of6 to 12 months. CBT sessions usually last for about an hour.
Your GP or care co-ordinator should be able to arrange a referral to a CBT therapist.
Many people with schizophrenia rely on family members for their care and support. While most family members are happy to help, caring for somebody with schizophrenia can place a strain on any family.
Family therapy is a way of helping you and your family cope better with your condition. It involves a series of informal meetingsover a period of around six months.
Meetings may include:
If you think you and your family could benefit from family therapy, speak toyour care co-ordinator or GP.
Arts therapies are designed to promote creative expression. Working with an arts therapist in a small group or individually can allow you to express your experiences with schizophrenia.
Some people find expressing things in a non-verbal way through the arts can provide a new experience of schizophrenia and help them develop new ways of relating to others.
Arts therapies have been shown to alleviate the negative symptoms of schizophrenia in some people.
The National Institute for Health and Care Excellence (NICE) recommendsthat arts therapies are provided by an arts therapist registered with the Health and Care Professions Council who has experience of working with people with schizophrenia.
Read about schizophrenia, a long-term mental health condition that causes a range of different psychological symptoms.
Read about symptoms of schizophrenia, including hallucinations, delusions, confused thoughts and changes in behaviour.
Read about the causes of schizophrenia. The exact causes of schizophrenia are unknown, but research suggests a combination of factors are responsible.
Read about diagnosing schizophrenia. There's no single test and the condition is usually diagnosed after assessment by a mental health specialist.
Read about treating schizophrenia. Schizophrenia is usually treated with an individually tailored combination of therapy and medication.
Read about living with schizophrenia. Most people with schizophrenia make a recovery, although many experience the occasional return of symptoms (relapses).