June 27, 2005
Social Ties Vital for Recovery
Although medication treatments for schizophrenia have taken huge leaps within the last decade, information from the World Health Organization (see http://www.who.int/mental_health/evidence/en/ for more information) reminds us that medication is far from the only thing needed for a complete recovery.
According to the three-decade long study from WHO, people who have schizophrenia in developing countries (such as India, Nigeria, and Colombia) tend to do better in the long term than people in developed nations. For example, patients in developing countries tended to spend fewer days in the hospital, were more likely to hold jobs and be involved in social communities, and were more likely to become symptom-free (during the course of the study). The rate of recovery (measured by symptom reduction) was half to two-thirds in developing nations, as opposed to about a third from richer countries.
A similar but separate study from rural China found that lower medication doses can be as effective as high doses. Interestingly, a much more recent study from the UCLA Neuropsychiatric Institute identified family relatioinships, supportive therapeutic relationships, and social skills among their list of 10 keys to recovery from schizophrenia.
The reason, WHO experts believe, is the strong social networks that are an integral part of the local cultures. This is supportive to the patient, and also allows for constant monitoring and adjustment of treatment as needed. Indian psychiatrist R. Thara Srinivasan (head of the nonprofit schizophrenia research foundation SCARF) also believes that constant family involvement and attention helps improve compliance to treatment, medication or otherwise.
For example, most people with schizophrenia in India live at home with their families, instead of in hospitals, psychiatric facilities, or on the streets. They are given low-stress jobs to keep them active and involved. Families are intimately involved by medical professionals in treatment planning and implementation.
William Carpenter, director of the Maryland Psychiatric Research Center and an investigator at one of the WHO study sites in Washington, points out that medication treatment in richer countries has (at least until very recently) been largely focused on controlling the more overt positive symptoms such as hallucinations and delusions. Although newer medications are focusing more on the biochemical origins of negative symptoms, Carpenter and others say that they are no subsitute for social support networks.
Experts who recognize the implications of this study are concluding that "the key to treating schizophrenia lies in integrating cultural and social supports with medicine, as villages such as Raipur Rani [India] have long done.
Source article: "Social Network's Healing Power Is Borne Out in Poorer Nations." Washington Post (http://www.washingtonpost.com), June 27 2005.
Resources for getting involved in social communities for people with schizophrenia and their families:
1. Check out local, face-to-face support groups such as NAMI (http://www.nami.org). See our complete list of Support Groups at http://www.schizophrenia.com/coping.html
2. Learn about the symptoms of schizophrenia that can affect social interactions, and about good ways to deal with them.
http://tinyurl.com/9g2k5
2. Find a low-stress, part-time volunteer position doing something that you enjoy.
3. Read Success Stories from people who have found solutions for coping with schizophrenia in their own lives. http://www.schizophrenia.com/success.html
Posted by Julia at June 27, 2005 07:36 AM
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Comments
This is great stuff, but unfortunately American society these days is completely incapable of dealing with the mentally ill in this civilized manner. They are simply expendable as far as the predominantly right wing yuppie scum mentality that mostly runs everything is concerned.
My experience as a schizophrenic since 1975 that has never had disability but remained in the workforce is that corporate America could care less about employing the disabled of any kind, much less the mentally ill. Couple this attitude from corporate America, and even most smaller, privately owned companies, with out corrupt disability system that automatically turns down most people who apply for disability, which takes four to six months for them to do, and then they have to go get a lawyer to get their disability for them, which takes up to another year or more, and we find that most of the mentally ill in this country wind up homeless and on the streets. Few can survive for the two years it takes to fight the feds for their disability.
A social support system from families is also laughable in America. Most families, particularly those of the Christian right, are far more apt to throw their mentally ill family members out on the street than anything else, and far more likely to view them as a shame to the family than as a person with a disease. Americans are, quite arguably, the most greedy and ignorant people in the developed world these days and I see no way that will change.
We also have the problem in this country that since Reagan the funding for mental health facilities and social services in general have been cut outrageously to the point that local mental health facilities have case workers and doctors who are so overloaded with cases that an appointment with them, after you wait about an hour or two after your scheduled time, lasts 15 minutes. If you cannot afford a private doctor, and few will take medicaid if one is fortunate enough to even have disability, then proper treatment, much less any kind of support network from the mental health facilities, is unlikely.
Fortunately for me, all I need is a scrip for prolixin every three months and deal with the local mental health facility, which I despise, in order to get it.
Another point in America is that Vocational Rehabilitation has been gutted fundwise to the point that there is almost no way at all, and no attempt even made in most cases anymore, to help people with mental illnesses enter the work force or learn a trade or job suited for them. Only in catastrophic cases of physical injury does Voc Rehab do anything much for anyone anymore.
Since Reagan the yuppie scum run this country. They care about nothing but the bottom line dollar in their own pockets. The average American family cares little about their own mentally ill people. I think the familys on this site from America are definitely the exception rather than the norm or there would be far more of them.
So, while I find this study laudable indeed, to think that America in the year 2005 gives a flying flip about it is laughable. The mentally ill in this culture of ours today are expendable just like anyone else with any kind of disability. We give them a pittance to survive on, make them choose between medication and food, our low income housing lists have an average time of a year wait. But so what, it's all for the good of corporate America and Wall Street, and that's all most in this country care about anymore.
Posted by: Gilthoron at June 27, 2005 09:15 AM
You are correct - this is the unfortunate case for many, many people with mental illness in the United States today. One small hope, though, is if the folks in charge start to see that lost productivity, overburdened criminal justice systems, and drain on public aid from unemployed, homeless people who cannot get the care they need is in fact more costly than providing a sort of mental health system in which supportive environments are available to people as an integral part of their treatment. Group living facilities can sometimes provide this kind of supportive community, at least the ones that are well funded and well run by trained individuals. True, they are few and far between now, but we can continue to hope that data such as this will convince our country that providing adequate support from the get-go is in the long run less costly than saving the almost-gone at the last minute. These studies from WHO at least show that poorer countries than the United States (so assumedly, spending less money on their health facility systems) can implement solutions that are helpful.
Posted by: Eva at June 28, 2005 08:29 AM
Yes, there is always such hope. But America these days is anti-science, anti-intellectual, and not at all concerned with the plight of the least helpless amongst us. As one far more cynical commentator than I put it on The Two Towers discussion boards, my favorite website, we kill the most helpless amongst us.
At the same time an appeal to the American public and their government that doing something worthwhile as you suggest may actually put more money in their pockets might, and I say might with great emphasis, just work. Any appeal to their sense of humanity is a lost cause in this day and age most certainly.
Posted by: Gilthoron at June 28, 2005 09:23 AM
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This is great stuff, but unfortunately American society these days is completely incapable of dealing with the mentally ill in this civilized manner. They are simply expendable as far as the predominantly right wing yuppie scum mentality that mostly runs everything is concerned.
My experience as a schizophrenic since 1975 that has never had disability but remained in the workforce is that corporate America could care less about employing the disabled of any kind, much less the mentally ill. Couple this attitude from corporate America, and even most smaller, privately owned companies, with out corrupt disability system that automatically turns down most people who apply for disability, which takes four to six months for them to do, and then they have to go get a lawyer to get their disability for them, which takes up to another year or more, and we find that most of the mentally ill in this country wind up homeless and on the streets. Few can survive for the two years it takes to fight the feds for their disability.
A social support system from families is also laughable in America. Most families, particularly those of the Christian right, are far more apt to throw their mentally ill family members out on the street than anything else, and far more likely to view them as a shame to the family than as a person with a disease. Americans are, quite arguably, the most greedy and ignorant people in the developed world these days and I see no way that will change.
We also have the problem in this country that since Reagan the funding for mental health facilities and social services in general have been cut outrageously to the point that local mental health facilities have case workers and doctors who are so overloaded with cases that an appointment with them, after you wait about an hour or two after your scheduled time, lasts 15 minutes. If you cannot afford a private doctor, and few will take medicaid if one is fortunate enough to even have disability, then proper treatment, much less any kind of support network from the mental health facilities, is unlikely.
Fortunately for me, all I need is a scrip for prolixin every three months and deal with the local mental health facility, which I despise, in order to get it.
Another point in America is that Vocational Rehabilitation has been gutted fundwise to the point that there is almost no way at all, and no attempt even made in most cases anymore, to help people with mental illnesses enter the work force or learn a trade or job suited for them. Only in catastrophic cases of physical injury does Voc Rehab do anything much for anyone anymore.
Since Reagan the yuppie scum run this country. They care about nothing but the bottom line dollar in their own pockets. The average American family cares little about their own mentally ill people. I think the familys on this site from America are definitely the exception rather than the norm or there would be far more of them.
So, while I find this study laudable indeed, to think that America in the year 2005 gives a flying flip about it is laughable. The mentally ill in this culture of ours today are expendable just like anyone else with any kind of disability. We give them a pittance to survive on, make them choose between medication and food, our low income housing lists have an average time of a year wait. But so what, it's all for the good of corporate America and Wall Street, and that's all most in this country care about anymore.
Posted by: Gilthoron at June 27, 2005 09:15 AM
You are correct - this is the unfortunate case for many, many people with mental illness in the United States today. One small hope, though, is if the folks in charge start to see that lost productivity, overburdened criminal justice systems, and drain on public aid from unemployed, homeless people who cannot get the care they need is in fact more costly than providing a sort of mental health system in which supportive environments are available to people as an integral part of their treatment. Group living facilities can sometimes provide this kind of supportive community, at least the ones that are well funded and well run by trained individuals. True, they are few and far between now, but we can continue to hope that data such as this will convince our country that providing adequate support from the get-go is in the long run less costly than saving the almost-gone at the last minute. These studies from WHO at least show that poorer countries than the United States (so assumedly, spending less money on their health facility systems) can implement solutions that are helpful.
Posted by: Eva at June 28, 2005 08:29 AM
Yes, there is always such hope. But America these days is anti-science, anti-intellectual, and not at all concerned with the plight of the least helpless amongst us. As one far more cynical commentator than I put it on The Two Towers discussion boards, my favorite website, we kill the most helpless amongst us.
At the same time an appeal to the American public and their government that doing something worthwhile as you suggest may actually put more money in their pockets might, and I say might with great emphasis, just work. Any appeal to their sense of humanity is a lost cause in this day and age most certainly.
Posted by: Gilthoron at June 28, 2005 09:23 AM