an x-ray of the brain

Addressing shortfalls in the understanding and treatment of schizophrenia

Schizophrenia is a serious and debilitating mental illness that affects approximately 1.1% of the world’s population. Yet, shockingly, almost half of those who have the disease (47.3%) do not seek treatment. This is due in part to a lack of insight on the patients’ behalf – many patients with schizophrenia do not recognise that they are ill – but it is also driven by the stigma attached to mental illness.

It is well recognized that stigma around mental illness, fuelled by media myths and misconceptions, increases feelings of guilt and shame. Often there is a vicious cycle of self-stigmatization that may deter a patient from seeking help or from taking their medication. To add to this gloomy picture, stopping treatment or failing to take antipsychotic medication properly leads to an increased risk of relapse, rehospitalization and even worse outcomes for patients with schizophrenia.

Evidently, there is a huge need to improve the general public’s understanding of mental illness and change society’s attitudes toward those who are afflicted. But there is another aspect to the poor outcomes associated with a diagnosis of schizophrenia. Many health professionals are failing to take people with mental illness seriously when they raise concerns about their physical health.

Prompted by the fact that people with serious mental illnesses – such as schizophrenia – on average die 20 years earlier than the rest of the population, a mental health charity in the UK has come up with a series of recommendations that could help address the problem.

Although people taking antipsychotics gain an average of 6 kg in the first 2 months of starting treatment, the majority do not have their weight and body mass index (BMI) monitored. Increased weight and BMI are linked to other serious problems, such as heart disease and diabetes. Monitoring and offering dietary and other advice should be routinely carried out for all patients receiving antipsychotics.

Additionally, more than 40% of all tobacco is used by people with mental illness. However, those with mental illness are less likely to be given the support needed to help them quit. This oversight could easily be addressed, but it is seen as a low priority compared with treating symptoms.

Clearly, these unmet needs are a challenge to the medical profession as a whole, but we can all help by developing a more tolerant and understanding approach to those with serious mental illness. Here at Sidra, we aim to create an environment that is safe and non-judgemental and allows patients to speak freely about the challenges they face in coping with their illness.