Guidelines for caring for people with schizophrenia (who are often called 'crazy people')

Schizophrenia is a term that is quite foreign to the ears of ordinary people. People with schizophrenia are more often called “crazy people” because they often hallucinate; his soul was disturbed, and was often seen as the result of trance, witchcraft, or curses. Because of this, many "crazy" people who are shackled and exiled from society after various attempts at alternative medicine have not succeeded in bringing them to their senses.

According to a Human Rights Watch (HRW) report, there are around 19 thousand Indonesians with schizophrenia who are in shackles, even though shackling has been prohibited by the government since 1977.

On the other hand, not a few of those who are "lucky" enough to live in mental hospitals or other mental health institutions have become targets of physical and sexual violence from unscrupulous officers, and have become guinea pigs for various dubious "alternative" treatments, such as therapy electric shocks without anesthesia, herbal concoctions, to solitary confinement.

It is important to understand that these two practices violate human rights and are proven ineffective methods for treating people with mental disorders. With proper treatment, many schizophrenic people can live normal and productive lives and find jobs according to their abilities and skills, just like healthy humans in general. This can especially be achieved with the full support and affection of those around him.

Living with someone with schizophrenia, is it possible?

The short answer is, yes, maybe. However, living together with someone with schizophrenia is not an easy thing to do. These strategies can help you guide your loved ones to their optimal recovery, without having to sabotage the well-being of yourself and other family members.

1. Learn about the disease as best you can

Schizophrenia is the most common mental disorder globally, characterized by an inability to distinguish between real and imagined. Symptoms of schizophrenia are usually indicated by hearing voices from the head or seeing something that is not real.

According to WHO, schizophrenia affects more than 21 million people from various parts of the world. Based on 2013 Basic Health Research data, about 1 in 1000 Indonesians are diagnosed with schizophrenia. Not much is known about the causes of this disease, but in general the appearance of symptoms is triggered by a variety of factors, ranging from genetics, trauma, to drug abuse.

Learning about schizophrenia, its symptoms, and treatment will allow you to make decisions about how best to manage symptoms, motivate patients to pursue self-help strategies, manage setbacks, and work together towards recovery.

2. Consultations with the schizophrenia community or local aid agencies

To be able to provide better support and care, you also need to get outside help. Meeting and discussing with other people who understand properly about schizophrenia and the situation you are currently in can do a lot to help lift feelings of stress and frustration, and fear.

Affected family communities and health assistance institutions can be invaluable places for families with schizophrenia to share experiences, advice, and information. Ask your doctor or therapist about the other reliable services and support available in your area, or contact trusted local hospitals and mental health clinics.

The more support you have, the better for you and the network for the recovery of the person with schizophrenia. But it is important to be realistic about how much or to what extent you can afford to help him. You can't do many things at once in a stressful situation like this, and you won't be of much help to a loved one if you're tired.

3. Guide the patient to medical care

The number of people with schizophrenia who are alienated or even shackled is because of the assumption that schizophrenia is dangerous. In fact, contrary to the assumption that crazy people are always “crazy”, schizophrenia symptoms are not always present all the time and may only appear if triggered by one reason or another. This means, there will be times where patients can interact like normal people in general.

A person with schizophrenia often doesn't realize they are unwell until they get treatment. Motivating him or her to get medical help to manage symptoms is a foundation of good treatment for people with schizophrenia. A study shows that schizophrenic patients who get adequate medical support and treatment will not be dangerous, unless the patient has limited access to health or is neglected.

Schizophrenia cannot be cured, but some of its symptoms can be treated with a combination of prescription drugs and cognitive and behavioral therapy. And all of this will have maximum impact if it is done as early as possible. But sometimes, the fear of being stigmatized as "crazy" makes him reluctant to seek treatment. You can make your doctor less threatening by suggesting visits to treat certain symptoms such as insomnia or lack of energy.

4. Always stay with the sufferer

It is important to ensure that he remains on the right path to recovery, even after he is discharged from hospitalization. The patient can stop the drug or stop going to the doctor for follow-up therapy. Your encouragement and support is of the utmost importance for him to continue with therapy.

Strategy self-help lifestyle changes can also be recommended to maintain his overall well-being. Starting from a healthy diet, managing stress, exercising, quitting smoking, to joining a similar support group. The more independent he is in determining the treatment of his illness, the more despair and misery he feels will be eroded. This in turn can make it easier for doctors to adjust their treatment.

5. Don't let the imagination run wild

Those in close contact with schizophrenic patients are often unsure how to respond when patients make statements that seem odd or are clearly wrong. To schizophrenic patients, strange beliefs or hallucinations appear real - not just imaginations. But rather than affirming the principle, you and other family members can tell them that you didn't see / hear these things, or disagree with their thoughts, while still acknowledging what the patient is feeling. For example, reacting like "No, I didn't hear that," rather than "Ah, it was all your imagination!"

It is important not to undermine the patient's beliefs or delusions. What they feel is real to those who experience it, and there is no point in arguing right and wrong with them. Instead, change the topic of conversation to other things that you both agree on or change topics that are completely different.

6. Help him live independently

In addition to being involved in seeking help, interactions with other family members, friends, and peer groups can provide support and encourage patients to regain life. It's important to have attainable goals, for example: to make her able to make decisions independently or to manage her own bedroom without help from other people. Instead of doing everything for them, help them develop or relearn skills that will allow them to gain independence.

But just like anyone else, people with schizophrenia need to know when they are doing the right thing. Patients who feel stressed or repeatedly criticized by others may experience severe stress, which can cause worsening of symptoms. A positive approach can be helpful and may be more effective in the long run than harsh criticism. These suggestions also apply to everyone with whom that person interacts.

7. Make notes of progress

These notes will be of great use to you and other family members to keep track of each type of symptom that appears, what drugs have been used (including the dosage), and what the effects of each treatment are. By knowing what symptoms have been present beforehand, family members may be better prepared to deal with them in the future.

The family may even be able to identify some of the "early warning signs" of potential symptom relapse, such as extreme fatigue or changes in sleep patterns, even better and earlier than the patient himself. Thus, the symptoms of psychosis can be detected early and treatment can prevent the disease from taking over again.

In addition, knowing which drugs have been helpful and which have had troublesome side effects in the past can help the family make it easier for doctors to find the best treatment for them more quickly.