‘Catastrophic Failings’ of Schizophrenia Care: Psychiatric Hospitals 'Frightening Places'

Care for people diagnosed with schizophrenia is failing "catastrophically" as the system is broken, demoralised, and worsens the outcomes of the "devastating" illness.

That is according to a new report by the Schizophrenia Commission, which was set up in November last year by Rethink Mental Illness to review current schizophrenia care.

The report found that many patients suffering from the schizophrenia - a term used to describe severe psychosis - spend time in psychiatric hospitals that have become "frightening places" and are "anti-therapeutic".

Professor Robin Murray, the psychiatrist who chaired the report, said the current system does not deliver the treatment needed to recover from the disease and that this is "clearly unacceptable in England in the 21<sup>st century".

"The inadequate care that many people with psychosis receive adds greatly to their distress and worsens the outcomes for what can already be a devastating illness," he said.

"Most have a period in a psychiatric hospital unit but too many of these wards have become frightening places where the overwhelmed nurses are unable to provide basic care and support."

For the first half of the 20<sup>th century, the outlook for people diagnosed with schizophrenia was bleak. Many were put in asylums for decades. In the 1950s, antipsychotic medicines were introduced for the first time and this enabled people to leave mental hospitals.

Now, almost half of people diagnosed with schizophrenia recover one or more episodes. However, around 20 per cent show unremitting symptoms.

There is no specific cause of schizophrenia, but a range of factors put together greatly increase the risk of developing the disease, including genes, children who are born prematurely and heavy abuse of drugs, such as amphetamines and cannabis.

The report found that people with schizophrenia have poor access to general practitioners and hospital care.

Their lives are shortened by around 15 to 20 years and the fragmentation of the service means that those who have a recurrence of the disease are passed between medical professionals "as if on a factory production line".

Dan, who has suffered from schizophrenia for around 15 years, gave his own account of the treatment he received: "Overall hospitals are terrible places. Over the years staff have largely been helpful but they rarely ask you what you want - not that I would know as it's a difficult question. At its worse, my illness makes me very anxious and I worry I will die.

"It's hard when staff don't take your worries seriously. I was convinced I had cancer but they dismissed this and laughed at me, which made my anxiety worse because I thought I wouldn't get treated because I was mental."

In 2000, schizophrenia was estimated to affect around 400,000 people in England. Symptoms of schizophrenia are split into two categories; positive and negative.

Positive symptoms represent a change in behaviour or thoughts, including hallucinations, delusions and confused thoughts. Sufferers may become more disorganised and unpredictable.

Negative symptoms are represented by a lack of emotional responses or thought processes, such as lack of interest, emotional flatness, lack of concentration and avoiding people.

Contrary to popular believe, schizophrenia does not result in an "inevitable decline", but sufferers can go on to recover and live happy and productive lives.

The report says that while much progress has been made in understanding schizophrenia in the last 20 years, the system needs a "radical overhaul", with health and social services working together and an emphasis on patient preferences.

It calls for greater caution in diagnosing schizophrenia as this can generate stigma and unnecessary pessimism, a stronger focus of prevention - including clear warnings about the risks of cannabis - and increased access to psychological therapies.