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Homelessness - schizophrenia

Schizophrenia • • Impact on Families and SocietyMay 12, 2009

Unfortunately,  some of the most severely ill schizophrenia patients leave a safe place like a hospital or private home and eventually live on the streets. One-third of all homeless people are believed to be mentally ill, and a large proportion of those are schizophrenic.

According to the Department of Health and Human Services, 6 percent of all schizophrenia patients are homeless at any one time. When schizophrenic patients are homeless, they rarely stay involved in any sort of treatment.

As a result, homeless schizophrenia patients may experience a worsening of their symptoms. Even more problems may be caused by the stress of living on the streets. Poor hygiene, lack of sleep, and the threat of violence may hasten the descent into psychosis for many patients.  Drug and alcohol use is common among schizophrenic homeless. When patients do not take their medications, they might try drugs or alcohol in an attempt to manage their symptoms.

-
Clea Simon: Author of Mad House
What would it be like to grow up in a household with a
schizophrenic   family   member?  What   if   you   lived   with   two
family members with schizophrenia?  Author Clea Simon had
just this experience and describes it in her book Mad House.
Clea was only eight years old when her older sister Katherine
developed   schizophrenia.  After   she   became   ill,  Katherine’s
behavior became erratic and sometimes violent.  On one occa-
sion,  Clea remembers Katherine killing her hamster in a fit of
rage.  Later,  her brother Daniel developed the disease while he
was a freshman at Harvard University.  Daniel dropped out of
school and returned home to his family.  Clea’s life was never
the same after both of her siblings developed schizophrenia.
She recalls her childhood being filled with late-night phone
calls from hospitals and visits from the police.  She became
accustomed to strange behaviors and volatile moods.  Because
she was close to her siblings,  her brother in particular,  Clea
experienced tremendous loss when they developed schizophre-
nia.  Her siblings became strangers to her and she felt isolated
and alone.
Like many family members of schizophrenia patients,  Clea
often had to ignore her own needs in order to take care of her
siblings.  She felt powerless in a family in which mental illness
was everywhere.  She did not want to worry her parents,  so
she always acted happy,  even when she was not.  Her troubles
were pushed aside so that she did not add more stress to the
household.  Still,  Clea managed to make a life for herself.  She
attended Harvard University,  graduated in 1983,  and is a writer
living in Cambridge, Massachusetts.

-

Unfortunately, substance use, as discussed later in this section, can be especially harmful to schizophrenia patients. All in all, the combination of homelessness and schizophrenia can be extremely problematic for both schizophrenia patients and society.

Schizophrenia patients become homeless for a variety of reasons. Inadequate funding can create a shortage of institutions to house those with schizophrenia. Also, schizophrenia symptoms can cause patients to leave a safe environment.

Some patients hear voices that tell them to leave because someone is harming them. Others might believe that the situation they are in is causing their symptoms and leave home in hopes that a new location will make the symptoms disappear.

How long they stay away varies—some patients return after only a few days,  but many others return to treatment only after being brought in by the police or a social service agency.

When someone with schizophrenia is missing, caregivers try to remember what, if any, places the patient may have mentioned wanting to visit. They may call the police or the hospital to help track down their relative. Unfortunately, some patients feel compelled to stay away from home and out of treatment.

One solution for caregivers to help them keep track of their relative is to only give them small amounts of money. The patient will then be forced to return home in order to obtain more money, helping the relative monitor the patient’s whereabouts and symptoms.

Heather Barnett Veague, Ph.D.
Heather Barnett Veague attended the University of California, Los Angeles, and received her Ph.D. in psychology from Harvard University in 2004. She is the author of several journal articles investigating information processing and the self in borderline personality disorder. Currently, she is the Director of Clinical Research for the Laboratory of Adolescent Sciences at Vassar College. Dr. Veague lives in Stockbridge, Massachusetts, with her husband and children.

References

  1. National Alliance on Mental Illness, "About Mental Illness." Available online. URL: http://www.nami.org/template.cfm?section=By_Illness. Accessed February 22, 2007.
  2. American Experience, "People and Events: Recovery from Schizophrenia." Available online. URL: http://www.pbs.org/wgbh/amex/nash/ peopleevents/e_recovery.html. Accessed February 22, 2007.
  3. John F. Nash Jr., "Autobiography." Availalable online. URL: http://nobelprize.org/economics/ laureates/1994/nash-autobio.html. Accessed May 10, 2007.
  4. Sylvia Nasar, A Beautiful Mind. New York: Simon and Schuster, 1998, 335.
  5. American Experience,"Transcript." Available online. URL: http://www.pbs.org/wgbh/amex/nash/filmmore/pt.html. Accessed February 22, 2007.
  6. See note 2.
  7. Robert L. Spitzer et al., eds., DSM-IV-TR Casebook: A Learning Companion to the Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text Revision. (Washington, DC: American Psychiatric Publishing, 2004), 189 - 90.
  8. H. Hafner et al., "The Influence of Age and Sex on the Onset and Early Course of Schizophrenia." British Journal of Psychiatry 162 (1993): 80 - 86.
  9. E. Fuller Torrey, Surviving Schizophrenia: A Manual for Families, Consumers and Providers, 3rd ed. New York: Harper Perennial, 1995, p. 79.
  10. G.A. Fava and R. Kellner, "Prodromal Symptoms in Affective Disorders." American Journal of Psychiatry 148 (1991): 828 - 830.
  11. British Columbia Schizophrenia Society, "Basic Facts about Schizophrenia," Available online. URL: http://www.mentalhealth.com/book/ p40-sc02.html#Head_4. Downloaded on November 13, 2006.
  12. Quoted in J.N. Butcher, S. Mineka, and J.M. Hooley, Abnormal Psychology. Pearson: Boston, 2004.
  13. Harrison et al., "Recovery from Psychotic Illness: A 15- and 25-year International Follow-up Study." British Journal of Psychiatry 178 (2001): 506 - 517.
  14. N.C. Andreasen, "The Role of the Thalamus in Schizophrenia." Canadian Journal of Psychiatry 42 (1997): 27 - 33.
  15. J. Hooley and S. Candela, "Interpersonal Functioning in Schizophrenia." In Oxford Textbook of Psychopathology, edited by T. Million, P.H. Blaney, and R.D. Davis. New York: Oxford University Press, 1999.
  16. J.D. Hegarty et al., "One Hundred Years of Schizophrenia: A Meta Analysis of the Outcome Literature." American Journal of Psychiatry 151, no. 10 (1994): 1409 - 1416.
  17. E.Q. Wu et al., "The Economic Burden of Schizophrenia in the United States in 2002." Journal of Clinical Psychiatry 66, no. 9 (2005): 1122 - 1129.
  18. C. Wallace, P.E. Mullen, and P. Burgess, "Criminal Offending in Schizophrenia over a 25-year Period Marked by Deinstitutionalization and Increasing Prevalence of Comorbid Substance Use Disorders." American Journal of Psychiatry, 161 (2004): 716 - 727.
  19. Suicide and Mental Health Association International, "NARSAD Publishes Top 10 Myths About Mental Illness Based on Nationwide Survey." Available online. URL: http://suicideandmentalhealth associationinternational.org/factsmythsment.html. Accessed February 22, 2007.

Provided by ArmMed Media

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