The British Psychological Society have published the report Understanding Psychosis and Schizophrenia – why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help. This is a comprehensive and extensively referenced report presenting a psychological approach to experiences that are often referred to as psychosis. It is jargon free and punctuated with service user quotes throughout. The report should be read by people who experience psychosis and by all people working in mental health. Click here to read the report and here to read a critique of different sections by Laws, Langford and Huda.
- Up to 10% of the general population experience voice hearing or feeling paranoid. Not all report this as distressing or seek help.
- People’s experiences can be seen as a continuum, there is no clear dividing line between psychosis and other thoughts and feelings.
- People’s experiences of psychosis are often a response to trauma, abuse or deprivation. The content of their experiences often reflects this.
- People should have the opportunity to talk in detail about their experiences and to make sense of them.
- Biological factors may contribute to cause but there are no biomarkers as yet. Poverty, inequality and social disadvantage impact significantly on mental health.
- An alternative to diagnosis is collaborative formulation – developing a hypothesis or ‘best guess’ as a basis for moving forward.
- Found to be helpful:-
- Self help – help from friends and family, community, peer support, Recovery Colleges
- Mental health services – support to achieve goals and overcome difficulties
- Talking based approaches/psychological help – such as CBT, Trauma Focused Therapy
- Medication – can help reduce frequency, intensity and amount of distress of experiences
- All interventions have advantages and disadvantages
- Services need to increase their capacity to offer psychological help
What does this mean for Planning Care?
This report presents evidence that challenges the prevailing medical model of psychosis. Depending upon your current values, attitudes and beliefs about mental health this may be old news or it may be a news flash. It signals:
- Service users being more activated; aware of their own and alternative views of psychosis; aware of what they should have access to
- Collaboration – a move away from paternalism, seeking to understand people’s belief about their experiences in their cultural context
- Meeting people’s needs – through listening, enabling people to talk and think, being calm, supportive and non-judgemental and open minded
- Supporting people to reach their goals
- Willingness to take positive risks with people; providing information and trying things out
- Offering choice: talking therapy, peer support, self help, medication or no medication
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