Surviving Schizophrenia: A Manual for Families, Consumers and Providers

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The third edition of this indispensable manual thoroughly details everything patients, families, and mental health professionals need to know about one of the most widespread and misunderstood illnesses.
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Surviving Schizophrenia, 6th Edition: A Family Manual

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The third edition of this indispensable manual thoroughly details everything patients, families, and mental health professionals need to know about one of the most widespread and misunderstood illnesses.
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Product Details

  • ISBN-13: 9780060151126
  • Publisher: HarperCollins Publishers
  • Publication date: 5/1/1983
  • Edition description: 1st ed
  • Pages: 288

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Dimensions of the Disaster
Schizophrenia is to psychiatry what cancer is to medicine: a sentence as well as a diagnosis.
—W. Hall, G. Andrews, and G. Goldstein, Australian and New Zealand Journal of Psychiatry, 1985

Schizophrenia, I said. The word itself is ominous. It has been called "one of the most sinister words in the language." It has a bite to it, a harsh grating sound that evokes visions of madness and asylums. It is not fluid like demence, the word from which "dementia" comes. Nor is it a visual word like ecrasse, the origin of "cracked," meaning that the person was like a cracked pot. Nor is it romantic like "lunatic," meaning fallen under the influence of the moon (which in Latin is luna). "Schizophrenia" is a discordant and cruel term, just like the disease it signifies.

Our treatment of individuals with this disease has, all too often, also been discordant and cruel. It is in fact the single biggest blemish on the face of contemporary American medicine and social services; when the social history of our era is written, the plight of persons with schizophrenia will be recorded as having been a national scandal. Consider the current dimensions of the disaster.

1. There are as many individuals with schizophrenia homeless and living on the streets as there are in all hospitals. Studies of homeless individuals in the United States have estimated their total number to be between 250,000 and 550,000. A median estimate of 400,000 would be consistent with the data from most of the studies. Studies have also reported that approximately one-third of homeless individuals are seriously mentally ill, thevast majority of them with schizophrenia. It is likely, therefore, that on any given day approximately 100,000 persons with schizophrenia are living in public shelters and on the streets. As will be described below, there are only approximately 100,000 people with schizophrenia in all hospitals at any given time.

2. There are as many individuals with schizophrenia in jails and prisons as there are in all hospitals. A 1992 survey of American jails reported that 7.2 percent of the inmates were overtly and seriously mentally ill. A shocking 29 percent of the jails acknowledged holding such individuals with no charges against them whatsoever, often awaiting a bed in a psychiatric hospital. The vast majority of those who do have charges have been charged with misdemeanors such as trespassing. The Los Angeles County Jail is now de facto the largest mental institution in the country. A study of American prisons concluded that 10 to 15 percent of the inmates have "thought disorder or mood disorder and need the services usually associated with severe and chronic mental illness." In 1991 there were a total of approximately 1.2 million individuals in jails and prisons in the United States. If patients with more covert symptoms of schizophrenia are also included, it would seem reasonable to estimate that approximately eight percent of all inmates have schizophrenia, which would mean that at any given time 100,000 individuals with schizophrenia are in jails and prisons.

3. There are increasing episodes of violence committed by individuals with schizophrenia who are not being treated. Individuals with schizophrenia who take medications are not more violent than the general population. Recent studies have shown, however, that some individuals with schizophrenia who are not taking medication are more violent. In one study nine percent of individuals with schizophrenia who were living in the community had used a weapon in a fight in the preceding year. In another study "27 percent of released male and female patients report at least one violent act within a mean of four months after [hospital] discharge." Assaults against family members by individuals with schizophrenia have also risen sharply. Drug and alcohol abuse and noncompliance with medications both appear to be important factors in increasing violent behavior in this population.

4. There are increasing episodes of violence committed against individuals with schizophrenia. Most crimes against individuals with schizophrenia are not reported; in those instances in which they are reported they are often ignored by officials. Purse snatchings and the stealing of disability checks are common, but rapes and even murders are not rare. In Massachusetts, when two mentally ill homeless individuals were savagely beaten to death by three teenagers, the newspaper editorialized: "The street people, among the most helpless of adult human beings . . . are rabbits forced to live in company with dogs." In California, a boarding home operator was accused of killing nine tenants, some of whom had schizophrenia, in order to cash their disability checks.

5. Housing for many individuals with schizophrenia is often abysmal. Because of pressure from state departments of mental health to discharge patients from state hospitals, seriously mentally ill individuals are frequently placed into housing that would not be considered fit for anyone else. For example, in 1979 the police removed 21 "ex-mental patients" living in New York City board-and-care homes "amid broken plumbing, rotting food and roaches . . . The police found the decaying corpse of a former patient lying undisturbed in one home inhabited by six other residents." Similar reports continued throughout the 1980s, and in 1990 the New York Times headlined still another report: "Mental Homes Are Wretched, A Panel Says." In Mississippi "9 ex-patients" were found in a primitive shed with "no toilet or running water" and "guarded by two vicious dogs" to insure that they did not run away.

6. Many individuals with schizophrenia revolve between hospitals, jails, and shelters. Because of the failure of mental health professionals to provide medications and insure aftercare for discharged patients, many individuals with schizophrenia undergo a revolving door of admissions and readmissions to hospitals, jails, and public shelters. In Illinois 30 percent of patients discharged from state psychiatric hospitals are rehospitalized within 30 days. In New York 60 percent of discharged patients are rehospitalized with a year. A study of readmissions to state psychiatric hospitals found patients with schizophrenia who had been readmitted as many as 121 times. The jail survey referred to above identified individuals with schizophrenia who had been jailed as many as 80 times. Between hospitalizations and jailings these individuals consume inordinate amounts of police and social service time and resources. For example, in Los Angeles a 1993 study found that policemen had to respond to a "mental health crisis" call equally as often as they had to respond to a robbery call. Hospital, jail, shelter, and back around again in random order—it is an endless revolving door odyssey.

7. Schizophrenia is remarkably neglected by mental health professionals. Despite an increase in total psychiatrists, psychologists, and psychiatric social workers from approximately 9,000 in 1940 to over 200,000 in 1993, schizophrenia has been remarkably neglected by these professionals. For example, a study published in 1994 reported that only three percent of all patients seen by psychiatrists in private office practice have a diagnosis of schizophrenia. One major reason for the failure of mental health professionals to treat patients with schizophrenia is the shockingly poor preparation they receive in their training programs. State psychiatric hospitals frequently must fill their positions with poorly trained and/or incompetent professionals; indeed, Wyoming State Hospital went for almost a year without a single psychiatrist on its staff. Many Community Mental Health Centers (CMHCs), originally conceived and funded to provide care for seriously mentally ill individuals being discharged from psychiatric hospitals, merely evolved into counseling centers to do personality polishing for the "worried well." Some CMHCs also built swimming pools with federal funds and paid their administrators handsomely. In 1989 three administrators at a Utah CMHC were charged with 117 counts of felony for paying themselves $3.6 million over five years. In 1990 the executive director of a CMHC in Fort Worth was indicted on four counts of felony theft. These stolen funds are but a fraction of the resources that were originally intended for individuals with serious mental illnesses such as schizophrenia but which have been diverted, legally or illegally, to other purposes.

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Sort by: Showing all of 5 Customer Reviews
  • Anonymous

    Posted December 29, 2013

    I read the 4th edition of this book, and it is by far the most a

    I read the 4th edition of this book, and it is by far the most amazing and informative book I have read. I highly recommend this for anyone who has a loved one with this illness. It will help you gain so much knowledge and understanding. Every page is packed with facts and useful information from an author who is very knowledgeable and passionate about the subject, has a sister who has the illness, and has done extensive research about it. I have a brother with this illness and I just got the new 6th edition for our family and am looking forward to reading it!!!

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted September 23, 2011

    Invaluble to loved ones living with schizophrenia. Very highly recommended.

    The book is written to apply to professionals, laymen and loved ones living with schizophrenia. As a layman living with a paranoid schizophrenic loved one I cannot recommend it too highly. Although some of the contents are more directed to professionals in the field, it is very easily understood and applicable to those of us living with the disease of schizophrenia.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted February 9, 2009

    I Also Recommend:

    great book

    it is very informative and well written.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted February 6, 2002

    An excellent book for all those coping with mental illness

    This book is an outstanding guide, not only for individuals with mental illness, but also for their family members. It is very educational, helpful, and sensitive to the subject of this devastating illness. I am glad I found this book-it helped me cope with the many struggles I have experienced living with a relative with this illness.

    1 out of 1 people found this review helpful.

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  • Anonymous

    Posted August 28, 2009

    No text was provided for this review.

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