How To Establish A Schizophrenia Care Plan
If you or someone you love has been diagnosed with schizophrenia, you may need to prepare for some major changes in your life. This mental health disorder can often be managed effectively, but this may require a considerable amount of effort, organization, and attention to detail. Putting together an appropriate schizophrenia care plan could increase your chances of ensuring a healthy, fulfilling life for yourself or the person for whom you’re caring. Your care plan will likely need to include regular interactions with a psychiatrist, a therapist, and a primary care doctor. Social workers may also provide helpful assistance. Effective schizophrenia care may involve meeting your social needs and maintaining a thriving connection with your local community as well.
Can schizophrenia be treated?
Receiving a diagnosis of schizophrenia can be frightening. Many people assume that individuals with this condition will inevitably experience poor quality of life and severe functional impairment. While schizophrenia can be a serious mental illness, the condition can often be effectively treated with a combination of medication, therapy, and interpersonal support. There’s no known method to completely cure this disorder, but if managed properly, those affected may still be able to lead full and satisfying lives. Some individuals have gone on to achieve significant personal, relational, and career successes following their schizophrenia diagnoses.
Evidence suggests that seeking treatment as soon as possible when signs of schizophrenia manifest may be a significant factor in achieving the best long-term outcomes. If you or someone close to you has been diagnosed with this disease, you may want to start planning for the future as soon as possible. Below, we’ll review some strategies that may help you create an effective schizophrenia care plan.
Educate yourself about schizophrenia
Learning as much as you can from reputable, evidence-based sources can help you make informed schizophrenia care decisions. Researchers have found that educational interventions can improve a patient’s adherence to a treatment regimen and decrease their odds of relapsing. Education can also improve the health and happiness of family caregivers while helping them better assist their loved ones.
You may want to start this process by reviewing the description of schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schizophrenia can include several different types of symptoms:
Positive symptoms
Active signs of psychosis, such as hallucinations, delusional beliefs, or disorganized and hard-to-understand speech and behavior
Negative symptoms
Diminishment of motivation, energy, emotional responsiveness, verbal complexity, enjoyment, and other mental health functions
Cognitive symptoms
Impairments in mental abilities like concentration, short-term memory, and reasoning
Mental health professionals and organizations focused on mental illness
Once you’re familiar with the DSM definition of schizophrenia, you can learn more about this disorder from professional, governmental, or nonprofit organizations focused on mental illness. Reliable sources include the following:
- American Psychiatric Association (APA)
- National Institute of Mental Health (NIMH)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- National Alliance on Mental Illness (NAMI)
- Mental Health America (MHA)
Assemble a care team for your schizophrenia care plan
Living well with schizophrenia is usually easier with help from professionals experienced in working with mental illness. An effective care team may include some or all of the following specialties:
- Primary care provider (PCP): Often a general medicine or family medicine practitioner, a PCP is generally the person the patient sees regarding general health and wellness.
- Psychiatrist: A medical doctor with a specialty in mental health care can both offer psychotherapy and prescribe medication, which may be important since antipsychotics can play a significant role in achieving positive outcomes in schizophrenia.
- Social worker: People with schizophrenia may face difficulties getting housing and employment. A licensed social worker may be able to help them locate social services, educational programs, rehabilitation programs, and other forms of assistance.
- Psychologist/therapist/counselor: While a psychiatrist will typically oversee medication management, they may not be able to see you frequently for psychotherapy. Seeing a therapist can help with negative symptoms, such as difficulties with social function, which may not respond to medication.
- Psychiatric nurse: Nurses may be heavily involved in day-to-day psychiatric care in both inpatient and outpatient settings, and many helpful treatment options may still be effective when delivered as nursing interventions. Individuals with severe functional impairments might also benefit from home mental health nursing.
- Family caregivers: While they may not be licensed medical professionals, caring family members can often make a significant difference in helping a person with schizophrenia recover and thrive.
Seek family support for negative and positive symptoms
Research suggests that people with schizophrenia usually have better long-term outcomes when their family members communicate and collaborate with treatment providers from the start. If you’ve been diagnosed with this disorder, you may want to let your trusted family members or friends know and ask if they’ll accompany you to some of your appointments with care providers. A robust family support network can help in a variety of ways. They can:
- Encourage better medication adherence
- Keep an eye out for indicators of relapse
- Provide opportunities for social engagement
- Assist with aspects of everyday life you may find challenging
Reaching out to family and friends for help may also be beneficial if a loved one is experiencing schizophrenia. Caring for a family member with a psychotic disorder can involve significant mental and emotional strain. Studies indicate that robust social support may improve resilience among caregivers.
Develop relapse prevention strategies for symptoms of schizophrenia
- Learn the potential warning signs
- Get regular exercise (30+ minutes per day)
- Avoid substance misuse and any use of cannabis or psychedelic substances
- Pay attention to unpleasant side effects of prescriptions and communicate with medical professionals about them
- Find healthy outlets for stress
- Ask your doctor whether long-acting, injectable antipsychotic medications may be right for you
Create a relapse care plan, including medication side effects
Although the techniques described above may lower the risk of relapse in schizophrenia, there’s still a chance of experiencing increased psychotic symptoms. You can talk with your care team about how to handle this if it happens. Creating a psychiatric advance directive (PAD) may help. This can be defined as a legal document spelling out the wishes of an individual if their mental illness symptoms prevent them from being able to make rational decisions. Even if your state doesn’t allow for advance directives, developing a relapse plan with the help of your care team may help you avoid problems during a schizophrenia relapse.
You might also want to prepare a list of key information that caregivers, doctors, and first responders can quickly review in a crisis, potentially including the following:
- Contact information of care providers and case managers
- Emergency contacts like trusted friends and family members
- Information about your diagnosis
- Names of medications you’re taking
- Information about what has helped with past relapses
Find ways to stay socially and mentally engaged
Regular social interaction may help people with schizophrenia achieve better outcomes. Not only can socialization provide a support network that may help with the stresses of daily life, but it may also defend and improve cognitive function. People with this condition tend to have a better prognosis when they stay connected with their communities and friends. Seeking out structured social activities, such as clubs and teams, can help, and so can any hobbies involving regular contact with other people. If you or your family member with schizophrenia can maintain steady employment, this can also be a source of cognitive stimulation and social connection.
Educational programs and resources
This may seem easier said than done. Many people with schizophrenia experience impaired social interaction, related both to dysfunction in social cognition and to stigma or discomfort from other people. However, educational programs like social skills training (SST) may improve social abilities. Many people with psychotic disorders can also benefit from supported employment (SE), in which they receive assistance from professionals in finding and maintaining steady work. Peer support groups could also be a helpful option, both for people with mental illness and their caregivers. Meeting regularly with others who have similar experiences can provide a sense of community as well as an opportunity to get advice and learn coping skills from those with more experience.
Engage in regular psychotherapy
Meeting regularly with a licensed therapist can have many benefits for people with schizophrenia, including a constructive outlet for stress, mental health support, and monitoring for relapse warning signs. If the realities of your condition make it hard for you to see a therapist in person, online therapy could be a helpful alternative. Attending sessions remotely rather than face-to-face is often easier.
Online therapy to add to your schizophrenia care plan
Online therapy may assist with obstacles like depression and cognitive difficulties. Some research suggests it may also be able to improve psychotic symptoms as well, although individuals experiencing acute psychosis may need to seek in-person care. A 2017 trial found that an internet-based cognitive behavioral therapy program typically reduced auditory hallucinations in individuals with schizophrenia.
Takeaway
What is a good treatment plan for schizophrenia without side effects?
Antipsychotic medications used to treat schizophrenia can have side effects, but there are complimentary nonpharmacological treatments that are generally side effect-free.
The primary nonpharmacological intervention for schizophrenia is psychotherapy, including individual therapy, group therapy, and family therapy. These treatments can help people adhere to their medication treatment plan, which can be beneficial as research has found that 37% to 74% of people with schizophrenia are non-adherent with their medication. People with schizophrenia who stop taking their antipsychotic medication are at a higher risk of relapse and hospitalization. Psychotherapy can help keep people informed about their illness and the importance of taking their medication.
Nonpharmacological treatments can also include psychosocial interventions and family support, which have been shown to decrease rehospitalization, improve social functioning, and help identify and manage symptoms.
While these nonpharmacological treatments can help, experts recommend that they be used in addition to medication, not in place of them.
What are the interventions for positive symptoms of schizophrenia?
Positive symptoms of schizophrenia are those that are abnormally present, like hallucinations, delusions, and distorted perceptions. The primary treatment for these symptoms is antipsychotic medication, but there are some therapeutic techniques that can help. For example, learning the communication skills necessary to talk to someone who is experiencing hallucinations or delusions can help build a trusting relationship with people experiencing acute schizophrenic episodes.
What worsens the mental health of someone with schizophrenia?
Multiple environmental factors can worsen the symptoms of schizophrenia, including using drugs and alcohol, not getting enough sleep, and not managing stress.
Do people with schizophrenia need caregivers?
Some people with schizophrenia may need caregivers if their symptoms are difficult to control and affect their ability to live on their own safely. The type of caregiver and support the person needs will likely depend on their symptoms and their severity.
For example, someone with schizophrenia who is experiencing impaired cognitive function (like a lack of problem-solving skills, disorganized thinking, disorganized speech, or disturbed sensory perception) or engaging in inappropriate behaviors like drug abuse may not be able to manage self-care tasks, or they may need support with daily living skills. These symptoms may require in-patient care or a live-in caregiver.
On the other hand, people with well-controlled schizophrenia who can maintain a safe environment at home may live independently. In some cases, they may need a strong support system, which can include someone to check in to ensure they are taking their medications and to provide extra support during an acute episode. Other types of support can help someone with this condition maintain their independence, including occupational therapists, supported employment programs, or other community resources.
What are the most common side effects of schizophrenia?
Schizophrenia can impact a person’s life in many ways. This condition is often associated with impairment in many areas, including their personal life, social life, and family life, and it can impact their education, career, and the client's ability to function independently. People with schizophrenia are also more likely to die early than the general population.
According to the World Health Organization, “Stigma against people with this condition is intense and widespread, causing social exclusion and impacting their relationships with others, including family and friends.”
What type of mental illness is schizophrenia?
In the DSM-5, schizophrenia is classified under “Schizophrenia Spectrum and Other Psychotic Disorders.”
How to write a nursing care plan for schizophrenia?
Nursing care plans are documents used by nurses to account for a patient’s diagnosis, condition, goals, and progress. Psychiatric nursing care plans centralize all patient information, making it easy for other caregivers to understand the patient, their condition, and their needs.
These documents have multiple parts, including a nursing assessment, nursing diagnosis, interventions, and rationales.
All nursing diagnoses are standardized and approved by the North American Nursing Diagnosis Association (NANDA). They are not the same as medical diagnoses. A nursing diagnosis is a clinical judgment about how someone responds to health problems, whereas a medical diagnosis identifies the condition or disease. For example, if the medical diagnosis is “schizophrenia,” nursing diagnoses might be as follows:
- Risk for Violence: Self-Directed or Directed at Others
- Impaired Social Interaction
- Disturbed Thought Processes
- Self-Care Deficit
Care plans also include long- and short-term goals and anticipated outcomes. For a schizophrenia care plan, these may include things like the following:
- Patient will maintain safety during an acute episode
- Patient will remain free from self-harm and injury
- Patient will verbalize an understanding that hallucinations are not reality-based
- Patient will speak openly with the healthcare team by discharge
Another part of a nursing care plan is interventions. Nursing interventions are not medical interventions but things that are within a nurse’s scope of practice that generally focus on meeting the patient’s needs, generally based on Maslow's Hierarchy of Needs. Some interventions in a schizophrenia nursing care plan may include:
- Help patient recognize triggers and early warning signs
- Encourage the patient to participate in group activities
- Ensure patient safety
- Present reality when patient is experiencing hallucinations
Nurses assess and document patients at the start of their care and throughout to monitor progress and help doctors and the overall treatment team determine if any changes need to be made to the patient’s treatment plan.
What is the nursing management for schizophrenia?
Nursing management for schizophrenia includes various tasks, like assessing vital signs and evaluating the person’s cognitive deficits and thought processes. They may assess and document various factors that can give insight into how the patient is managing their symptoms, like social interactions, social withdrawal, facial expressions, and whether they make eye contact. The nurse will also ensure the person is getting appropriate care for any physical health problems, like high blood pressure or diabetes.
Nurses also ensure that patients take their medications as ordered and try to help them feel safe and comfortable. For example, a nurse may use therapeutic communication, speak in a slow and calm manner, check on the patient’s safety, and educate the patient and their family about schizophrenia and any other mental health conditions the person may be managing.
What is the best schizophrenia care?
The most effective treatment for schizophrenia may be a combination of antipsychotic medication, psychotherapy, and psychosocial treatments. Antipsychotics can help people with this condition improve cognitive function and manage delusions and hallucinations, while psychotherapy can help them learn coping strategies to manage symptoms like impaired communication as well as learn how to gain control of other mental illnesses, like substance abuse.
How can a nurse help someone with schizophrenia?
Nurses can help people with schizophrenia stay with their medication, keep them safe during acute episodes, and teach the patient and family about risk factors and triggers to look for. Nurses can also educate families about the risks of developing schizophrenia and pay attention to the patient's relationships to help them form and maintain healthy connections.
A nurse or other healthcare provider can also help advocate for patients by encouraging the public to rethink mental illness and understand how schizophrenia affects people.
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