Schizophrenia

During the 1950s, mentally disordered people who were harmful to society and themselves could be treated with medications and were able to return safely to their communities. During the 1980s, the cost of health care increased more than any other cost in our national economy. As a result, strategic planning has been made to reduce costs. "The political decision made to deinstitutionalize chronic mental patients started with the appearance of phenothiazine medications. Dramatically reducing the instability influenced by psychosis, these medications were of great significance to many individuals with serious mental disorders. At both the state and federal levels, legislators looked at the high cost of long-term psychiatric hospitalization. Social scientists guaranteed them that community-based care would be in the best interests of all concerned: the mentally ill and the general, tax-paying public (Barry 13)." It was believed that a social breakdown syndrome would develop in chronically mentally ill persons who were institutionalized. The characteristics of this syndrome were submission to authority, withdrawal, lack of initiative, and excessive dependence on the

institution.

While deinstitutionalization was kindhearted in its primary logic, the actual

execution of the concept has been greatly undermined by the lack of good community alternatives. At this time a large amount of the individuals using community mental health treatment services are the homeless. Nearly half of the homeless are chronically mental ill. These individuals are often separated from their families and all alone on the dangerous street. These homeless schizophrenics stay away from social structures such as community health treatment centers. Since they start a new life of independence they often stop taking their medications, become psychotic and out of place, and begin to live on the street. Since the schizophrenics are deinstitutionalized they are thrown into a whole new world of independence. Since their brain functions different than the usual human being they can't cope with the problems of life. The schizophrenics drive themselves crazy wanting to kill themselves and others in order to escape from this perplexing world.

Schizophrenia is the most common psychoses in the United States affecting

around one percent of the United States population. It is characterized by a deep

withdrawal from interpersonal relationships and a retreat into a world of fantasy. This plunge into fantasy results in a loss of contact from reality that can vary from mild to severe. Psychosis has more than one acceptable definition. The psychoses are different from other groups of psychiatric disorders in their degree of severity, withdrawal, alteration in affect, impairment of intellect, and regression.

The severities of psychoses are considered major disorders and involve confusion in all portions of a person's life. Psychosis is seen in a wide range of organic disorders and schizophrenia. These disorders are severe, intense, and disruptive. A person with a psychotic disorder suffers greatly, as do those in his or her immediate environment. Individuals suffering from withdrawal are said to be autistic. That is, the person withdraws from reality into a private world of his or her own. The psychotic individual is more withdrawn than a person with a neurotic disorder or any other mental disorder. The affect, mood, or emotional tone in a person with a psychotic disorder is immensely different from that of normal affect. In the mood disorders, one observes the exaggeration of sadness and cheerfulness in the form of depression and mania. In the schizophrenic disorders, affect may be exaggerated, flat, or inappropriate.

In psychotic disorders, the intellect is involved in the actual psychotic process,

resulting in derangement of language, thought, and judgment. Schizophrenia is called a formal thought disorder. Thinking and understanding of reality are usually severely impaired. The most severe and prolonged regressions are seen in the psychoses, regression. There is a falling back to earlier behavioral levels. In schizophrenia this may include returning to primitive forms of behavior, such as curling up into a fetal position, eating with one's hands, and so forth. The symptoms of schizophrenia usually occur during adolescence or early adulthood, except for paranoid schizophrenia, which usually has a later onset. The process of schizophrenia is often slow, with the exception of catatonia, which may have an abrupt onset. As an adolescent, a person who later develops schizophrenia is often antisocial with others, lonely, and depressed. Plans for the future may appear to others as vague or unrealistic.

It is possible that there may be a preschizophrenic phase a year or two before

the disorder is diagnosed. This phase may include neurotic symptoms such as acute or chronic anxiety, phobias, obsessions, and compulsions or may reveal dissociative features. As anxiety mounts, indications of a thought disorder may appear. An adolescent may complain of difficulty with concentration and with the ability to complete school work or job-related work. Over time there is severe deterioration of work along with the deterioration of the ability to cope with the environment. Complains such as mind wandering and needing to devote more time to maintaining one's thoughts are heard. Finally, the ability to keep out unwanted intrusions into one's thoughts becomes impossible. As a result, the person finds that his or her mind becomes so confused and thoughts so distracted, that the ability to have ordinary conversations with others is lost.

The person may initially feel that something strange or wrong is going on.

He or she misinterprets things going on in the environment and may give mystical or symbolic meanings to ordinary events. The schizophrenic may think that certain colors hold special powers or a thunderstorm is a message from God. The person often mistakes other people's actions or words as signs of hostility or evidence of harmful intent. As the disease progresses, the person suffers from strong feelings of rejection, lack of self-respect, loneliness, and feelings of worthlessness. Emotional and physical withdrawal increases feelings of isolation, as does an inability to trust or associate with others. The withdrawal may become severe, and withdrawal from reality may be noticeable from hallucinations, delusions, and odd mannerisms. Some schizophrenics

think others are controlling their thoughts or that their thoughts are being

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