|Treat schizophrenia as you would any other serious medical illness in your teenager|
"My 18yr son is aggressive, hearing voices, and not sleeping."
"Since the last two months he is not attending college. He talks to himself in his room and is not going out with his friends."
"He feels he is being tracked through the TV and yesterday assaulted his mother when she put it on."
"We tried taking him to our doctor but he refuses saying there is nothing wrong with him."This is a common introduction to the more severely ill teenagers presenting at Pathfinder Clinic.
Why teenagers with schizophrenia refuse to see a psychiatrist
Illness related factors
"You really need to get your act together"or
"You better snap out of it or people will think you’re crazy."So in their mind your adolescent rationalises the problems as being outside themselves
– "You won’t let me do what I want and now you are trying to label me as crazy, you need therapy, you go to the doctor."Taking medication is seen as an acknowledgement of their own failure. To the teenager denial of illness and rejection of medical care appears more acceptable.
The advisers and 'well wishers' of teenagers and their families are a third set of influencers whose lack of specific knowledge can reinforce self-stigma. Statements like
"Send him to us for a few weeks and he’ll be OK"and
"Avoid ‘psychiatric’ medications because they are addictive"or
"Medicines will cause permanent damage"add further obstacles to the path to standard and adequate treatment.
When the adolescent is functioning well on the medication these misinformed 'well wishers' are the ones who advise
"What do you need the medicine for? I can see nothing wrong with you"and set the stage for relapse and refusal to meet with the doctor when the illness relapses
– "Chacha said there is nothing wrong with me, why are you trying to label me?"
What to do?Refusing help for schizophrenia is not an option.
- We have already seen what can be done to get a reluctant patient to see the psychiatrist.
- However, for schizophrenia, more urgent measures may be required. Involuntary admission to a mental health facility for initiation of treatment may be needed. This is especially so when the adolescent is violent, suicidal, using addictive substances, or repeatedly missing from home. Involuntary admission helps in the same way that it helps get your adolescent admitted to hospital if they had dengue fever even if they did not want it. There are provisions in the Mental Health Act to ensure this is done in safety with respect for your adolescent’s rights. After they receive treatment and brain function returns to normal they will thank you. For they will be relieved from the terrors of reality distortions and desperation of suicide thoughts.
- Once treatment is initiated ensure they take medications every day as prescribed. Don’t take on any other responsibility regarding the medication. Leave that as a dialogue between your teenager and their psychiatrist. Just make sure it continues to happen.
Why teenagers with schizophrenia must get treatment even if they don't want it
Brain cell death
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