Which of the following is an example of a positive symptom of schizophrenia?

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There are different types of treatment available. Medical professionals should work with you to find the right treatment for you.

The National Institute for Health and Care Excellence (NICE) recommends that you should be offered a combination of medication and talking therapies.

People who live with schizophrenia can respond to treatment differently. For many treatment helps to reduce symptoms to help make daily life easier. You may find that you need to continue with treatment to keep well.

On average, for every 5 people with schizophrenia:

• 1 will get better within 5 years of their first obvious symptoms.
• 3 will get better but will have times when they get worse again.
• 1 will have troublesome symptoms for long periods of time.

What medication should I be offered?

Your doctor may offer you medication known as an ‘antipsychotic’. These reduce the symptoms of schizophrenia, but don’t cure the illness.

Your healthcare professionals should work with you to help choose a medication. If you want, your carer can also help you make the decision. Doctors should explain the benefits and side effects of each drug.

Antipsychotic medication can come as tablets, a syrup or as an injection. The injections are called a depot. You may find a depot useful if you struggle to remember to take your medication, or might take too much.

Your doctor should take your views into account when prescribing you medication.

Your medication should be reviewed at least once a year.

Some older type antipsychotics had bad negative side effects. Some people find that the side effects of newer antipsychotic drugs are easier to manage.

You might have been on an antipsychotic for a few weeks and find the side effects too difficult to cope with. You can ask your doctor about trying a different one.

NICE guidelines state that people who have not responded to at least 2 other antipsychotic drugs should be offered clozapine.

For more information see our webpages on the following:

What type of psychosocial treatment should I be offered?

Your doctor should offer you psychosocial treatments. These treatments help you to look at how your thoughts and behaviour are influenced by the people and society you live in. This can include the following.

What is cognitive behavioural therapy for psychosis (CBTp)?
NICE says the NHS should offer cognitive behavioural therapy for psychosis (CBTp) to all adults with psychosis or schizophrenia. CBTp does not get rid of your symptoms. CBTp can help you to manage your feelings and symptoms better.

What is family intervention?
NICE recommend family members of people who live with psychosis and schizophrenia should be offered family intervention. This can help to improve how you feel about family relationships. This can help reduce any problems in the family caused by your symptoms.

Family intervention is where you and your family work with mental health professionals to help to manage relationships.

It should be offered to people who you live with or who you are in close contact with. The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions.

Your family should get support for 3 months to 1 year and should have at least 10 planned sessions.

Family intervention could be to,

• learn more about your symptoms, and
• improve communication among family members.

Family intervention could help you and your family to:

• learn more about your symptoms,
• understand what is happening to you,
• improve communication with each other,
• know how to support each other,
• think positively,
• become more independent,
• be able to solve problems with each other,
• know how to manage a crisis, and
• improve mental wellbeing.

What is psychoeducation?
This involves learning about your illness, your treatment and how to spot early signs of becoming unwell again. It can prevent you having a relapse. Psychoeducation may also be helpful for anyone who is supporting you, such as family, a partner or a trusted colleague.

What are arts therapies?
In arts therapies you do art activities in therapy sessions with help from a trained professional.

People can benefit from the sessions of any age and art skill level or experience.

They therapy session can be one-to-one or in a group. They can help you express your feelings and thoughts and help you to look at things in different ways. This can help to reduce the negative symptoms of the illness.

See our webpage on Talking treatments for more information.

NHS early intervention teams

Early intervention teams are specialist NHS services which provide treatment and support for people when they first experience psychosis and schizophrenia.

They are usually made up of psychiatrists, psychologists, mental health nurses, social workers and support workers.

Your doctor should refer you to an NHS early intervention team if they think you’re experiencing a first episode of psychosis.

NICE suggests that you should start treatment within 2 weeks of referral.

See our webpage on NHS mental health teams for more information.

What if I am not happy with my treatment?

If you are not happy with your treatment you can:

• talk to your doctor about your treatment options,
• ask for a second opinion,
• get an advocate to help you speak to your doctor,
• contact Patient Advice and Liaison Service (PALS) and see whether they can help, or
• make a complaint.

There is more information about these options below.

Treatment options

You can speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.

Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.

Second opinion

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.

You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.

See our webpage on Second opinions - About your mental health diagnosis or treatment for more information.

Advocacy

An advocate is someone independent from the NHS. They can help to make your voice heard when you are trying to resolve problems. Advocacy services are usually free to use.

There are different types of advocacy services. The types that might be of use to you in this situation are.

• NHS complaints advocacy. This service can help if you want to complain about the NHS. It’s a statutory service, which means that there has to be a service in your area.
• Community or mental health advocacy. This service could help if you don’t want to make a formal complaint about the situation. But you want help dealing with professionals in the NHS about your second opinion. This isn’t a statutory service, meaning it isn’t available in every area of England.

To find your local NHS complaints advocacy service you can:

To find your local community or mental health advocacy service you can try the following.

• Search on the internet – type in ‘advocacy in [city/ county/ London borough]’.
• Contact your local NHS complaints advocacy service to ask if they know of any community or mental health advocacy in your area.

See our webpage on Advocacy for more information.

The Patient Advice and Liaison Service (PALS)

You could talk to your local Patient Advice and Liaison Service (PALS). The NHS say that PALS are there to help patients resolve problems with care and treatment.

You could ask PALS if there is a local policy on second opinions. If there is, you can then mention the policy when asking your doctor to reconsider.

You can find your local PALS by searching on the NHS Choices website:
www.nhs.uk/service-search/other-services/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363. Or you can call NHS 111 and ask for their contact details.

Complaints

If you still have no success, you can complain using the NHS complaints procedure.

This is where your concerns are investigated in further detail.

You can ask a member of your health team to explain how to make a complaint

You can ask for the complaints procedure of the service you are complaining to.

See our webpage on Complaining about the NHS or social services for more information.

What can I do to manage schizophrenia?

People deal with their experience in different ways. You might need to try different things before finding something that works.

Support groups

You could join a support group. A support group is where people come together to share information, experiences and give each other support. Hearing about the experiences of others can help you feel understood. This may help you feel less alone and boost your self-confidence.

You might be able to find a local group by searching online.

You can search for local mental health support groups below:

Recovery college

Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your experiences.

They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college.

Unfortunately, recovery colleges are not available in all areas. To see if there is a recovery college in your area you can use a search on the internet.

Peer support through the NHS

Your doctor may offer you peer support with someone who has lived experience of psychosis, and who are now in recovery. They should be able to offer advice and support with:

• side effects,
• recognising and coping with symptoms,
• what to do in a crisis,
• meeting other people who can support you, and recovery.

Self-management techniques

Managing your condition on your own is called self-help. Health professionals may offer you help to manage your condition on your own. They may call this a self-management programme.

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