Getting help

If symptoms of psychosis are occurring, ask your GP for a referral for specialist assessment. Family members and friends are usually the first to notice symptoms and suggest medical help. Remember, if the ill person accepts hallucinations and delusions as reality, they may resist treatment.

Find a doctor who is familiar with psychosis, or even better an Early Intervention Service. The assessment and treatment of early psychosis should be carried out by people who are well qualified. If you don’t have access to an Early Intervention Service try to find a doctor who has an interest in this area someone who is competent and has empathy for people and their families. Remember, if you lack confidence in a doctor or psychiatrist, you will always have the right to a second opinion.

People with psychosis may not be able to volunteer much information during an assessment. Talk to the doctor yourself, or write a letter describing your concerns. Be specific. Be persistent. The information you supply can help towards more accurate assessment and treatment.

Many families are shocked when they try to find a doctor for a young person with psychosis. It seems that some doctors have little or no interest in this area. There is no easy solution to this problem. First of all, psychosis can resemble other illnesses, so assessment and treatment must involve well qualified people. Appropriate assessment, medical care and prescription medications are all likely to be needed.

One way to start is to ask a person in the medical profession whom they would go to if someone in their family showed signs of psychosis. If the young person is still in school, a counsellor may also be able to assist with an appropriate referral. Another way is by talking with other families who have been through the mental health system. They will often be able to put you in touch with the best resources in your community and save you a lot of time and frustration.

Besides finding someone who is medically competent, you need to find someone who works well with other members of the treatment team, and will help both the person and family understand and participate in the treatment plan.

Psychologists, psychiatric nurses, social workers, occupational therapists, support worker and others are all part of the therapeutic process. Specifically, you need to find a doctor who:

• Believes psychosis must be thoroughly assessed
• Takes a detailed history
• Screens for problems that may be related to other possible illnesses
• Is knowledgable about antipsychotic medications
• Follows up thoroughly
• Adjusts the course of treatment when necessary
• Reviews medication regularly
• Is interested in the person's entire welfare and makes referrals for aftercare, psychosocial education, rehabilitation, housing, social support and financial aid
• Explains clearly what is going on
• Involves the family in the treatment process.

In order to get enough information to make informed decisions, you may have to ask the doctor some direct questions.  If you are uneasy or lack confidence in the medical advice you receive, remember, you do have the right to another opinion.

Rehearse what you want to say before you call. State what you need clearly and briefly.

Make a note of the names of the people you talk to, along with the date and approximate time.

If you cannot get the help or information you need, ask to speak to a case manager, supervisor or the person in charge.

If you cannot immediately reach the doctor or case manager, ask when you may expect a return call, or when the person will be free for you to call back.

There may be exchanges between the team and the person that are of a highly personal nature which your relative will want to keep confidential. However, family members or close friends often need information related to care and treatment. You should be able to discuss the following with the doctor:

• Signs and symptoms of the psychosis
• Expected course of the illness
• Treatment strategies
• Signs of possible relapse
• Other related information.

Help the person accept their illness by dealing with it in a matter of fact manner. Try to show by your attitude and behaviour that there is hope, that things can be managed and that life can be satisfying and productive.

• Symptoms that have appeared
• Medications (including dosage)
• Impact of various types of treatment.

Family and friends should be familiar with the signs of “relapse” where the ill person may suffer a period of deterioration due to a flare up of symptoms. It helps to know the signs of impending relapse are quite specific to some people. Signs vary from person to person, but the most common are:

• Increased withdrawal from activities
• Deterioration in personal care.