For many psychologists, greater experience comes at a costly price tag of desensitization. When conducting a routine structured interview, the phrase “Do you often hear or see things that others cannot?” would hardly elicit a noticeable response reaction, from even the most novice clinician. We may unintentionally disregard that the field of Human Services often times involves evaluating very real, sometimes very difficult human experiences. Treating these experiences with the great humility and reverence they deserve can unfortunately sometimes fade with time. It is therefore imperative that clinicians be hypervigilent and proactive in submerging themselves into research studies and literature, which aim to connect and help clinicians to understand these distressing experiences. Experiences such as psychosis can be extremely frightening, confusing and deeply personal not only for those experiencing it, but also for those closely related and wanting to help, like friends and family members.
The National Alliance on Mental Health conducted an online survey of people who experienced psychosis or witnessed a friend or family member have an episode of psychosis. The 2011 survey followed another NAMI survey that found that, on average, there is a nine-year gap between a person’s first psychotic episode and the time they begin to receive treatment for their diagnosis.
The 2011 NAMI survey also focused on finding the possible reasons why people with psychosis go close to a decade before receiving treatment, and possible solutions to solving the problem. First, there was the issue of lack of knowledge about psychosis. According to the survey, approximately 40 percent of the people who had psychosis said they were the first to recognize the problem themselves. These people reported that they realized something was wrong but they did not know what it was, due to lack of understanding about psychosis in general. This problem was compounded by the fact that many people who experience psychosis tend to isolate from others. According to the NAMI survey, around 20 percent of the responders reported that they did not receive help from friends or family when they had their first psychosis episode (NAMI, 2011). Lack of knowledge also proved to be a problem among family and friends. Just like the patients who experience a psychotic episode, family and close friends have a difficult time understanding and recognizing the symptoms of psychosis when they see it, making it difficult to get the help needed for their loved one.
A second challenge that prevents psychosis sufferers from receiving treatment is the stigma attached to mental illness. Again, this problem stems from lack of knowledge about psychosis. Respondents to the NAMI survey said that the issues they found the most challenging were confronting the stigma of mental illness, telling others about their psychosis, and worrying about no longer being taken seriously by others.
All these issues lead to a similar problem, which is, mental health professionals do not become a part of the treatment of patients who have psychosis, until many years down the line after their first episode. This is a significant obstacle to the treatment of psychosis because many of the respondents to the survey suggested that finding the “right” doctor, keeping appointments, and taking medication were very helpful in their treatment.
Observing the results of the NAMI survey, this writer believes that a comprehensive approach is necessary to solve the problem of delayed diagnosis of psychosis. According to the survey, many of the respondents said that they first received information about psychosis online. As such, putting relevant information online would be a good first step in educating the public about psychosis. Also, having an educational blitz in schools, workplaces and other institutions about psychosis would go a long way in both destigmatizing mental illness, and providing relevant information for people to get help for themselves and their family members.
Finally, understanding that psychosis can be a frightening, confusing, and very personal experience for any individual. The human exchange of simply gaining information and marking a check symbol in some box cannot (hopefully) be a comforting solution for any clinician, when uncovering someone’s experiences with psychosis. In fact, if the tables were turned, what kind of qualities would you require from the person sitting across from you, before you felt comfortable enough to open up about such a deeply profound experience?
“The psychological equivalent to air, is to feel understood” – Stephen R. Covey
Dianne Rapsey-Vanburen, M.A.
WKPIC Doctoral Intern