CHRONIC/SERIOUS MENTAL ILLNESS

Who is this population?

. . . individuals who, through no fault of their own or their families, suffer from one of several diseases affecting the brain, the most complex of human organs. The causes remain unknown, but are probably multiple. There is no cure, but we do have effective treatment. In addition to having a brain disease, people with serious mental illness are (by definition) significantly functionally impaired by the illness for an indefinite period of time (diagnosis, disability, duration). At least 1% of the population are seriously mentally ill. The problems of victims and their families are compounded by stigma, one of the cruelest and most prevalent forms of bigotry that exists.

Symptoms of chronic/serious mental illness:

Acute, "positive" symptoms (at least one of these usually present, at least during an exacerbation of illness):

Residual ("negative") or deficit symptoms (several of these usually present most of the time):

(Rule out depression, demoralization, social breakdown syndrome, medication side effects, or alcohol/drug abuse).

"Normal" reactions to serious illness:

These reactions are common in anyone who realizes they have a serious, chronic (incurable) illness, and may progress through stages (like the mourning process). Some of these characteristics are often present and can be mis-diagnosed as positive or negative symptoms.

Social breakdown syndrome:

This includes loss of normal role functioning and varying degrees of extrusion (or exclusion) from normal family/community functioning. Characteristics are similar to the negative symptoms and also resemble institutionalization syndrome. Social breakdown syndrome can be a side effect of any treatment that removes the client/patient from his/her usual social environment (or excuses him from usual role expectations) (e.g., prolonged hospitalization or too much "overprotection" on the part of clinical staff and/or family members).

Coping and adaptation:

This is the hoped for and very possible outcome of treatment, rehabilitation, family support and self-help.

GENERAL TREATMENT/REHABILITATION CONDITIONS:

IN GENERAL, patients/clients need:

THE BIO-PSYCHO-SOCIAL APPROACH TO TREATMENT AND REHABILITATION:

BIOLOGICAL needs:

PSYCHOLOGICAL needs:

SOCIAL needs:

This handout developed by Charles R. Goldman, M.D. (revised 7/30/98)

 

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