A patients guide to Psychosis and Schizophrenia
SYMPTOMS, TREATMENT AND SUPPORT
Psychosis is used to describe a group of severe mental health disorders which disrupt a person’s perception, thoughts, emotions and behaviour through delusions and hallucinations. The most common form is schizophrenia - over a lifetime, about 1 in 100 people will develop schizophrenia, but it is most likely to start between the ages of 15 and 35 years Professor Mark Baker, Director of the Centre for Clinical Practice at NICE
I don’t trust myself to know the difference between reality and the voices in my head
Can’t find what you’re looking for or need general assistance with any aspect of information or a referral?
Contents
you can contact our central enquiry line on
Who are we?
4
Living with Psychosis or Schizophrenia
6
Symptoms of psychosis
9
0854 467 0120 24 hours Alternatively please email us at: huntercombemarketing@fshc.co.uk
www.huntercombe.com
Edited by Dr Shakeel Ahmed Consultant Psychiatrist (Adults) Dr Maite Ferinn Consultant Psychiatrist (CAMHS)
How do you know if you or your loved one has a psychotic disorder ?
12
Our child and Adolescent Services (CAMHS)
14
Our Adult Mental Health Services
16
Help and Support
18
How to make a referral
19
Anon patient
2
huntercombe.com
huntercombe.com
3
Who are we?
Symptoms of psychosis
At The Huntercombe Group we provide three specialist areas of care: adult mental health, specialist brain injury and CAMHS (including eating disorders). With 55 hospitals and specialist centres across England and Scotland, we work in partnership with the NHS and Local authorities to provide person-centred quality health care services.
Whilst each psychosis type may differ, early identification can greatly improve the outcome for a person who can gain access to the most appropriate treatment for their needs. Often individuals will enter a prodromal period (this is where a persons functioning may deteriorate and often follows a period of illness or distressing life event) prior to more typical symptoms of psychosis.
Our Child and Adolescent Mental Health Services provide assessment and care for children, young people and young adults (aged 11-25 years) with short-term mental distress or diagnosed mental illness. Eating Disorders are also delivered as integral to the CAMHS services. Our five age appropriate hospitals are located in Edinburgh, Stafford, Norwich, Cotswold Spa and Maidenhead. Our Adult Mental Health Services are offered at 26 locations throughout England and Scotland and offer holistic care and treatment to adults with complex mental health conditions and intellectual disability.
Early symptoms can include: • Withdrawing from their usual activities • A loss of interest, energy and motivation • Difficulties with memory and concentration • Problems at school or work • In-appropriate emotional responses to situations • Anxiety (which can be acute)
Teenage years and young adulthood are largely accepted to be the time at which psychosis will begin. Individuals with psychosis should ideally seek help as soon as an issue is identified, this is to ensure that by providing the appropriate treatment quickly and effectively suffering and risk for the individual with these symptoms is minimised. Key for healthcare professionals in treating psychosis is to decrease the duration of un-treated psychosis this is referred to as DUP (untreated psychosis). The shorter the length of time is prior to the patient seeking treatment the better the outcomes and it also minimises the suffering and decline of a person with psychotic symptoms by seeking treatment as promptly as possible. When treating the first episode of psychosis in young people, the treatment team tasked with that persons care will always work to maximise the possibilities of a total recovery so that they can return to their previous lives and levels of functioning.
An individual may also begin acting suspiciously of or begin feeling un-easy around friends and family, and this can be accompanied by confusion between reality and fantasy (so for example wondering if a dream is reality, suggestions that people might be able to read their minds, finding connections between un-related events), unusual perceptual experiences (finding everyday sounds that have word associations or a shadow that forms the shape of a figure) and circumstantial speaking (using an odd combination of words or going off track when speaking) There is also an increased risk of psychosis when combined with substance misuse (especially in young people). These type of substances include: marjunana, amphetamines, LSD and ketamine.
• Problems in dealing with everyday routines • Changes to sleep pattern • Un-usual ideas and behaviours • Feeling they have changed in some way • Deterioration in their hygienic routine (e.g not washing or cleaning their teeth)
4
huntercombe.com
huntercombe.com
5
When a psychotic disorder has advanced, symptoms will become more pronounced and can include: • Thinking or talking without clarity • Hallucinations (hearing voices, smelling, tasting and seeing things that have no source) • Delusions (false beliefs not based in reality so believing their thoughts can be read by others) • Disorganised thinking and behaviour (thinking their speech has speeded up or slowed down) • Disorganised movements • Reduced ability to function normally • Feeling paranoid (like someone is watching them or wishes them harm) • Disordered thought symptoms, where a person will experience unusual thoughts or feelings, which may “alien” or that there thoughts are no longer private
6
huntercombe.com
How do you know if you or your loved one has a psychotic disorder ? In the first instance it is advisable to seek help from your family GP (if you haven’t already) they will refer you to a specialist mental health team who will assess your symptoms to find the most suitable care pathway for you. Evidence supports the need to seek help as soon as an illness is suspected, therefore maximising the best possible outcome for you or your family member.
If your GP suspects a psychiatric condition may be causing your symptoms they will make a referral to a CAMHS mental health team or early intervention crisis team (if they are under 18 years of age) if you are over 18 you will have to ask for help yourself again this would be via your GP who can refer you to adult mental health services. These specialist mental health teams are skilled and experienced in managing mental health conditions and will provide support, treatment and care for your condition.
An assessment will usually consider the following factors:
If at any point you feel there is risk to yourself or others you should seek assistance from the emergency services or go to your nearest A+E and ask for an urgent psychiatric assessment.
• If you are exhibiting positive symptoms (if you are having any hallucinations or delusions)
We understand that, as a parent or guardian of someone with these symptoms it can be upsetting and distressing to involve emergency services, but by doing this it ensures the safety of your child and others.
Dependent on the outcome of your assessment and severity of your symptoms, it may be decided that it is best you are admitted to hospital to receive treatment or assessment, when this happens you are detained under the “Mental Health Act”. ( We have produced a short booklet on the Mental Health Act in the guides to health section of our website). Alternatively individuals may continue receiving support in their home and this is referred to as community mental health services.
• The risk to yourself/others and • Wether or not you will be able to engage with medical/psychological treatment and follow up • How anxious or depressed you may or may not be • If you appear disorganised in your thinking and/or movements • If you are exhibiting any negative symptoms (withdrawal from usual activities, deterioration in cleanliness etc) • They will consider your overall functioning,
• Considering the symptoms and your quality of life • Your social functioning (how you currently interact with your immediate environment and friends/family).
huntercombe.com
7
Our child and Adolescent Services (CAMHS) At The Huntercombe Group we deliver in-patient care for children, young people and young adults who are experiencing mental distress or illness (this includes psychotic disorders). Our CAMHS services are provided on behalf of NHS England who are the national specialist commissioners for all children and young peoples mental health services (including eating disorders).
8
huntercombe.com
Our age-appropriate hospitals are led by experienced, specialist consultant psychiatrists and supported by a team of therapists, nurses and teachers. Our passionate and dedicated teams deliver evidence based care through innovative, progressive and reversible care pathways to enhance and promote recovery for an early return to the young person’s home environment outside of the hospital.
In addition we provide treatment for complex and previously treatment-resistant mental health problems, such as post-traumatic stress disorder (PTSD) and emerging personality disorder. Promoting independence, community integration and continued education in our hospital-based schools, which are also accredited examination centres, enabling young people to continue their studies whilst receiving treatment.
We are active in clinical research and have contributed to an International multi-site research collaboration this research enables us to improve our services and clinical expertise through learning and innovation, ultimately rewarding the patients that access our services.
“At all times in all of our CAMHS services, we aim to ensure that all patients are afforded the opportunity to maintain, promote and enhance their own recovery through empowerment”.
Our services include: General CAMHS Adolescent Service, Psychiatric Intensive Care Service and a Low Secure Service.
You can find out more about our CAMHS by visiting http://huntercombe.com/our-services/camhs
huntercombe.com
9
Our Adult Mental Health Services At The Huntercombe Group we understand the difficulties of living with a long term or recently diagnosed mental health condition. We are able to provide a specialist range of integrated in-patient adult Mental Health and Intellectual Disability services in both healthcare and adult social care settings at various levels of security.
10
huntercombe.com
Our services are delivered in appropriate and safe environments with specialist clinical teams who have extensive expertise in their field, combined with compassion to support the patient along their care pathway, ensuring that where appropriate the patient is at the centre of their own care. We work collaboratively and in partnership with commissioners and case managers and also patients and their families where our priority is to provide the very best holistic and most appropriate care via our team of clinical specialists.
We offer; forensic mental health service, women and men’s mental health services, psychiatric intensive care service and assessment and diagnostic service. You can find out more about these services by visiting our website www.huntercombe. com/our-services/adult-mental-health-andintellectual-disabilities/services
huntercombe.com
11
Help and Support
How to make a referral
Young Minds: www.youngminds.org.uk Young Minds is the UK’s charity committed to improving the emotional wellbeing and mental health of children and young people.
A referral can be made by contacting the relevant hospital directly on the contact details listed alongside. This is usually done via your mental health team. Referrals for inpatient treatment will only be accepted from the consultant or designated team member from the patient’s local NHS, CAMHS or CMHT, or from another inpatient service where the referral is supported by the local NHS team and commissioners.
Mind: www.mind.org.uk Mental Health charity which provides information and support NHS Choices: www.nhs.uk/Conditions/Psychosis/Pages/Treatment.aspx The national patients NHS website Rethink Mental Illness: www.rethink.org national mental health charity offers useful information and support Mental Health Foundation: www.mentalhealth.org.uk national mental health charity and think tank offers useful information and support. Royal College of Psychiatrists: www.rcpsych.ac.uk College of Psychiatrist professionals, with helpful advice and information for parents and patients.
12
huntercombe.com
Our consultant psychiatrist or associate specialist at the hospital where your referral has been made, will discuss the case with the referrer by telephone the same day to agree an immediate action plan. This may sometimes involve a planned admission within the next few days (based on the local team’s prior assessment, and discussion with us) or an assessment with our team. Patients who are physically or psychologically unsafe to remain in the community can be admitted within 24 working hours this will be discussed between referrer and the hospital admissions office,
huntercombe.com
13
The Huntercombe Group Tulip House, Craven Court Willie Snaith Road, Newmarket Suffolk CB8 7FA
@HuntercombeTHG
Telephone: 0845 467 0120
The Huntercombe Group
Website: www.huntercombe.com
www.linkedin.com/company/the-huntercombe-group
www.facebook.com/TheHuntercombeGroup www.youtube.com/user/Thehuntercombegroup
Telephone:
0845 467 0120 Website:
www.huntercombe.com The Huntercombe Group is part of Four Seasons Healthcare one of the largest healthcare operators in Europe.