Moving beyond “one-size-fits-all”
When it comes to caring for people with schizophrenia—a persistent and often disabling mental illness that affects how a person thinks, feels, and
behaves—healthcare providers constantly strive to strike a delicate balance. We aim to provide effective care while also being mindful of our patients’ overall well-being, including family and social support, therapy, and treatment that’s both efficacious and tolerable. As a board-certified psychiatric nurse practitioner, I’ve seen many patients living with this neurological condition. What I know from my experience is that people living with schizophrenia deserve a comprehensive, compassionate approach that addresses the full scope of their needs.
Schizophrenia affects 2.8 million people in the United States. Symptoms can include hallucinations, delusions, difficulty enjoying life, social withdrawal, and deficits in memory, concentration and decision-making. Signs of the condition typically appear in teenage years or early adulthood and present differently in each person.
Without adequate treatment and comprehensive care, individuals living with schizophrenia often struggle to maintain employment, live independently, and manage relationships. People living with schizophrenia also often face the stigma that their diagnosis means putting aside personal and professional aspirations.
Due to its heterogeneous nature, schizophrenia isn’t a one-size-fits-all condition, and people often find themselves in a cycle of discontinuing and switching therapies. In fact, adults living with schizophrenia have the lowest rates of adherence to medication as compared to other psychiatric conditions per a systematic review and meta-analysis. In my experience, some people discontinue treatment without informing their provider, who may not see them again until the patient relapses or is hospitalized.
Comorbidities and secondary conditions can place additional burdens on patients with schizophrenia. In some cases, these comorbidities can be caused by their schizophrenia medications, which can make finding the right treatment option more challenging.
There are people living with schizophrenia who are actively telling us what they need, for example through social media. Channels like Instagram and YouTube are useful tools when it comes to addressing schizophrenia. Digital platforms have helped lift up the voices of people living with this condition, enabling them to share their stories in their own words. This provides important context, which can help destigmatize this complex condition. Those with lived experience are sharing information that enables providers to be more informed and effective.
With the right support and comprehensive care—including therapy, family and peer support, a medication management plan, and community resources—many people with schizophrenia can work, pursue education, build relationships, and lead meaningful and fulfilling lives. As providers, we play a crucial role in helping patients and their families navigate the balance of comprehensive care that supports their journey toward better outcomes. It’s essential for individuals with schizophrenia to know their ambitions aren’t only valid, but achievable.
There are a number of different schizophrenia treatment options for clinicians and patients to consider when managing schizophrenia. The best approach to care is one that takes into account what treatment best suits an individual patient’s needs, rather than a one-size-fits-all approach.
For most patients, schizophrenia is something that must be managed for a lifetime. That means that our treatment goals need to be both realistic and effective for our patients, striving for the best possible outcomes. We have more tools at our disposal than ever before. Healthcare providers owe it to our patients, and ourselves, to use them.
Reference
Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: a systematic review and meta-analysis. Syst Rev. 2020;9(1):17. doi:10.1186/s13643-020-1274-3.
Desiree Matthews is a board-certified psychiatric nurse practitioner and founder/owner of Charlotte, North Carolina–based Different MHP, a telepsychiatry practice, which provides affordable, accessible, precision-focused, integrative psychiatry services. Matthews earned her Master of Science in Nursing with a Psychiatric Mental Health Nurse Practitioner specialization at Stony Brook University in Stony Brook, New York.
