Chapter 15 - ‘Psychotic’ Disorders

Summary

Three groups of severe mental illness have disproportionately high rates of suicide – Schizophrenia, bipolar disorder, and anorexia nervosa – but effective treatment can save lives. Despite more positive conversations about mental health, we often avoid the very mention of schizophrenia and psychotic disorders. It is impossible and unsafe to support a seriously mentally ill person unaided. Clinicians and lay carers need to be part of a mutually supportive network. Integrating care involves a series of permissions - preferably arranged in advance – to communicate with confidentiality, privacy and dignity. Effective treatment of acute psychoses involves thoughtful prescribing and monitoring of medication. It is understandable to feel angry and sad about having an illness that interrupts life and education. There are effective treatments even for the most severe mental illnesses that affect young students. However, it takes far longer to see recovery than with most physical conditions. Policies on admissions, fitness to study and time taken out of studies need to take account of this. Students usually need care to be transferred to the location of the family home and later back again. NHS teams may be able to use telemedicine to communicate with a distant University.