It can be very distressing to realize that someone close to you
is experiencing psychosis. You may feel shocked, confused, bewildered
and guilty. There is no right or wrong way to feel.
Families, partners or friends find it hard to take the first step
to obtain help for many reasons. They may be unsure what the problem
is. The person experiencing a psychotic episode may not wish to
get help or even acknowledge that they are unwell. It can be extremely
difficult to cope with a person who is in a psychotic state.
The person may need help to find out exactly what is happening
and what type of treatment is required. Help is also needed for
families, partners and friends so they can understand what is going
on and find out how to be involved in the assessment, treatment
and recovery process.
Often the first step is to visit the family physician who can then
refer to more specialized professionals such as psychiatrists, mental
health centers, or programs that specialize in early psychosis.
should a referral to a doctor or mental health professional be considered?
A referral to EPI is a good idea if some of these signs are present:
- a definite change in normal personality, which lasts weeks or
- a change in speech, either speeded up or very slow, and hard
to follow (makes no sense)
- the individual appears suspicious, guarded and fearful
- a severe change in sleep pattern
- an inability to function at his/her normal level (eg. can't
perform at school or work, neglects hygiene or personal affairs)
- a preoccupation with unusual ideas (eg. thinks he/she hears
God's voice or believes the TV is talking to him)
to make a referral
Initial contact is made by telephone to the EPI Intake Clinician
who will assess the situation and provide supportive counselling,
education and outreach. The information obtained by the Intake Clinician
helps to determine whether the referral fits into the EPI Program
and what other services may be needed.
Family, partners and friends are very important in the process
of recovery. When a person is recovering from their psychotic episode
you can provide love, stability, understanding and reassurance.
Checking on safety (suicide
risk, poor judgment)
Always take talk of suicide or self-harm seriously. It is important
to stay calm. Be there to listen to the person's concerns,
show them that you love and care for them, see about reducing any
stressors that may be adding to their depression, notify your mental
health professional if the ideas persist and above all, stay positive.
agreement for help
Give hope. Assure the person that help is available and that things
can get better. Point out that seeking help is a sign of strength
rather than a sign of weakness or failure.
Most of the time the person will feel relieved that there is help
available. Sometimes, however, getting the person to agree to seek
help involves overcoming such things as the person's inability
to see that something is wrong, their fear of appearing strange
or abnormal, or of dealing with the stigma associated with mental
Prepare the person for what they might expect. Tell them what you
know about what help is available and reassure them that your decision
to seek help is based on your best judgement. Tell them in clear
and calm terms, what you have noticed that makes you concerned.
Reassure them that you will support them throughout. Be patient
and persistent. Mental illness is treatable.
In an emergency or life-threatening situation, you must ensure
that the individual gets professional help immediately. This may
be done by accompanying the individual to the appropriate service
or by utilizing emergency resources such as your local hospital
emergency department or crisis program.
to cope as a caregiver or friend
It is important to be yourself and to understand that psychotic
symptoms are stressful for everyone. You may have a range of feelings
- shock, fear, sadness, anger, frustration or despair.
Mental illness is not usually short term, and can continue for
months or several years. Be prepared for setbacks, as recovery may
not come quickly.
Remember that families, partners and friends also need a period
of recovery and time to understand and accept what has happened.
Don't keep things a secret. Talking with others, whether they
be family members, friends or professionals, can be very helpful.
Stay positive. With proper treatment, most people make a successful
recovery from a first episode of psychosis.