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Up to thirty per cent of night shelter residents have experienced schizophrenia, a disease that leads to a significant death rate in this setting. In the acute (short-lived) states of schizophrenia, sufferers complain of bizarre beliefs and experiences such as:
Sometimes sufferers have an odd way of speaking that makes it hard to have a normal conversation with them.
Chronic (long term) schizophrenia presents differently, and often sufferers do not come to the immediate attention of welfare staff. A typical sufferer may be sitting quietly, withdrawn, apathetic, monosyllabic, with minimal emotional responsiveness, little drive, and showing little enjoyment in life. These are the so-called 'negative' symptoms of schizophrenia, which are the cause of much social disability. Schizophrenia and alcoholism may occur together, making treatment more difficult.
With the client's agreement, urgently contact medical and/or psychiatric services. Tell them they need to keep in contact with these services for treatment and medication. Remain friendly, and facilitate stable accommodation, ideally with a supportive work environment. Provide advice about schizophrenia treatment, perhaps via the Schizophrenia Fellowship, or general psychiatric services (see Table 4 and Table 6).
Twenty-five per cent of schizophrenic persons who experience an acute psychosis remain well, but will require up to two years of medication before antipsychotic drugs can be safely withdrawn. The remaining seventy-five per cent will suffer from recurrent psychosis. Of these people, half will develop chronic illness.