Family and friends of a person with schizophrenia often do their best to support their loved one initially, but over time, may find themselves frustrated by the what seems like a lack of progress while the person is in treatment or even their inability to even continue treatment. A family’s emotional support may wane, and some families will feel the need to terminate communication with their schizophrenic loved one.

It may be difficult to maintain a friendship with a schizophrenic person, as well, due to friends feeling helpless and unable to really understand the situation. The friendship may drift apart when the schizophrenic person experiences delusions or hallucinations; the friend may feel ill-equipped to handle it. The schizophrenic person may also drop out of treatment, which can also leave a friend unsure as to what to do. While friends and family want the best for their loved one, the most common challenge for them is not really knowing how to help – or offer sustained support – to their loved one who suffers from schizophrenia. With continuous, long-term support a person with schizophrenia may be less inclined to become homeless or unemployed.

Support options can be varied. Not only can family and friends be potential sources for encouragement for a schizophrenic person, but also shelter operators, roommates, case managers, residential or day program providers, and churches. While many patients reside with their families, it is not always the case that families are the primary support system for those with schizophrenia.

There are a number of instances in which people with schizophrenia may need help from people in their family or community. Often, a person with schizophrenia will refuse to go to treatment, believing they do not require psychiatric help and their that delusions or hallucinations are real. At times, family or friends may need to take an active role in having them evaluated by a professional.

Civil rights may be an obstacle for those trying to get help for their loved one with schizophrenia. Strict laws protecting patients from involuntary commitment may prevent families from getting a severely mentally ill loved one the help they need, which can be frustrating for all involved in seeking treatment. These laws vary from state to state; generally, when people are dangerous to themselves or others due to a mental disorder, the police can assist in getting them an emergency psychiatric evaluation and even hospitalization, if needed. In some situations, staff from a local community mental health center can evaluate an individual’s illness at home if he or she will not voluntarily go in for treatment.

6 Tips to Help Family Members and Friends of a Schizophrenic Person

1. Stick by and advocate for the person with schizophrenia.

Encourage the schizophrenic person to choose a person (e.g., their partner, a friend, or another family member) who will continue to support them for as long as they need it. Having someone they trust that will stick by them in difficult times is very important. When a person with schizophrenia is unwell, they may turn against people with whom they are normally close. Family members or friends can also validate any behaviors that the schizophrenic person may not address during an examination. It is important that family and friends can relay their observations to the person evaluating the patient so all relevant information can be considered.

2. Ensure treatment is being followed, particularly following release from inpatient care.

It’s important to stay connected and follow up with a person who continues treatment after hospitalization. If the patient stops taking their medications or neglects to continue follow-up treatment, psychotic symptoms may return.

3. Be there for emotional support as treatment continues.

Encouraging the person to continue treatment and supporting them through treatment can help them stay on the right track, with greater chance for recovery. Some people with schizophrenia become so psychotic and disorganized when they are not getting treatment, that they cannot care for their basic needs, such as food, clothing and shelter. It is common for people with severe mental illnesses such as schizophrenia to find themselves on the streets or in jails, where the necessary treatment is not available.

4. Respond accordingly to bizarre statements or beliefs.

It can be challenging to navigate a conversation with a schizophrenic person who is making statements that are strange or false. Someone with schizophrenia truly believes their bizarre thoughts or hallucinations – they appear to be real to the person, not just “imagined fantasies.” Rather than agreeing with the person’s delusions, family members or friends can convey to the person that they do not agree with what they are seeing and saying, but they can still acknowledge that the patient has his or her point of view, rather than challenge the person’s beliefs or delusions. It would be futile to try to change the person’s mind or convince them otherwise, since these delusions are very real to the person who experiences them. It is more appropriate to gently direct conversation to areas or topics that can be agreed upon by both parties.

5. Log symptoms.

Keeping a record of symptoms that have appeared, as well as medication usage (including dosage), and the effects various treatments have had on the person can be very helpful. Understanding what symptoms were present previously, family members may have a better understanding as to what to look for in the future. Families may even be able to identify some “early warning signs” of potential relapses. As a result, if psychosis returns, it may be detected early and immediate treatment may help to prevent a full-blown relapse. Also, by chronicling which medications helped and which did not in the past, the most suitable treatment options may be discovered quicker.

6. Assist the person set attainable goals in his or her life.

Family and friends can support the person with schizophrenia in regaining his or her abilities. In addressing goals for the person, it is important to be mindful in keeping the goals within reach; a patient who feels pressure or is criticized will more than likely feel stress, which could lead to a worsening of symptoms. Like anyone else, people with schizophrenia need to know when they are doing things right. A positive approach may be more effective in the long run over criticism. This advice applies to everyone who interacts with the person.

» Back to the beginning of the Series:Introduction to Schizophrenia

Based upon material from the National Institute of Mental Health.