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Stigma: Part 2. How does stigma about schizophrenia affect people?

“When stigma is present, any individual belonging to a particular category, such as schizophrenia, is assumed to possess all of th enegative stereotypes associated with that category and is therfore feared, disliked, or avoided. (Mueser, K. and Gingerich, S. 2006, p. 431)

 

Stigma can be caused by people’s exposure to biased information. For example, though the number of people with schizophrenia who are violent is quite low, only slightly higher than the general population, there is an idea among the general public that most people with schizophrenia are extremely violent. This is in large part due to the disproportionate amount of news coverage and media (movies, etc.) stories of people with schizophrenia who are violent. There seems to be a tendency for people to try to distance themselves from frightening experiences, like “He was a heavy smoker, that’s why he got lung cancer. I’m different, I don’t smoke, so that won’t happen to me.” In relation to schizophrenia, they might think, “She has schizophrenia, no wonder she freaked out and attacked four cops. I don’t have schizophrenia, so that would never happen to me.” People cling to this difference, despite the real fact that many more people without schizophrenia are violent against police than people with the disorder.

 

The effects of stigma are profound, ranging from people refusing to hire someone or rent an apartment to a person with mental illness to people just plain avoiding them out of misplaced fear. Neighbors fight against a proposal to open a group home or halfway house in their area, people call the police on peaceful, well-behaving strangers, and news reports frequently equate mental illness with crime. Schizophrenia has some of the worst stigma of all the mental illnesses. An additional issue is self-stigma, in which a person incorporates stigmatized beliefs that they then apply to themselves. Self-stigma can result in a person’s refusal “to acknowledge having schizophrenia because he feels that to accept the label would be tantamount to admitting he is crazy, worthless, or has nothing to contribute to society” (Mueser, K. and Gingerich, S. 2006, p. 432) or in feelings of hopelessness and grief and giving up on goals and resigning themselves to a lesser life than they could achieve.

 

The tragedies of stigma include the decrease in the quality of life of people with schizphrenia and the loss of some of the wonderful things people with schizophrenia can bring to the world. I personally have had clients who came in intially dejected, self-hating, and passive, thinking they were the lowest of the low and couldn’t’ do anything. Many of them have since started working, building friendships and hobbies, and bringing joy to their families with their kindness. As I mentioned in the previous blog post, the news and movies discard this type of story as one that won’t sell, one that’s not worth mentioning. However, I feel it’s the most important type of story worth mentioning regarding people with schizophrenia, as it gives them hope and gives the rest of us the knowledge that these people matter and bring a lot of good to the world.

 

In the next part of this series of blog posts, we’ll take a look at what you and your family and friends can do in the battle to fight stigma.

 

 

Citations:

 

Mueser, K. and Gingerich, S. (2006). The Complete Family Guide to Schizophrenia

Stigma: Part 1. We finally see a heroic main character with psychosis in a video game!

 

As the people who have been in my therapy groups will know, I am a video game player. So I was interested when one of my group members told me about a video game called Hellblade: Senua’s Sacrifice, a game in which the main character is portrayed as having psychosis, including hearing voices, seeing visions, having paranoia, and flashbacks. Intrigued, I read several reviews about how the game’s portrayal of psychosis was handled. (e.g. Distance, Critical, “Perspectives Differ on How ‘Hellblade’ Handles Mental Illness”, waypoint.vice.com; Lacina, Dia, “What Hellblade: Senua’s Sacrifice Gets Wrong About Mental Illness”, polygon.com; Lloyd, James, “How Hellblade: Senua’s Sacrifice Deals with Psychosis”, sciencefocus.com). Not surprisingly, the reactions were mixed, with some people praising the game’s sensitivity and insightfulness and others finding the portrayal invalidating and hollow. However, the fact is, it’s rare to see a character with psychosis being a nuanced character who isn’t evil or pathetic. It’s even more rare to find a positive main character with psychosis, be it a movie, book, or video game. I can come up with a handful—the movie “The Soloist,” the movie “A Beautiful Mind,” and now, this video game. (An argument could also be made for “Benny and Joon,” and I’m sure there are some newer ones I’m missing, but you get the idea.) I’m not saying that these are realistic characters, or that they’re handled perfectly, I’m noting that the idea of treating a main character with psychosis as a real person, who is neither a villain nor a pathetic object of pity, is a relatively rare one. I’m encouraged by this development, while at the same time still disappointed by the flaws in portrayals of characters with psychosis and by the slow progress of awareness/understanding of these symptoms. The primary reason for this appears to be stigma against mental illness, especially against people with psychotic symptoms.Stigma. “People with schizophrenia and their families have to live with an extraordinary amount of stigma. Schizophrenia is the modern-day equivalent of leprosy, and in the general population the level of ignorance about schizophrenia is appalling.” (Torrey, 2013, p. 356) Serious mental illness is often seen as worse than physical or intellectual disabilities, and, more dishearteningly, the fault of the person with the illness. (Corrigan and Lundin, 2001, p. 15) Stigmas are stereotypes, and with mental illness, they almost always affect the people with the illness in a negative way. Researchers have found three broad categories of stigma against people with mental illness: that they are dangerous and should be kept out of our communities; that they are irresponsible and others should make decisions for them; and that they are incompetent and need to be cared for as if they were children. (Corrigan and Lundin, 2001, p. 20) I would add, that in the media, both news and entertainment, there is an erasure of positive, realistic portrayals of people with psychosis. The vast majority of people with psychosis that are covered in the news or portrayed in movie/book/video game stories are negative. I joke with my clients sometimes about how the news would never air a story like, “Local woman takes her meds, symptoms are stable, enjoys her job, going to her grandchildren’s sports events, and playing the piano.” These are many of the people with a psychotic disorder, but for the layperson, people with psychosis are all scary or incompetent. Fortunately, as the video game discussed above shows, the public is slowly starting to be aware of people with psychosis in a more realistic way. Flawed, sure, like any person, but not a one-dimensional caricature.
This series of blog posts aims to 1. take a close look at stigma and how it affects those with schizophrenia, their families, and the public at large, 2. Study how stigma hurts society, and 3. Examine how all of us can fight stigma and move forward in the progression of understanding and helping people with psychosis have enjoyable lives and bring as much positivity to the world as they can. We are early on in the journey, but when it occurs to large video game companies to try to present a hero with psychosis as the main character in the game, this gives me heart. We are moving forward.

Citations:
https://waypoint.vice.com/en_us/article/433kjj/perspectives-differ-on-how-hellblade-handles-mental-illness

https://www.polygon.com/2017/9/15/16316014/hellblade-senuas-sacrifice-mental-illness

https://www.sciencefocus.com/the-human-body/how-hellblade-senuas-sacrifice-deals-with-psychosis/

Corrigan, Patrick, and Lundin, Robert. (2001). Don’t Call Me Nuts! Coping with the Stigma of Mental Illness. Champaign, Illinois. Abana Press.

Torrey, E. Fuller. (2013). Surviving Schizophrenia: a Family Manual. New York. HarperCollins Publishers.

The Science Museum of Minnesota Now Has a Mental Health Exhibit!

https://www.smm.org/mindmatters

 

The Science Museum in St. Paul, Minnesota, in having this traveling exhibit show through January 2019, is aiming to #MakeItOk to talk about mental health. Mental health is often seen as an unimportant or “taboo” topic, something that should be avoided entirely. This has led to understandable but significant ignorance among people about what mental health and mental illness is, the effectiveness of treatment, and most importantly for people with schizophrenia-spectrum disorders, how “normal” people with these illnesses often are.

 

I attended the exhibit recently, and was very impressed by it. The most common mental health disorders all have displays, including schizophrenia. The information presented was clear, comprehensive, and understandable to people with any level of education or experience with mental illness. The exhibit does not shy away from the history of many of our horrific ways of treating mental illness, and highlights current treatments and how consumers experience them. There are also interactive exhibits, like the one where you can try to do some math puzzles while speakers play taunting voices from several different directions, mimicking the experience of hearing voices. Other exhibits involve a warped mirror to help one experience Body Dysmorphic Disorder (having an unrealistically negative view of one’s body) and writing down one’s worries and shredding them. I especially liked the booths running videos of interviews with people with various mental health disorders. The people in the videos talked about their experiences with their symptoms before they got treatment, how those symptoms changed after getting treatment, and about their lives since treatment, in general and about how they’re coping. These videos presented the interviewees as regular people, not as “mental patients,” and showed the real human side of people struggling with and managing mental illness.

 

I’ve had some clients attend this exhibit, and heard positive things from them as well. They found it was accurate, easy to comprehend, and most importantly, treated people with mental illness with dignity and respect. In addition, in order to encourage lower-income people to attend, the Science Museum offers a reduced-price ($3.00) admission ticket if one can present evidence of being lower-income (GA/MA/EBT/SSI/SSDI card). I would highly recommend this exhibit to anyone. I hope it continues to travel around the U.S., exhibits like these are so beneficial. Check it out!

Ways to Learn More About Schizophrenia

girl-3195810_1920Once someone hears the word “schizophrenia” from a doctor as a possible diagnosis, they and/or their family often want to learn as much as possible about the illness. Which is wise, since there is significant misinformation and misunderstanding of schizophrenia. Over the years, I’ve compiled a list of various ways you can learn more.

General Resources:

https://www.helpguide.org/home-pages/schizophrenia.htm Offers some very specific advice not always found in other guides.

https://www.livingwithschizophreniauk.org/modern-treatments/ A very comprehensive guide, addresses all the typical information plus issues like debt, depression, and mental health care for people who are caregivers of a person with schizophrenia.

http://www.schizophrenia.ca/learn_more_about_schizophrenia.php

http://www.bcss.org/wp-content/uploads/2008/02/basic-facts-141.pdf  A helpful online booklet about schizophrenia in printable form.

https://www.nimh.nih.gov/health/publications/schizophrenia-booklet/index.shtml Another helpful online booklet, has a PDF you can download.

http://www.schizophrenia.com/family/perstory5.htm Personal stories by family members about what they saw happening to their loved one as they began to develop schizophrenia and what they recommend if you think you or one of your loved ones may be developing the illness.

www.nami.org

www.namihelps.org

  • Free information: NAMI has brochures and fact sheets on the illnesses, adult mental health system, data practices laws, dealing – with a crisis and understanding the criminal justice system.
  • Classes:  NAMI has classes and programs that may be of interest to the families of your clients. Hope for Recovery, Family-to-Family, and Children’s Challenging Behaviors.
  • Support Groups: NAMI has support groups for families and for persons living with a mental illness.
  • Help Line: NAMI provides information on locating resources and navigating the mental health system.
  • Educational Conferences: NAMI hosts educational conferences with great speakers and information for providers, families and persons with a mental illness.
    • Special Topics: NAMI holds workshops on retaining custody when seeking residential services for a child, Evidence-Based Practices (EBP), and dealing with a crisis.

Hope For Recovery Workshops (held Saturdays from 9:00 to 3:00 unless noted; call NAMI-MN, 651-645-2948.)

 

Resources for Families:

Forums for family members of people with schizophrenia to talk to each other about how to help their loved ones or get support and advice

http://forum.schizophrenia.com/category/family

https://www.facebook.com/groups/friendsfamilyschizophrenia/

http://www.healthcentral.com/schizophrenia/c/120/158043/forum-helping/

http://www.supportingfamilies.org.nz/resources/mental-health-info/schizophrenia.aspx

 

Blogs written by people with schizophrenia disorders

Vlogs on YouTube by people with schizophrenia disorders

  • Rachel Withers

 

Resources for people with schizophrenia:

Forums where people with schizophrenia talk to each other online

 

Books about Schizophrenia:

The Complete Family Guide to Schizophrenia: Helping Your Loved One Get the Most Out of Life, by Kim T. Mueser, PhD and Susan Gingerich, MSW, 2006, The Guilford Press—a very thorough, practical, and easy-to-read guide, highly recommended

I Am Not Sick, I Don’t Need Help! Helping the Seriously Mentally Ill Accept Treatment: A practical guide for families and therapists, by Xavier Amador, 2011, Vida Press

Surviving Schizophrenia: A Manual for Families, Patients, and Providers, by E. Fuller Torrey, M.D., 5th edition copyright 2006, HarperCollins Publishers–an excellent resource, covers the nature, causes, symptoms, and treatment of schizophrenia, as well as how people and their families survive this illness

Diagnosis Schizophrenia: A Comprehensive Resource, by Rachel Miller and Susan E. Mason, 2002 Columbia University Press–a great resource, includes many first-person accounts by people with schizophrenia, as well as chapters by professionals on a wide range of issues from hospitalization to rehabilitation

The Everything Health Guide to Schizophrenia, by Dean Haycock, 2009, Adams Media–an excellent resource with straightforward and easy to understand explanations

The Center Cannot Hold: My Journey Through Madness, by Elyn R. Saks, 2007, Hyperion Books–an excellent memoir about living with schizophrenia

 

National Resources for Schizophrenia/Mental Illness:

American Psychiatric Association

1000 Wilson Blvd, Suite 1825

Arlington, VA  22209

703-907-7300

www.HealthyMinds.org

 

Mental Health America (formerly NMHA)

2000 N.  Beauregard St.

6th Floor

Alexandria, VA  22311

1-800-969-NMHA (6642)

www.nmha.org

 

National Alliance for Research on Schizophrenia and Depression (NARSAD)

60 Cutter Mill Road, suite 404

Great Neck, NY  11021

516-829-0091

www.narsad.org

 

National Institute of Mental Health (NIMH)

Public Information Branch

6001 Executive Boulevard, Room 8184, MSC 9663

Bethesda, MD  20892

www.nimh.nih.org

Early Psychosis: Learning to Recognize Psychosis Early On and What to Do About It

For schizophrenia, symptoms like psychosis can often start in the mid-to-late teen years. Sometimes no one realizes that the person is having psychosis, which means they don’t get treatment as quickly.

For several years now, one focus in schizophrenia research and treatment has been identifying and treating people with psychosis (and possibly schizophrenia) early on in the course of their illness. It is thought that, in general, the earlier a person gets treatment, the better they will do overall. (JAMA. 2013;310(7):689-690. doi:10.1001/jama.2013.8804)

There are a lot of signs that sometimes point to someone starting to have psychosis, including sudden drop in school or work performance, trouble concentrating, not trusting others all of a sudden, not taking care of appearance or hygiene like they used to, having strong, inappropriate emotions or no emotions at all, and spending way more time alone than is typical for the person. However, these signs can also just be signs of typical teen/young adult behavior, or signs of other issues (other mental illness, drug and alcohol abuse), so it’s critical to get the opinion of a professional, preferably a mental health professional with some experience with people with psychosis.

Recently, the National Alliance on Mental Illness (NAMI), a nationwide non-profit organization, posted a thorough article on how to identify psychosis early on, what it is, what you can do, helping people with psychosis get the help they need, and working with school staff to work with the person with early psychosis. They include how to recognize early signs of psychosis, different treatments, therapies, resources, and support programs for people with the psychosis and for their families.

Sometimes, a person who’s beginning to have psychosis may not understand that they have psychosis, or may not want to get help. Here is a helpful tip sheet posted in the NAMI article above that addresses ways to engage a person in treatment and things to avoid.

For information about your local NAMI chapter, look on their national webpage for a search window based on what state you live in (halfway down the page, on the left), or call their national hotline at 800-950-6264.

Here in Minnesota, there is a Youth Psychosis program at the University of Minnesota, which provides consultation with psychiatrists about medications, therapy, school consultations, and education with the family of the person with psychosis. For questions or to set up an appointment, call 612.273.8710.

The group I run, called Living with Schizophrenia, can accept people new to the disorder as well, but the focus is not specifically on early psychosis, but rather on skills and support for people at any stage of the illness. However, I do have a packet of information about schizophrenia and related illnesses as well as about how to access available resources in the Twin Cities. Contact me for a copy of the packet if you’d like one.

Schizophrenia and seasonal depression: more than just the winter blues

January can be a tough month, especially in Minnesota. It’s often brutally cold, the days are short, and holidays are over. As I mentioned in a previous blog, the experience of depression is people with schizophenia can be overlooked. For some people, lack of sunlight during the depths of winter hit especially hard.

If you notice yourself feeling down, sleepy, unmotivated, and sluggish during the months with the shortest days of the year, you may want to look into asking your doctor about what to do. Remember, with seasonal symptoms, help may come in the form of a lightbox or other treatments rather than just more medications. As always, talk to your doctor if you have concerns. See this article for more.

Resources 2

Several weeks ago I posted about urgent mental health resources for people with schizophrenia and related disorders. This post is a follow-up, a post about less urgent, more long-term resources. Please note some of these resources may not be available for those who live outside of Minnesota. Also, while I have tried to make sure all this information is updated and accurate, sometimes things change without my knowledge, please let me know if there are any errors in this list.

Getting yourself or your loved one the right treatment as soon as possible will minimize the illness’s impact. However, because of the nature of the illness, some people with schizophrenia don’t believe they have a problem and resist the treatment they need. The book “I Am Not Sick, I Don’t Need Help” by Xavier Amador gives some very useful advice on this subject.

In this second list is information about therapists, CADI waivers, home health nurses, ARMHS workers, and Community Support Programs. Look in the coming weeks for part 3, which addresses housing, foster care providers, PCAs, and job training.

Therapists:

Many people with a schizophrenia disorder can benefit from some sort of talk therapy. They often do best in a large clinic with clinicians who are experienced with their specific issues; I specialize in working with people with psychotic disorders and do individual, family, and group therapy at Psych Recovery in St. Paul. Here is a list of clinics that commonly provide services to people with schizophrenia:

CADI waivers:

Community Alternatives for Disabled Individuals (CADI) Waivers are a separate program that offers funding for home and community-based services with the goal of keeping people with serious mental illness out of the hospital or other institutions. More information can be found here and here. If possible, you want to get a case manager/social worker to help you with this application, but if none is available, the client can fill out the application here. For a list of county offices that may be able to assist you, call 1‑866‑333‑2466.

Home health nurses:

Home health care nurses are nurses who come to the client’s home and set up their medications in a weekly pill container. The nurse can also assess the client’s physical and mental health. These home health nurses can be requested by physicians (in order to get covered by insurance) or a case manager. Another way to get a home health nurse is to request a waivered program assessment from the county. There are several programs that the consumer may be able to access and the county is required to complete an assessment if one is requested. The waiver programs offer financial programs for in-home services to help individuals with mental or physical disabilities continue to live in their homes. To request a waiver program, call the county at the number listed in the case manager section. Finally, a person can call a home health nursing agency (e.g. Abbey Health Care, Aspen Medical, Dakota Valley) themselves and ask for an assessment as well.

Adult Rehabilitative Mental Health Services (ARMHS) workers:

If a client has Medical Assistance, they may qualify for an ARMHS worker. A case manager can make the referral, or the client can call to an agency that offers ARMHS services. The referring agency will do an intake and assess the need and do a treatment plan. Usually issues that allow an ARMHS worker to assist is with paperwork, budgeting, maintaining an apartment, and other independent living skills. For a list of ARMHS providers by county, see here.

Community Support Programs

These are programs offering various resources like case management, housing assistance, and drop-in centers. Drop-in centers-these are like clubs for people with mental illnesses, they are places where people can go where people won’t judge them, there are many recreational activities and social opportunities available through these centers. The following is a list of drop-in centers, listed by county.

Anoka County

  • Bridgeview CSP at 7920 University Ave. NE Fridley, MN 55432 call 763-783-7440 (free transportation available)

Carver County

Dakota County

  • Guild CSP at 130 South Wabasha Street, Suite 90,St. Paul, MN 55107, call 651- 291-0067
  • Horizons CSP at 3450 O’Leary Lane, Eagan, 55123, call 651-395-5783

Ramsey County

  • Resource CSP at 651 University Ave. W., St. Paul, 55104, call 612-752-8670

Hennepin County

  • Charaka CSP at 7888 12th Avenue South, Bloomington, 55425, call 612-752-8350
  • Lighthouse CSP at 1825 Chicago Ave. S, Minneapolis, 55404, call 612-752-8200
  • Northside CSP at 1309 Girard Ave. N, Minneapolis, 55411, call 612-521-2116
  • Plymouth Drop-In at 1900 Nicollet Ave., Minneapolis, MN 55403 call 612-977-1282
  • Northwest CSP at 7000 57th Avenue North, Suite 100, in Crystal, call 612-752-8300
  • Seward CSP at 2105 Minnehaha Ave., Minneapolis, 55404, call 612-333-0331
  • Vail Place-Hopkins at 809 Mainstreet, Hopkins, 55343, call 952-938-9622
  • Vail Place-Minneapolis at 1412 W. 36th St., Minneapolis, 55408, call 612-824-8061

Scott County

  • Anchor Center at 742 Canterbury Road S., Shakopee, 55430, call Cindy at 952-496-8541

Resources: How to Get What You Need for Recovery

There are a variety of resources available to people with a schizophrenia / schizoaffective disorder, but I have found that people are often not given much guidance as to what these resources are or how to access them. Often people tell me that they don’t even know what they or their family member will need. So I have compiled a brief summary of some of the more important resources for recovery. Please note some of these resources may not be available for those who live outside of Minnesota. Also, while I have tried to make sure all this information is updated and accurate, sometimes things change without my knowledge, please let me know if there are any errors in this list.

Getting yourself or your loved one the right treatment as soon as possible will minimize the illness’s impact. However, because of the nature of the illness, some people with schizophrenia don’t believe they have a problem and resist the treatment they need. The book “I Am Not Sick, I Don’t Need Help” by Xavier Amador gives some very useful advice on this subject.

Due to the list being so long, I have separated it into two parts. This first part lists more urgent needs, the second part will address resources a person will benefit from over the long term.

In this first list is information about psychiatrists, NAMI, Social Security Disability, medical insurance, mental health case managers, and crisis resources.

Psychiatrists: The vast majority of people with a schizophrenia disorder do much better on antipsychotic medications. Your family member will need to get connected with a psychiatrist for these medications. Keep in mind that there is a shortage of psychiatrists, so there may be long waits to get in to see one. If your family member is in crisis, take them to the ER. Sometimes family practice doctors will be willing to prescribe antipsychotic medications for a limited time while a client waits to get in to see a psychiatrist. Your best bet for finding a psychiatrist is through your family member’s insurance–call or look up online and ask for a referral.

NAMI: The National Alliance on Mental Illness (NAMI) of Minnesota is a non-profit organization dedicated to improving the lives of children and adults with mental illnesses and their families. NAMI Minnesota offers education, support and advocacy. NAMI Minnesota offers more than 500 free classes and presentations and over 60 support groups each year, and was recently recognized with prestigious national and state awards for its advocacy successes. I have heard many people say that the support groups and education classes offered have been of enormous help to them. There is a specific program called Transitions for education and support for young adults and their families, as well as a youth-specific website. Contact Andrea Lee for the youth program at 651.645.2948 ext. 106, e-mail alee@namimn.org, or for general classes or support groups, go to namihelps.org or call 651-645-2948.

I highly recommend the NAMI resources, and encourage all of my clients and their families to get in touch with them.

Social Security Disability benefits: Many people with a schizophrenia disorder will not be able to work full time. If this is the case for you or your family member, it’s probably a good idea to apply for disability benefits to get some financial help. Keep in mind that these benefits can be cancelled at any time if your ability to work improves enough that you no longer need them. There are two general types of disability benefits, SSI and SSDI. If you have worked a certain number of hours, you’ll qualify for SSDI, if not, you’ll qualify for SSI. But you don’t have to worry about which one you qualify for, they can figure that out for you. To apply for disability benefits, go to the government online application or call 1-800-772-1213. (A smaller number of people may qualify for a program called RSDI, see here for a further explanation.)

Sometimes people’s first application will be denied and they need some extra legal help in getting the right information in their application. If you are denied, call a law firm that deals with these issues. There are some that do pro bono or sliding-scale fees, such as Southern Minnesota Regional Legal Services (651-222-4731).

Medical Insurance–Medicare, MinnesotaCare, and Medical Assistance (MA): It is vital that people with a schizophrenia disorder have some sort of health insurance. If they are not working due to their illness and aren’t on a family member’s plan, they are likely eligible for Medicare, MInnesotaCare, and/or Medical Assistance, which is Minnesota’s Medicaid program. Apply for Medicare through their online application here, MinnesotaCare here, and apply for MA through their online application here.

Mental health case managers: Case managers are trained people, usually social workers, who are very familiar with the “system,” in that they know the ins and outs of how to get clients certain services and benefits. To apply depends on the county that the client lives in:

  • Anoka County: call 763-422-7326 or 763-422-3283
  • Carver County: call 952 442-4437
  • Dakota County: call 651-554-6000 or 651-554-6424
  • Hennepin County: Call Front Door Access at 612-348-4111
  • Isanti County: a provider (therapist, psychiatrist, etc) can call 763-689-1711 for a referral
  • Ramsey County: call 651-266-7890
  • Scott County: call 952-445-7751
  • Washington County: call 651-430-6484.

Crisis resources:

Sometimes a person with a schizophrenia disorder will experience symptoms getting out of control, and often they are not able to get in to see a psychiatrist the same day. If a person seems overwhelmed by symptoms, seems at a point that they might harm themselves (or others), or if they are not able to care for themselves due to symptoms, they are in crisis. There are several options if someone is in crisis. They can always call 911 or go the Emergency Room of their preferred hospital, they will be assessed and possibly admitted to the psychiatric unit of that hospital.

If it doesn’t seem like the person needs hospitalization, you could call a crisis service. One such services is Crisis Connection: 612-379-6363 or 1-866-379-6363, from any location. Alternatively, you could use this online crisis resource locator.

The following is a list of crisis numbers for counties in and around the Twin Cities:

  • Anoka County-Mental Health Crisis Outreach-763-755-3801
  • Carver County- Mental Health Crisis Program, available 24-7, provides both phone assessments and on-site crisis management. 952-442-7601
  • Chisago County – Crisis Line 1-800-523-3333
  • Dakota County Crisis Response Unit at 952-891-7171, which provides 24-hour telephone or on-site response
  • Hennepin County Community Outreach for Psychiatric Emergencies (C.O.P.E) To reach our mobile team, call 612-596-1223, available 24-7.
  • Isanti County- Crisis Line 1-800-523-3333
  • Mille Lacs County – Crisis Line 1-800-523-3333
  • Ramsey County, 24/7 Crisis Hotline 651-266-7900. Also, with more limited hours, Urgent Care for Adult Mental Health. Walk-in crisis services at 402 East University Avenue, St Paul, MN 55130, M-F 8am-7pm, Sat 11am-3pm.
  • Scott County– Mental Health Crisis Program, available 24-7, provides both phone assessments and on-site crisis management. 952-442-7601
  • Washington County-crisis outreach at 651-777-5222

If you live outside the Twin Cities area, here is a list of crisis numbers, listed by the county that the person in crisis lives in.

Also see Resources Part 2, which covers information on therapists, home health nurses, CADI waivers, ARMHS workers, housing, vocational training, and community support programs.

New results for treatment of negative symptoms in schizophrenia

Boy sitting among daisies

Most people associate the word “schizophrenia” with its positive symptoms–hearing voices, seeing visions, having paranoid thoughts. However, negative symptoms can be as difficult as positive symptoms. Negative symptoms refer to symptoms where something is less than expected, such as one’s face showing less emotions than average, one having less ability to get things started, and having less interest in activities than one used to.

For years, there have been medications that target positive symptoms, but there aren’t many medications that target negative symptoms, and they are not always effective. However, the research continues, and now there’s more hope on the horizon for treatment of negative symptoms. An article cited on ScienceDaily.com from the European College of Neuropsychopharma-cology sheds more light on these medications and what they can do.

Small Talk 3: Ending a Conversation

Sometimes it can feel awkward to end a conversation, even more so here in Minnesota where we have “the long Minnesota good-bye,” which drags it out further. However, you can certainly develop skills to make ending conversations easier and smoother. There are many reasons for ending a conversation, including running out of time, needing to go somewhere else, running out of things to say, or the other person seems bored or distracted. When you feel like it’s time to end the conversation, try these suggestions:

  1. wait until a pause in the conversation or the other person is finished speaking
  2. use a nonverbal gesture like standing up, moving toward the door, looking at your watch or picking up your coat or glancing away
  3. do a verbal summary of what you’ve been talking about, like, “I’m glad your sister is feeling better,” or “yeah, I’m tired of watching the Vikings lose, too”
  4. make a closing statement, like, “Well, I have to get going” or “Anyway, got to get back to work” or “Well, it’s been fun talking,” Make sure they understand the conversation is ending, like they wind up what they were saying or say “Ok, see you later.” If they don’t, be more direct and say something like, “It’s been fun talking, but I have to go now.”
  5. say “good-bye” or “see you soon” and start walking away
  6. sometimes people will miss these cues or will do the long Minnesota good-bye and keep talking and even follow you while still talking—at this point, make sure to keep walking, somewhat slowly, end eye contact with them, and don’t start any new topics. Eventually they’ll realize the conversation is over.

Other helpful resources for small talk skills are:

http://www.succeedsocially.com/endconversations

http://www.realsimple.com/work-life/work-life-etiquette/manners/10-big-rules-small-talk

http://www.ou.edu/class/bc2813/ConversationTips/MasteringSmallTalk.htm

a productive meeting