Schizophrenia Stories from People on the Front Lines: Managing Patients with Schizophrenia — Dr. Chen’s Approach

Despite a myriad of challenges, these people within the network of care have been able to make a meaningful impact.

Treating people living with schizophrenia — Hear Dr. Chen’s story

Dr. Chen sees over 100 people living with schizophrenia each month. He recognizes the importance of being a constant in the lives of his patients. Hear about his strategies to help each person individually.

Transcript

My name is Dr. Frank Chen and I’m a psychiatrist who treats patients suffering from schizophrenia.

I think my principle with patients who continuously are symptomatic or patients who are not compliant with medications is to actually just hang in there with them, because the alternative is that they lose that connection with you, and they end up getting into some type of a much more serious situation. You’re always a constant for these patients, and even though they may not comply completely with your recommendations, you still serve as a purpose in their lives. The unfortunate thing about being a psychiatrist is that we sit in an office all day long, and that we are not out there looking at every aspect of the lives of our patients. I think that one of the fundamental difficulties with schizophrenia is that it is a disease entity where the patients will naturally gravitate towards being alone. Patients with schizophrenia may need the critical support of a number of players, including a psychiatrist, family members, counselors, case managers to navigate their treatment needs; a primary care physician to manage their medical illnesses. It is difficult sometimes for primary care physicians to understand that our patients are suffering from the same type of medical issues that a lot of other normal patients suffer from, and we really need the help of primary care physicians to keep our patients healthy. The tendency is to just say that see your psychiatrist to treat your symptoms. The tendency is not to say that this is another human being with all the risk factors of an American.

So I always think about the family perspective as I approach treatment. Not only do I include the patients in the decision-making process. Not only do I include the patients in the educational component, I often think about the critical need to include family members, especially in those early weeks of diagnosis. I think that having families recognize the need for these patients to be educated about social skills, about urging the patients to be a part of a community of people who all suffer from some of the same symptoms may allow them to help each other in their struggles with this very difficult illness.

Having recognition that they struggle with an illness is one of the hallmarks to success. Without that recognition they continue to live in a reality that causes alienation from society. If they’re able to take responsibility for, let’s say, a menial job, that may point towards progress. Sometimes getting into a relationship may be a successful outcome, because these individuals they often times can’t navigate that social aspect that’s critical for most of us. So sometimes when your patients can deal with responsibilities and can deal with interacting with others and being empathetic about others, that may be a progress towards normality. I think to be completely effective to some of these patients you really have to understand the plight that they’re in. They certainly need other people around to help them navigate this illness.

A robust care team can be critical for people living with schizophrenia1

People living with schizophrenia benefit from access to a complete health care team.1 For example, a multidisciplinary team might include a community psychiatric nurse, psychiatrist, social worker, support worker, and occupational therapist.1,2

  • Consistent, long-term relationships between people living with schizophrenia and their provider have been shown to increase medication adherence3

Continuity of care is an important factor for people living with schizophrenia — it affects their satisfaction with their treatment plan.4

  • A 2013 survey among adults with schizophrenia showed 36% of patients had a change in their psychiatrist over the past year. This was directly associated with lower treatment satisfaction4

In an effort to reduce hospital readmissions, communication is key among members of the clinical treatment and discharge planning teams.5

  • All providers including mental health, primary care, specialists, and others, should be notified if a patient is admitted to the hospital and prior to discharge to ensure successful transitions of care5
  • Ideally, discharge planning is a team approach and may include a social worker, nurse, case manager, and others6