How to Support a Family Member with Schizophrenia During Crisis?

Q: How to Support a Family Member with Schizophrenia During Crisis?

Hello： Actually, experiencing auditory hallucinations at night and running out on your own can be a dangerous behavior. <br>It is recommended that in such situations, you should go to the emergency department. <br>Typically, if there are available beds in the emergency department

What should our family members do at this moment?

Hello Dr.
Wang, my sister has been suffering from schizophrenia for about 10 years.
During this time, she has experienced episodes after stopping her medication.
She was originally taking three 3 mg doses of Risperidone, but recently the doctor switched her to three 2 mg doses of Aripiprazole due to side effects.
Lately, she has been experiencing a lot of auditory hallucinations and has been going out at night, repeatedly calling the police to say that the people around her keep changing faces, as if they are wearing makeup and acting in a movie.
She believes that someone is casting spells on her.
We took her back to Mackay Memorial Hospital, and the doctor advised us to arrange for hospitalization.
No medication or injections were given, but currently, there are no available beds, and due to the pandemic, we are unsure how long we will have to wait.
She feels unable to sleep at night because of the hallucinations and has been going out.
We initially went to a clinic to get her sleeping pills so she could rest at night.
I called the inpatient center for inquiries, and they told me to please be patient and wait; if it’s urgent, we could go to the emergency room.
Other family members feel that she is not aggressive, and that calling an ambulance to take her to the emergency room might have a negative impact on her.
However, we do not know when a bed will become available.
I would like to ask the doctor what we should do to handle this situation better.
Thank you.

wee, 40~49 year old female. Ask Date: 2022/04/15

Dr. Wang Yaoting reply Psychiatry

Hello: Actually, experiencing auditory hallucinations at night and running out on your own can be a dangerous behavior.
It is recommended that in such situations, you should go to the emergency department.
Typically, if there are available beds in the emergency department, they will arrange for admission more quickly.
If you still wish to wait for the inpatient center to notify you, it is advisable to return to Mackay Memorial Hospital early to adjust your antipsychotic medication, as the effectiveness of sleep medications prescribed at the clinic is limited.
I hope this answers your question :)

Reply Date: 2022/04/15

More Info

Supporting a family member with schizophrenia, especially during a crisis, can be incredibly challenging and emotionally taxing. Your sister's situation, characterized by auditory hallucinations and erratic behavior, requires careful handling to ensure her safety and well-being while also addressing the family's concerns. Here are some strategies that may help you navigate this difficult time:

1. Stay Calm and Supportive
It’s essential to remain calm and composed when interacting with your sister. Schizophrenia can cause significant distress, and your calm demeanor can help create a sense of safety. Listen to her concerns without judgment, even if they seem irrational. Acknowledge her feelings and reassure her that you are there to help.

2. Encourage Professional Help
Since your sister is experiencing increased hallucinations and has a history of medication changes, it’s crucial to encourage her to seek professional help. If she is resistant to going to the hospital or seeing a doctor, try to frame it as a way to help her feel better rather than as a treatment for a mental illness. You might say something like, “Let’s go see a doctor together; they can help us understand what’s happening.”

3. Utilize Emergency Services if Necessary
If your sister poses a risk to herself or others, it may be necessary to involve emergency services. While you mentioned concerns about how this might affect her, safety is paramount. If her behavior escalates or if she becomes a danger, calling 911 or taking her to an emergency room may be the best course of action. Explain the situation to the responders clearly so they can provide the appropriate assistance.

4. Explore Alternative Treatment Options
While waiting for a hospital bed, consider exploring other treatment options. If your sister is open to it, you might look into outpatient services, community mental health centers, or crisis intervention teams that can provide immediate support. Some areas have mobile crisis units that can come to your home to assess the situation and provide assistance.

5. Create a Safe Environment
To minimize risks at home, ensure that your living space is safe. Remove any potentially harmful objects and create a calm environment. If your sister is prone to wandering at night, consider implementing safety measures, such as locking doors or using alarms to alert you if she leaves the house.

6. Educate Yourself and Your Family
Understanding schizophrenia can help you and your family respond more effectively. Read about the condition, its symptoms, and treatment options. This knowledge can empower you to advocate for your sister and make informed decisions about her care.

7. Involve Other Family Members
Engage other family members in the conversation about your sister’s care. It’s important to present a united front and ensure that everyone understands the seriousness of the situation. Family support can be crucial in encouraging her to accept help.

8. Take Care of Yourself
Supporting a family member with a mental illness can lead to caregiver burnout. Ensure you are also taking care of your own mental health. Seek support from friends, family, or support groups for caregivers of individuals with schizophrenia. It’s important to have a support system for yourself as you navigate this challenging situation.

9. Follow Up on Treatment
Once your sister is stabilized and receiving treatment, ensure that she follows up with her healthcare providers. Regular appointments and medication adherence are crucial for managing schizophrenia effectively. Encourage her to communicate openly with her doctors about any side effects or concerns regarding her treatment.

Conclusion
Supporting a family member with schizophrenia during a crisis requires patience, understanding, and proactive measures. While the situation may feel overwhelming, remember that you are not alone in this journey. Seek help from professionals, engage your family, and prioritize safety for both your sister and yourself. With the right support and treatment, it is possible for individuals with schizophrenia to lead fulfilling lives.

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