Schizophrenia is a disorder shrouded in myth and misperception, which affects about 1 in every 100 people during their lifetime. Three years ago a damning report by the Schizophrenia Commission described the system of treatment in this country as being “broken and demoralised.” Since then little has been done to address the root causes of the failings in the standards of care, despite the welcome focus on early access to services. The question of what can be done to better the outcome for those affected by schizophrenia or psychosis formed the basis of a roundtable hosted by Prospect less than 50 days before the General Election.
The discussion, supported by Otsuka and Lundbeck, set out to describe the scale of the problem, the proposed solutions, and the appropriate roles to be played by government and the National Health Service. Robin Murray, Professor of Psychiatric Research at King’s College, who presided over the Schizophrenia Commission, began by emphasising the redefinition of schizophrenia as a syndrome rather than a disease. “It’s another way of thinking about people who have hallucinations, delusions, and other psychotic symptoms…There is very little evidence that it hangs together as a distinct condition,” he said.
There was relative consensus on the causes of schizophrenia, which Murray identified as including childhood adversity, adverse life events such as physical and sexual abuse, genetic predisposition and drug abuse. The latter is “a much bigger problem than we had recognised…In South London 24 per cent of all first psychotic episodes can be attributed to cannabis use,” he said. Less clear though is why the numbers of those susceptible to psychosis/schizophrenia is greater in England than in Spain and Italy, and significantly higher than that of less developed nations such as Brazil “…it could be partly drugs and it could be the psychotogenic aspects of our inner cities…I now think schizophrenia is multi-factorial,” Murray concluded.
The fragmentation of services within primary care was cited by many as one of the key causes of the NHS’s poor performance in mental health, particularly in relation to managing someone’s physical health. “We found that 60 per cent of people when given an initial diagnosis were given no information at all,” said Marjorie Wallace, Chief Executive of the charity Sane. “People [suffering from schizophrenia or pyschosis] are made to feel like unwanted parcels, shunted from a GP to a…