Psychosis and Schizophrenia Overview

Psychosis and schizophrenia are mental health conditions. The former involves hearing or seeing things that are not there and is often a symptom of the latter, which includes other non-psychotic symptoms. Almost 250,000 people in the UK are living with schizophrenia.

What are the signs and symptoms of psychosis?

Symptoms of psychosis include:

  • Hallucinations – experiencing a sensory phenomenon that is not there
  • Delusions – firm beliefs that are unfounded, but the person cannot see this
  • Confused and disturbed thoughts, including rapid speech and a loss of train of thought

Some women will experience post-natal psychosis as a type of post-natal depression.

Symptoms of schizophrenia include, in addition to psychosis:

  • Confusion based on hallucinations and delusions
  • Loss of interest in everyday activities
  • Avoiding friends and family
  • Not caring about personal hygiene

How do psychosis and schizophrenia get diagnosed and treated?

GPs can assess psychosis symptoms in conversation with the person to determine a need to access treatment. Early treatment intervention is proven to be very effective for psychosis, so referrals are often made quickly. Somebody who is diagnosed with psychosis must be seen by specialist treatment within 14 days. 

Psychological treatments include cognitive behavioural therapy, which involves changing thought and behaviour patterns associated with the person’s psychosis to enable them to better manage it.

Group therapy can also help people by enabling them to speak about their experiences with people who are experiencing similar symptoms.

Medication is sometimes prescribed too, such as an anti-psychotic to help reduce delusions and hallucinations. These medicines can also help the person with feelings of anxiety.

As psychosis is often triggered by something – stress, trauma, substance misuse – or a symptom of another condition such as bipolar disorder, treatment will address these underlying or associated conditions too.

Schizophrenia is typically longer-term than psychosis as a more isolated condition.

Someone will usually receive a diagnosis if they have experienced one of the typical symptoms more or less constantly throughout the course of a month.

Schizophrenia shares symptoms with bipolar disorder, PTSD and anxiety and so it may be difficult to come to the correct diagnosis.

A combination of antipsychotics and psychological therapy is used to treat someone with schizophrenia.

Some people with very severe symptoms of psychosis or schizophrenia may need to be admitted to inpatient care under the Mental Health Act 2007.

There are a few ways to determine whether an employee with psychosis or schizophrenia might require reasonable adjustments:

The employee may or may not wish to disclose their psychosis, as many people feel shame regarding their condition. Regardless, questions regarding the nature of any additional needs and what extra support may be required can be broached sensitively. For example:

  • Have they required adjustments in the past? It is important that an employer does not jump to conclusions or assumptions based on their existing understanding of psychosis or schizophrenia but instead keep up a dialogue with the employee, in order to empower them in spite of their condition.

What reasonable adjustments are possible for employees with psychosis?

Employers have a legal duty to make reasonable adjustments for employees with psychosis or schizophrenia if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has psychosis/schizophrenia. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of psychosis and schizophrenia:

  • Extra time to complete tasks to accommodate difficulties the person may have juggling work tasks and depressive thoughts or anxiety, for example.
  • Adjustment to duties so that the person with psychosis or schizophrenia can keep themselves and others as safe as possible. For example, people with psychosis or schizophrenia are required to inform the DVLA in case their ability to drive safely has been impacted. An employee may, as a result, be unable to commute, or operate machinery at work. This would also apply if there were any scenarios or duties which may trigger a flashback to a traumatic event for the employee, or cause them distress relating to their psychosis or schizophrenia.
  • Time off to attend appointments, so that the person can work on recovery while staying in work.
  • Flexibility regarding working from home if the employee is having a particularly difficult time with their symptoms and they would find it easier to work without the added commute, for example.
  • Raising awareness so that colleagues understand the employee’s psychosis or schizophrenia and can help ensure the employee feels comfortable at work. This might involve learning more about the condition to gain a better understanding of what the employee might be facing day-to-day.

Psychosis Signposting

Living with Schizophrenia – charity providing information on schizophrenia and schizo-affective disorder for people living with the conditions and healthcare professionals working in the field of mental health, as well as challenging the stigma attached to these conditions.

Hearing Voices Network – charity raising awareness of the nature of hearing voices and seeing visions, challenging stigma and creating more spaces for people experiencing voices and visions to talk about their experiences in order to better deal with them.

Mind – mental health charity with resources and advice to support someone with psychosis or schizophrenia and the impact this has on their wellbeing (0300 123 3393).

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