At the 2008 convention, I was fortunate to catch up with Dr. Ken Duckworth, NAMI's medical director, and his colleague, Stephen M. Goldfinger, MD, professor and chair, Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center. Their insights into schizophrenia in young people I offer as a complement to my first blog outlining the findings of NAMI's recent survey. We chatted outdoors in the Florida sun.
CB: First, I'd like to know how you got involved in the blog for MTV's True Life: I Have Schizophrenia. All three of the people featured had different stories. Schizophrenia in each person is as unique as his or her thumbprint. Comment on this, and how MTV put human faces on the illness.
KD: I think MTV did a great job, and they picked interesting young adults living with schizophrenia and each of them has a different kind of package of what they're doing, how they're living, the supports and the symptoms they have. MTV did a good job. NAMI was a resource to MTV. Basically, I answered some questions that have come in, and it's been fun.
CB: Do you believe stigma is the culprit in not getting the treatment that works?
KD: I think it's one of the culprits. Young people tend to not like the idea of having an illness, and that's normal. Also, if you have an illness like schizophrenia, you can't see that you're ill, and that makes it harder, too. Most young people like to hang out and drink, that's how they socialize, or in some cases smoke dope and socialize. That complicates life for a person with schizophrenia. Then of course the attitudes that people have in society of people with mental illnesses are still negative. So that it's hard for a person to consider that they may have such a condition.
SG: I'd add that the larger healthcare system harbors the stigma that isn't talked about: unlike virtually every medical illness, mental illness hasn't been insured the same way, and the availability of treatment, even if it exists, is often not paid for in the frequency where you can see your doctor or get your medication covered. That makes it even harder, because if you have someone who is willing and wants to participate, a clinic will say, "We'll see you fifteen minutes a month," and what he really needs is a person to spend half an hour twice a week with him. That's just not part of the package.
CB: That's sad, so sad because given the right treatment, one can recover. Talk about the statistics on recovery from schizophrenia after a first episode.
KD: After a first episode, I think many people do pretty well for a period of time, but then many have recurrences. Yet if you look more longitudinally, which is Courtenay Harding's study, it shows about half the people do pretty well over time. How much of that is age or better services, how much of that is rehabilitation, these are really good questions. Not every first episode is a lifetime of episodes.
