Several recent tragedies, including the January 2014 shooting at The Mall in Columbia in Howard County, have been linked to mental illness. Jason Schiffman, an associate professor of psychology, is director of a clinical high-risk program at the new Maryland Center for Excellence on Early Intervention for Serious Mental Illness, and talked recently about common misconceptions about psychosis and mental illness. What can be done to help those affected to lead better lives?
UMBC Magazine: What is psychosis, actually?
Schiffman: Psychosis is an illness that is characterized by a few hallmark symptoms. Probably the most notable two symptoms are hallucinations and delusions. Hallucinations are perceptions in the absence of sensation. The most common hallucination is hearing voices, but they can come in any modality. Delusions are defined as thoughts or ideas that are held onto tenaciously despite evidence to the contrary. Sometimes these can take the form of thoughts such as “I’m not sure, but I think that person is out to get me and there might be some reason for me to be on the lookout,” or even more extreme thoughts that “there are space creatures who have infiltrated my dental work and are transmitting information through my teeth.” Negative symptoms are also part of psychosis. These include things like not experiencing joy or emotion or even not being able to express emotions in a way that’s reflective of what a person is feeling on the inside.
What are common misconceptions associated with psychosis?
The most global misconception is that people with psychosis are completely different from people who don’t have it. That’s simply not true. We all have far more in common than we have differences. What’s in the media now, which tends to be perpetuated by a lot of media coverage, is that psychosis is strongly related to violence. Although there might be a subtle link with some psychosis and some types of psychotic symptoms and violence, in general that link is far less strong than the media would have most folks believe. The vast majority of people who have psychosis aren’t violent, and in fact are more likely to be victims of violence than perpetrators.
How can we break down stigmas that might prevent people from getting the care they need?
There is a lot of stigma against people with psychosis, and that stigma has bad implications. When we are able to better educate folks that people with psychosis tend not to be violent and are far more similar than different to others, then we can work on breaking down these misconceptions in society. Once we do that, we reduce public stigma and internalized stigma – the public stigma that a person with psychosis takes on as their own. They become ashamed, embarrassed or afraid to acknowledge some of their needs and struggles to the outside world for fear of retribution, embarrassment or violence against them. What we know is that if folks get help early and are engaged in treatment, their life course ends up taking a turn for the better more times than not.
To what extent is early intervention and treatment of psychosis a family and community issue?
Clearly this illness and many others don’t just impact the individual. We know through a lot of research that there’s a tremendous burden shared by family members who are caring for someone who has psychosis. It could be general stress and struggles added to a person’s life by navigating the mental health care system and getting the right help and care for family members. It could be stigma and it could be increased risk for their own mental health challenges, which might lead to increased rates of depressive symptoms and symptoms of anxiety. I think there are things that all of us can do to help foster a more open and inclusive society where we are more sensitive to the variety of different challenges people may have. That will in turn allow folks with psychosis to be more willing and able to reach out for the kind of help that is most useful for them.
— Max Cole