Caring for patients with schizophrenia and other psychiatric disorders

Psychiatric care for schizophrenia and depression has come a long way. Herbert Pardes, MD, explains how mental health treatment has evolved and why that treatment is working.

Transcript

00:00

It's a dangerous disease because schizophrenia and depression are two of the most likely reasons for suicide.

00:06

In my earlier years, I did a lot of psychiatric practice, and I was fortunate that I never lost a patient to suicide.

00:15

But my feeling was, I wanted the patient, any time they walked out of my office, to feel there was some hope.

00:22

You should never let them go without hope. And you're there for them, and you try to make yourself available at any time they

00:30

run into trouble. [MUSIC PLAYING]

00:37

You've got to stop thinking about other people as, in some way, being bad, terrible, killable, whatever.

00:45

That has effects on wide populations, and certainly on the psychiatric [INAUDIBLE]..

00:51

For many people, unfortunately, there's nothing that makes them feel better than to be able to point to somebody else who's worse than they are.

00:58

Psychiatric patients are not generally violent. They're actually more victims of violence. We had a homeless shelter, and the psychiatric patients

01:06

had to be protected from the criminals. However, when they do become violent, they become violent in blatant and public,

01:18

attention-gathering ways that are disturbing. So the impression is-- a bunch of crazy people are the danger .

01:24

There are people who are not that crazy who also can be dangerous. The way we treated psychiatric patients in past years was horrendous.

01:32

And what's happened is-- more humanity brought to it, a decrease, but not

01:39

an elimination, of stigma, and efforts which are rehabilitative. They focus on employment.

01:45

They focus on housing. They focus on family relationships, which restore, to some degree, the functioning of a lot

01:54

of schizophrenic patients. At the worst, we had close to 600,000 people housed in state hospitals in the mid '50s and on.

02:01

That's down to about 25, 30,000 in the country. That isn't all good. Some of them perhaps still need something like that,

02:08

but we've made some advances. But we still don't have precision with regard to what actually causes it.

02:15

We're becoming increasingly convinced that very early intervention of many of the psychiatric illnesses, as well as other illnesses,

02:22

I would say, has value and that outcomes are better. So what you try to do is you try to go backwards and look

02:29

for signs that this is developing, even when it's not as florid as it might otherwise be.

02:35

But what you'd like to find is a trusted therapist with whom the patient can work and a focus

02:43

on finding that person reasonable places to live, to work, to have relationships, and that

02:51

should be done with a therapist, with the help-- the support of help of the family, or sometimes organized provider enterprises.

03:00

There is nothing I find more attractive than playing a role in taking somebody who hurts and getting rid

03:10

of that hurt. And my feeling is if we can keep doing the research we should do-- that we're going to be able to do that with more

03:17

and more and more people. [AUDIO LOGO]