Follow the treatment

See to it that the patient takes his prescribed dosage of medication regularly. Failure to keep to the dosage may lead to a relapse.

Take an interest

Talk to the patient and show an interest in what he is doing as part of his treatment program. Continue to be interested in what he is doing even if it sounds dull and repetitious to you. Simple routine tasks ate important for the schizophrenic to master first.

Assign small responsibilities

As the patient improves, it helps to bolster his sense of worth by getting him to perform simple tasks around the house. Keep these tasks small and uncomplicated, do not push him, for 'over-loading' will only tire and confuse him. Let him feel that he is as valuable and productive a member of the family as any other.

Encourage and support the patient

The most important thing a relative can do is to let the person concerned know that there is a future for him - far though it may be from what was originally hoped for. A person with schizophrenia is very vulnerable - he desperately needs assurance of his worth, is very sensitive and needs people to believe in him.

Supervise

The need for supervision varies. Patients who are chronically ill or who express suicidal thoughts and seem very depressed need constant supervision. Those undergoing treatment must be supervised periodically in order to ensure that drugs are taken. Personal hygiene is looked after and that there is no return to depression. As patients improve. The need for supervision will slowly decrease as the patient becomes self-sufficient and can be trusted to function safely alone.

Appreciate

Appreciate of the smallest task is important Until a person's abilities and efforts are recognized and appreciated, his self-confidence is severely limited. As far as possible ignore deluded or abnormal talk. Show interest and try to prolong normal talk and conversation.

Do not ignore

Ignoring the patient's attempts to regain his self-esteem, his smallest achievement or his desire to talk or discuss his future can have serious effects on the patient, Be patient and do not ignore him.

Do not criticize

Derogatory criticism, taunting or disbelief can have a very traumatic effect on the schizophrenic who is in a very sensitive state and easily hurt Haranguing and harassing the patient only adds to the stress and may lead to a return of the acute symptoms.

Do not exert social pressure

Trying to make the schizophrenic aware of his social and financial responsibilities while he is undergoing treatment is the wrong thing to do, for now, just show him that you believe in him and him that you believe in him and aim at self-sufficiency. As the patient improves, he himself should be allowed to grow slowly into a realization of his own abilities and responsibilities.

Refrain from over involvement

Sometimes the patient may interpret interest and support as interference and 'meddling'. In that case it is better to back off and stand by in case of need, rather than involve yourself actively. But do not ignore him altogether. It is important to strike the right balance between a caring involvement and constant intrusion.

Remember he is still intelligent

Do not write off the patient as mentally deficient. Aside from distortions in thought and perception, he is still an aware and sensitive individual. Insensitive discussions of his condition or his future while he is present could prove to be very harmful.

Watch for a Relapse

Patients may sometimes suffer a relapse for no obvious reason. Watch out for early signs of this such as sleeplessness, increased restlessness, irritability and a return of hallucinations. Take the patient immediately to a psychiatrist, so that medication may be adjusted and a relapse prevented.

Medical Treatment

Medical Treatment is the most important part of the program and must be adhered to strictly if the patient is to show consistent improvement. The antipsychotic drugs prescribed aim at controlling the acute symptoms of the illness and suppressing distortions in perception. Sometime ECT-Electro convulsive therapy or shock treatment - is advised during a schizophrenic episode but usually in conjunction with the drugs.

Psycho-therapy

Very often the sever loss of self-esteem and depression suffered by the patient can be countered only by effective psychotherapy - sessions of counseling, encouragement and extension of positive support to the patient by friends and family. Supportive individual talks on a regular basis with mental health professional such as a psychiatrist or psychologist helps the patient to talk freely about his perceptions, problems and experiences. Sympathetic counseling enables him to learn to distinguish the real from the unreal and distorted, and gradually to understand more about his illness and himself. Very often he learns to live with symptoms which cannot be completely eradicated.

Social Rehabilitation

In order that the patient may function normally and become a productive member of society social rehabilitation becomes essential. One aspect of rehabilitation is Occupational therapy which aims at the acquisition of simple social and trade skill in keeping with the patient's capabilities so that he may be gainfully employed and resettled in life. A second aspect is Group Therapy by which means a patient is enabled to interact freely with others and thus to regain and strengthen his inter personal skills and his self-confidence.
An important feature of this efforts to rehabilitate the patient is Family Counseling where the family can discuss the patient, his problems and theirs with a professional psychiatrist and be given guidance on how to treat the patient and how best to aid the recovery process. All aspects of this program are important although it must be emphasized that medication, as prescribed, should never be neglected, even in case of substantial improvement, since that may lead to a relapse . The overall result of such a comprehensive approach to the treatment of schizophrenia is that the patient not only improves as a result of medication, but as he becomes proficient at some trade and continues his counseling sessions, also recovers his self-esteem and become more confident of his place in society.

In India, we now have Clozapine and Risperidone and Olanzapine is expected to be introduced shortly.

Maintain a check

Even after a patient is rehabilitated and goes back to work or study, it is important to check regularly on his progress in order to prevent a sudden, unforeseen relapse. If the patient leaves to work in another city, be sure to stay in touch with someone - a friend or relative - who can give you periodic reports of the patient's progress.

Accept him as he is

It is very important for families to realize the limitations and weaknesses of the patient. You can minimize your own frustrations by learning not to expect the impossible from him. The patient's condition can be made to improve - but slowly. The best thing you can do to set him speedily and surely on the road to recovery is to refrain from rejection and to accept him wholeheartedly as he is.