Welcome back to our explainer blog series where we unpack specific mental health conditions and share stories of those with lived experience. In this edition we are looking at schizophrenia.
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Schizophrenia affects an estimated 24 million people or 1 in 300 people (0.32%) worldwide. This is 1 in 222 people (0.45%) among adults. People with schizophrenia are 2 to 3 times more likely to have a reduced life expectancy than the general population. (WHO 2022).
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According to the World Health Organisation (WHO) schizophrenia “causes psychosis and is associated with considerable disability”.
Whilst not as common as other mental illnesses, schizophrenia does affect an estimated 24 million people around the world. Unfortunately there is a lack of prevalence data in South Africa , but a study from 2006 estimated that 1% of South Africans were living with schizophrenia at the time.
Symptoms of schizophrenia may include hallucinations, delusions, lack of emotion, racing thoughts, poor or non-existent social functioning, finding it difficult to complete tasks, difficulty concentrating and/or following instructions and memory trouble. People often don’t understand what the difference is between someone experiencing hallucinations or delusions. The difference is that hallucinations are sensory experiences that a person experiences as real, while they are not. This may include auditory, visual, olfactory [smell], taste or touch related hallucinations, for example someone feeling insects crawling on their skin, hearing voices or seeing things that are not there. On the other hand, delusions involve beliefs that are not real. The person holds these beliefs even when there is evidence of the contrary and regardless of what other people may think. Delusions may include delusions of persecution, grandeur, love, or religious delusions.
For Christina Steenkamp, it was a fluke accident at the age of fifteen that led to her diagnosis.
I had a cricket accident where the ball hit my head during practice, so that was my trigger. They initially thought that I had a physical brain injury but after all the tests and everything they realised there was a psychological effect. It was only a year after the accident happened that I was diagnosed with schizophrenia.
To date, there has been no research proving a single cause of schizophrenia, however there are some factors that have been identified, including environmental factors and genetics.
Despite Christina’s father having lived with schizophrenia, she was not prepared for her diagnosis at all.
Of course when you’re 15 years old, you never ever think that could be a possibility. So I was quite shocked, I didn’t even know what the word meant when I was diagnosed.
There are a variety of treatment options for schizophrenia, including:
- medication
- psychosocial rehabilitation
- cognitive behavioural therapy (CBT)
- family therapy
The WHO stresses that supported housing, supported employment and facilitated assisted living should also be made available for persons with schizophrenia.
For Christina, it is a mix of medication, family support and therapy that works for her.
I see a psychiatrist and a psychologist. I am a big advocate for seeing a psychologist not only if you have a mental illness but just to reflect and talk to someone who is not very close to you, so I will see her [psychologist] when I need to. And I spend a lot of time with friends and family who really support me.
Despite the research proving urgent need, most people living with schizophrenia are not receiving the adequate mental health care.
Approximately 50% of people in mental hospitals have a schizophrenia diagnosis. Only 31.3% of people with psychosis receive specialist mental health care. – (WHO, 2022).
This is also true for South Africa where there is a lack of treatment guidelines for schizophrenia. Apart from the inadequacies when it comes to treatment, many people living with schizophrenia also fear being discriminated against. Stigma is seen as major barrier keeping persons with schizophrenia from seeking help.
There are many myths and misconceptions when it comes to persons with mental illness, including that they are violent and dangerous – this is especially true of persons living with schizophrenia. In a study from 2009 that documented personal stigma experiences of 732 persons living with schizophrenia from 27 countries (both developed and developing), the results found that 72% of respondents felt they could not be honest about their diagnosis, 64% believed they would be discriminated against when applying for education or employment opportunities and 55% expected discrimination in their close relationships.
These myths and misconceptions can be harmful to people living with schizophrenia. Just last year Jostina Sangweni, who lived with schizophrenia, was beaten and burned alive after being accused of witchcraft. Sadly, after being taken to a hospital for care, she passed away. This incident shows the lack of awareness surrounding schizophrenia and how dangerous, and even fatal, the lack of awareness can be.
When asked about the myths surrounding schizophrenia, Christina said:
What people see in media and on the news and in movies, it’s not like that. It’s not a death sentence. If you have the correct medication, the correct support, you can live a completely normal life. I live a completely normal life. I drink my meds and I see my psychologist but it’s not a death sentence.
Fortunately for Christina, she has an incredible support system and has not shown signs of any symptoms for five years now.
If there was one thing I promised myself, it’s that I will always do stuff and I will always take up any opportunities I can. I think that is really important to remember when you have a mental illness – it shouldn’t consume your life. It is part of who you are but it’s not who you are.
Christina has put her motto into practice having studied and graduated with a BA in Psychology and she is currently working in client relations for a corporate company. Christina is also proud to note that she has even started playing cricket again!
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If you suspect that you or someone you know may be experiencing symptoms of schizophrenia, always seek the help of a mental health professional. If you are interested in connecting with the organisation in your province, feel free to reach out to us via our enquiries Help Desk. For those who are looking for more guidance, you can head to our website and check out our Information Library.
If you or your loved one is feeling hopeless and/or having suicidal thoughts, please call the SADAG Suicide Crisis Line on 0800 567 567 or SMS 31393. These numbers are free and counselling is available in all 11 official languages.
