Managing Psychosis: An Australian Guide

Psychosis is a complex mental health condition where the person has difficulty distinguishing what is real from what is imagined. The person may hear, see, feel and believe things that are real in their own head but aren't actually happening. This is confusing and frightening and may be dangerous to themselves or others if they act on their false realities. According to the Australian Department of Health, 45% of the population will experience a mental illness of some kind, such as depression, anxiety or stress over their lifetime. Within a 12 month period about “one in every 200 adult Australians will experience a psychotic illness” (SANE Australia). It is important to remember that psychosis is an illness and it is treatable. There is an increasing focus on raising awareness, diagnosis, treatment and support for people with mental health conditions. However, the focus has not extended to the more severe end of the mental health conditions, that is to the complex mental health conditions such as schizophrenia and bipolar disorders that frequently include psychotic episodes. Complex mental health conditions have limited treatment options, poor coordination of services and relatively few resources to support treatment and recovery, even though their very complexity makes it difficult to negotiate the journey through a psychotic episode, the life changing aftermath and living with a complex mental illness for a period, or sometimes for your whole life. Not only are there inadequate and fragmented treatment options but people with complex mental health conditions, but additionally these people experience discrimination and stigma in part due to ignorance, inadequate treatment and associated poor health outcomes. Jack Heath, the dynamic CEO of SANE Australia expresses the issues around complex mental illnesses succinctly: “Now more than ever people are seeking help for diagnoses such as depression and anxiety, but Australians living with complex mental health conditions still experience unacceptable levels of stigma and discrimination, as well as poorer health and social and economic outcomes such as poverty, homelessness and unemployment.” This guide has been written for precisely these reasons - to address ignorance and inadequate treatment by helping people with symptoms of psychosis and their supporters negotiate their way through the maze that is mental health services to attain the best possible outcomes. The guide broadens recovery encouraging people with psychosis to take an active role in recovery focusing on building/rebuilding a healthy pattern of life with physical and psychological wellness, a strong support group, a network of friends and a rewarding array of activities to lead a full and productive life. The guide focuses on providing a practical resource for people experiencing psychosis and their support persons. It is also hoped that the guide will start more conversations about psychosis and lead to greater awareness and more consumer-centred care. The guide comes out of lived experience of complex mental illness, negotiating through psychotic episodes, letting go of the old, understanding and acceptance of a different set of circumstances. It also comes out of the lived experience of building a life again in a new order - adjusting to new realities, renegotiating relationships, building personal and social relationships, starting from scratch again with work and a career. The guide also comes with the perspective of a carer and as carer and consumer, we structure our experiences, to research the literature and learn from it and apply it in a practical way to help those on a similar journey. The guide is structured around the pathway through psychosis to resuming a full and productive life, keeping symptoms in check and avoiding recurrences. The steps in the pathway are: -Understanding psychosis -Early intervention and minimising harm -Managing a psychotic episode -Recovery and renewal This guide is as much for support people as for people experiencing a psychotic episode. The role of supporter will be both rewarding and challenging. Supporting people through psychotic episodes is particularly challenging as the person you are supporting may, at times be out of touch with reality and not their normal selves. They may at times be living through terrifying experiences in the form of hallucinations and delusions. They may at time treat support persons disrespectfully. Support persons may at times need to make difficult decisions to get them professional help without their consent. Through all of this it is important to remember that they have an illness. The illness can be treated and they will improve. You need to listen and remain calm. You need your own support mechanisms. Mental health is not merely the absence of disease. Achieving `mental health' involves actively working on all aspects of your life, throughout your life to achieve a healthy and fulfilling life. Every journey is different. We hope this guide helps you with your journey.