Myth / People with schizophrenia are not able to make decisions about their own treatment.
Fact / Most people with schizophrenia are both able and eager to participate in decision-making about their treatment. During the onset of the illness or during periods of relapse, people may have some difficulty with decision-making. A person’s ability to make these decisions may change during the cause of the illness. Research shows that patient and family involvement improves outcomes and increases the likelihood of the patient adhering to his or her treatment plan.
     People with schizophrenia and their families also have an important role to play in planning (and some delivering) treatment services, as well as in training mental health professionals. This kind of "consumer" input results in demonstrable improvements in professional attitudes and in treatment outcomes.

What Is Reintegration and Why Is It So Important? / Rehabilitation improves quality of life for people with schizophrenia and reduces relapse and rehospitalization rates. The goal of rehabilitation is to reintegrate the ill individual into life in the community.
     Several types of services are needed. After a psychotic episode, an individual may need to relearn basic social and life skills. This training is often provided by Clubhouse or day hospital programs. Supported housing is essential; often the only affordable housing former mental patients can find is in sub-standard inner-city hotels and boarding houses. As well, landlords are often reluctant to rent to former mental patients.
     Vocational rehabilitation and job placement give the person meaningful, productive activities and increase self esteem. Enabling people with schizophrenia to work also reduces welfare costs. Recreational opportunities are another need. Peer support groups provide socialization, emotional support, and give people an opportunity to learn coping strategies that have worked for others. Supportive counselling can help the person accept the fact of his or her illness and deal with the losses it entails.
     People with schizophrenia often have trouble locating the services they need. Typically different services are provided by different agencies, each with its own rules and bureaucracy. Accessing services requires knowledge, perseverance, and planning. Even making and keeping an appointment may be difficult for a person with low motivation and impaired organizational skills. Ironically, healthier individuals are the ones who are most able to access services, while the severely afflicted are most likely to fall between the cracks, especially if they lack family support.
     Case management, in which one professional is responsible for advocating for the patient and coordinating needed services, is one successful model for providing rehabilitation. Another approach makes use of a team of mental health professionals from different disciplines to provide services. The team approach allows for maximum communication among the patient’s caregivers and provides long-term continuity of care. Unfortunately, neither of these models is widely used in most countries.

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