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Social Aspects of Schizophrenia Care

  • Oliver Freudenreich
Chapter
Part of the Current Clinical Psychiatry book series (CCPSY)

Abstract

Schizophrenia is never treated in a vacuum: the social aspects of care (social determinants of health) and adversity matter for realistic treatment planning. Recognizing barriers to care in the form of structural violence and advocating for improvements are an ethical professional duty. In addition, this chapter highlights the pernicious effects of stigma on patient’s outcomes which include social exclusion and loneliness.

Keywords

Social adversity Social determinants of health (SDOH) Homelessness Structural violence Racism Social advocacy Psychosocial history Stigma Loneliness 

References

  1. 1.
    Goffman E. Asylums. Essays on the social situation of mental patients and other inmates. Garden City: Anchor Books; 1961.Google Scholar
  2. 2.
    Cooper B. Schizophrenia, social class and immigrant status: the epidemiological evidence. Epidemiol Psichiatr Soc. 2005;14:137–44.CrossRefGoogle Scholar
  3. 3.
    Dickey B. Review of programs for persons who are homeless and mentally ill. Harv Rev Psychiatry. 2000;8:242–50.CrossRefGoogle Scholar
  4. 4.
    Foster A, Gable J, Buckley J. Homelessness in schizophrenia. Psychiatr Clin North Am. 2012;35:717–34.CrossRefGoogle Scholar
  5. 5.
    Aubry T, Nelson G, Tsemberis S. Housing first for people with severe mental illness who are homeless: a review of the research and findings from the at home-chez soi demonstration project. Can J Psychiatr. 2015;60:467–74.CrossRefGoogle Scholar
  6. 6.
    Zhuo C, Tao R, Jiang R, Lin X, Shao M. Cancer mortality in patients with schizophrenia: systematic review and meta-analysis. Br J Psychiatry. 2017;211:7–13.CrossRefGoogle Scholar
  7. 7.
    Dickerson F, Schroeder J, Katsafanas E, Khushalani S, Origoni AE, Savage C, et al. Cigarette smoking by patients with serious mental illness, 1999–2016: an increasing disparity. Psychiatr Serv. 2018;69:147–53.CrossRefGoogle Scholar
  8. 8.
    Martinez ME, Gomez SL, Tao L, Cress R, Rodriguez D, Unkart J, et al. Contribution of clinical and socioeconomic factors to differences in breast cancer subtype and mortality between Hispanic and non-Hispanic white women. Breast Cancer Res Treat. 2017;166:185–93.CrossRefGoogle Scholar
  9. 9.
    Fleche S, Layard R. Do more of those in misery suffer from poverty, unemployment or mental illness? Kyklos (Oxford). 2017;70:27–41.CrossRefGoogle Scholar
  10. 10.
    Farmer PE, Nizeye B, Stulac S, Keshavjee S. Structural violence and clinical medicine. PLoS Med. 2006;3:e449.CrossRefGoogle Scholar
  11. 11.
    Griffin M, Weiss Block J, editors. In the company of the poor: conversations between Dr. Paul Farmer and Fr. Gustavo Gutierrez. Maryknoll, New York: Orbis Books; 2013.Google Scholar
  12. 12.
    Metzl JM, Hansen H. Structural competency: theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126–33.CrossRefGoogle Scholar
  13. 13.
    ABIM Foundation, American College of Physicians-American Society of Internal Medicine, European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243–6.CrossRefGoogle Scholar
  14. 14.
    Popovic D, Schmitt A, Kaurani L, Senner F, Papiol S, Malchow B, et al. Childhood trauma in schizophrenia: current findings and research perspectives. Front Neurosci. 2019;13:274.CrossRefGoogle Scholar
  15. 15.
    Brezing C, Ferrara M, Freudenreich O. The syndemic illness of HIV and trauma: implications for a trauma-informed model of care. Psychosomatics. 2015;56:107–18.CrossRefGoogle Scholar
  16. 16.
    Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved. 1998;9:117–25.CrossRefGoogle Scholar
  17. 17.
    Morgan C, Charalambides M, Hutchinson G, Murray RM. Migration, ethnicity, and psychosis: toward a sociodevelopmental model. Schizophr Bull. 2010;36:655–64.CrossRefGoogle Scholar
  18. 18.
    Montenegro RE. My name is not “interpreter” [A piece of my mind]. JAMA. 2016;315:2071–2.CrossRefGoogle Scholar
  19. 19.
    Allen AM, Thomas MD, Michaels EK, Reeves AN, Okoye U, Price MM, et al. Racial discrimination, educational attainment, and biological dysregulation among midlife African American women. Psychoneuroendocrinology. 2019;99:225–35.CrossRefGoogle Scholar
  20. 20.
    Sue DW, Capodilupo CM, Torino GC, Bucceri JM, Holder AM, Nadal KL, et al. Racial microaggressions in everyday life: implications for clinical practice. Am Psychol. 2007;62:271–86.CrossRefGoogle Scholar
  21. 21.
    Gamble VN. Under the shadow of Tuskegee: African Americans and health care. Am J Public Health. 1997;87:1773–8.CrossRefGoogle Scholar
  22. 22.
    Bathje GJ, Marston HN. Self-stigmatization. In: Teo T, editor. Encyclopedia of critical psychology. New York: Springer New York; 2014. p. 1713–6.CrossRefGoogle Scholar
  23. 23.
    Lee EE, Depp C, Palmer BW, Glorioso D, Daly R, Liu J, et al. High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor. Int Psychogeriatr. 2019;31:1447–62.CrossRefGoogle Scholar
  24. 24.
    Eglit GML, Palmer BW, Martin AS, Tu X, Jeste DV. Loneliness in schizophrenia: construct clarification, measurement, and clinical relevance. PLoS One. 2018;13:e0194021.CrossRefGoogle Scholar
  25. 25.
    Wiesjahn M, Jung E, Kremser JD, Rief W, Lincoln TM. The potential of continuum versus biogenetic beliefs in reducing stigmatization against persons with schizophrenia: an experimental study. J Behav Ther Exp Psychiatry. 2016;50:231–7.CrossRefGoogle Scholar
  26. 26.
    Crichton P, Carel H, Kidd IJ. Epistemic injustice in psychiatry. BJPsych Bull. 2017;41:65–70.CrossRefGoogle Scholar
  27. 27.
    Melle I, Larsen TK, Haahr U, Friis S, Johannesen JO, Opjordsmoen S, et al. Prevention of negative symptom psychopathologies in first-episode schizophrenia: two-year effects of reducing the duration of untreated psychosis. Arch Gen Psychiatry. 2008;65:634–40.CrossRefGoogle Scholar
  28. 28.
    Joa I, Johannessen JO, Auestad B, Friis S, McGlashan T, Melle I, et al. The key to reducing duration of untreated first psychosis: information campaigns. Schizophr Bull. 2008;34:466–72.CrossRefGoogle Scholar
  29. 29.
    Tranulis C, Lecomte T, El-Khoury B, Lavarenne A, Brodeur-Cote D. Changing the name of schizophrenia: patient perspectives and implications for DSM-V. PLoS One. 2013;8:e55998.CrossRefGoogle Scholar
  30. 30.
    Maruta T, Matsumoto C. Renaming schizophrenia. Epidemiol Psychiatr Sci. 2019;28:262–4.CrossRefGoogle Scholar
  31. 31.
    Yamaguchi S, Mizuno M, Ojio Y, Sawada U, Matsunaga A, Ando S, et al. Associations between renaming schizophrenia and stigma-related outcomes: a systematic review. Psychiatry Clin Neurosci. 2017;71:347–62.CrossRefGoogle Scholar
  32. 32.
    Sontag S. Illness as metaphor, and, AIDS and its metaphors. New York: Picador USA; 2001.Google Scholar
  33. 33.
    Sennett R. The culture of the new capitalism. New Haven & London: Yale University Press; 2006.Google Scholar

Additional Resources

    Book

    1. Griffin M, Weiss Block J, editors. In the company of the poor : conversations between Dr. Paul Farmer and Fr. Gustavo Gutierrez. Maryknoll, New York: Orbis Books; 2013. – If you are interested in accompaniment, solidarity, or structural violence, then this book is for you. Gustavo Gutierrez from Lima, Peru is one of the father’s of liberation theology. While you may not like it’s theoretical foundations (theology and Marxism), there is value in its ethical stance towards improving the social lives of the poor.Google Scholar

    Article

    1. Montenegro RE. My name is not “interpreter” [A piece of mind]. JAMA. 2016;315:2071–2. – Mandatory reading if you believe the American experience is the same for everybody in our “post-racial” world. The author who is an accomplished physician and sociologist and who happens to be Latino provides a striking example of microagression when he was mistaken for the valet.CrossRefGoogle Scholar
    2. Weissman MM. Stigma [A piece of my mind]. JAMA. 2001;285:261–2. – If you believe there is parity between medical care and mental health care, read this essay about one patient and his mother who encounter both treatment systems. While written in 2001, this powerful essay is as current as ever.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Oliver Freudenreich
    • 1
  1. 1.Department of PsychiatryMassachusetts General HospitalBostonUSA

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