School of Healthcare FACULTY OF MEDICINE AND HEALTH The Lived Experiences of People with Schizophrenia Prescribed ‘Atypical Antipsychotic ’ Medication. Tony Gill Supervisors:Peter Morrall & Peter Knapp

(The experience and consequences of people with mental health problems, the impact of stigma upon people with schizophrenia: a way forward Journal of Psychiatric and Mental Health Nursing, 2010, 17, 242–250)

Methodology & Analysis  The study encapsulates a phenomenological approach to appreciating the meanings humans attach to their lives.  A purposeful sample of 20 patients with a diagnosis of schizophrenia, who are currently receiving atypical neuroleptic medication were selected.  Participants were asked to keep a daily diary of their activities, experiences, and feelings for 4 weeks and were interviewed at the half way point and end point of diary completion  Data was analysed using Bernard's content analysis to see what common themes emerged & to produce an account of their lives and experiences as they see them

Schizophrenia is accompanied by a second illness, the reactions of the social environment leading to social isolation, limited life chances and delayed help seeking behaviour.

Goffman (1986:3) conceptualises stigma as an attribute that is deeply discrediting….. and which makes the person carrying it.. different from others and of a less desirable kind. Goffman adds that it disqualifies one from full social acceptance.

With stigma comes isolation, discrimination, low self esteem and feelings of worthlessness. People’s quality of life has been affected by stigma, and they withdraw and become secretive. People also become disempowered This study encapsulates a phenomenological approach to appreciating the meanings humans attach to their lives. Candidates will keep a daily diary to encourage a narrative account of their lived experiences.

Emerging themes 1.Isolation - daily activities 2.Stigma - media perspectives, knowledge, labeling & diagnosis, secrecy, discrimination. 3.Confidence - motivation, self esteem, hobbies, coping 4. Quality of life – side effects 5.Social networks – family & friends, social contacts, normality

Findings o“Ashamed of being called it. Many years ago when my dad was alive, he died in 1994 and I was hearing voices I used to walk through the house you know, up and down stairs and things so my dad said you want locking up and the keys throwing away and my sister said she’s going out of her head she is” (P9) o“I think it’s stopped me from having lots of friends, like you say, I’ve got friends here but it stopped my life opening up” (P17) o“I used to look at the walls, scared to go out, scared someone would see me, I just wanted to hide away all the time” (P11) o“when I was ill I never went out, I hid in the house with the curtains shut, I just wanted to be locked away for ever so no-one could see me”(P4)

findings  A year ago I used to cope!!!! But now I feel as if I am living actually enjoying doing stuff, participating in life, even if I its just pottering about at home, I know people don’t really think about my illness but it would appear that people accept it and me!!!”(P1)  I feel like I can do things that normal people do….in fact I feel like normal myself”(P8)  “I enjoy things more now, I get on better with people now, have more friends and socialise more now” (P13) “I am in charge of the schizophrenia, its not in charge of me” (P1)

Findings “ It kept me isolated, I never socialised with others, and they didn’t accept me for who I was”(P6) P5: Oh it’s been marvellous, I’m a different woman altogether with this new medicine they’ve invented Researcher: can you give me an example of why you feel a different woman? P5: well I can knit, I can sew, I can lead a normal life, not staying in after a tablet, on the chlorpromazine I was like a zombie….. Further on in interview P5: its really good medicine, I can live a fulfilled normal life.

Oh yeah, I’m motivated, this morning I’m motivated to actually get washed, changed and out of the flat and down to Leeds” (P7) “I hope he doesn’t take me off the clozaril because it helps me so much, a good drug it is…………. The best I’ve been since I left high school, since I was 16”(P3) “Will be seeing people I haven’t seen since my illness became public knowledge last year, last time I was unwell I decided to let family and friends know, it was such a hard decision to make, to let people know about my schizophrenia. There’s such a stigma attached to it!!” (P1)

“I guess I can cope with my life or should I say what my life has become, because everything in it has echoes from the past, being locked up, being alone and most of all being rejected”(P12)

Can you see all of me

Faces at the window

Vulnerability

School of Healthcare FACULTY OF MEDICINE AND HEALTH Thank you Tony Gill