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Why Reclassifying Schizophrenia Is Necessary

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Why Reclassifying Schizophrenia Is Necessary USA Today Article May 18, 2017 Why Reclassifying Schizophrenia Is Necessary Advocacy Schizophrenia needs to be officially classified as a neurological disease for society to be able to give people with schizophrenia support. Linda Stalters, MSN, CEO, Schizophrenia and Related Disorders Alliance of America While most mental illnesses carry some measure of stigma, many - including celebrities and other public figures -speak openly about depression, bipolar, anxiety, substance use and other disorders, the same cannot be said for schizophrenia, a brain illness that remains firmly in the closet. People with schizophrenia experience enormous discrimination based on misunderstanding. The thought processes experienced by someone with schizophrenia are not elective but due to changes in the neuro- circuits in the brain. Thus, schizophrenia is a physiological, medical illness that is treatable by medication and evidence based therapies and support. While some headway has been made to educate legislators, insurance companies and the public, the negative associations with schizophrenia dominate popular discourse, greatly affecting people diagnosed and their loved ones. Discrimination leading to self-stigmatization, lack of treatment and rejection causes abuse, homelessness, incarceration, misunderstanding, persistent fear and pain. Less than 50% of the more than three million American’s living with schizophrenia are fortunate enough to receive treatment. Those who do receive appropriate treatment can hold meaningful positions, have fulfilling interpersonal relationships, and raise families. But the discrimination attached to it is so great that disclosure about the illness is rare. Neuroimaging, genetic studies, neuropathological and longitudinal studies support the neurodevelopmental and neurodegenerative hypothesis. In fact, schizophrenia is a neuro-circuitry disorder of the brain with genetic and progressive implications. WHY, then has this illness not been reclassified as a neurological/neuropsychiatric brain illness? The social & legal movement surrounding Autism (once known as childhood schizophrenia), succeeded in breaking the myth it was based on poor parenting and now Autism is identified as a neurodevelopmental disorder and receiving better coverage. People are treated both socially and medically depending on classification. For instance, the neurotransmitter dopamine (DA) and dopaminergic neurons play an important role in both schizophrenia and Parkinson’s disease (PD). A decrease in DA is implicated in PD and an excess of DA is implicated in schizophrenia. Both illnesses can manifest dystonia and psychosis, but schizophrenia is labeled psychiatric thus subject to mental health laws and behavioral health care standards. Whereas, Parkinson’s is neurological, and under medical standards of care. There are significant differences in resources and supportive care for illnesses labeled neurological. Parkinson’s patients are not homeless, incarcerated or abused because of their symptoms. Mental health laws often usurp medical advice and care. Through no fault of their own, many with schizophrenia go untreated, are criminalized and judged as deserving the fate their illness has bestowed upon them. The longer the duration of untreated psychosis the poorer the prognosis. Society must be re-educated in the fact schizophrenia is a progressive, yet treatable, neurological brain disease. People diagnosed deserve the same respect, empathy, clinical treatment, resources and protection afforded Autism, Alzheimer’s and Parkinson’s patients. It’s NOT imagined, it’s not behavioral, and it’s not elective. Reclassification will lead to patients who are properly educated, protected, comprehensively (medically, neurologically and psychiatrically) assessed and treated. This will not only lessen the long term chronic burden on society and families, but restore the lives of some creative, gifted, and highly intelligent human beings. Holding off on reclassification because neurology and psychiatry aren’t ready to merge or the “timing isn’t right” would be a very poor excuse considering the millions of patients punished within our judicial system, left to fend homeless, and abused. It’s time!.
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