Steps to improve coordinated care for schizophrenia

Schizophrenia is a serious mental illness that disrupts thoughts, emotions, and behavior. It can cause a wide variety of symptoms that include hallucinations, delusions, disorganized speech, and catatonic or disorganized behavior.

An individual with schizophrenia may also experience difficulty with emotional expression, social interaction, and motivation, as well as motor impairment and/or cognitive impairment. Not everyone with schizophrenia experiences every possible symptom, and the condition varies from one person to the next.

Beyond these symptoms, schizophrenia has a significant impact on many aspects of a person’s quality of life. Many people with schizophrenia experience challenges with relationships and stigma. Unemployment, weight gain, and substance use disorders are common challenges.

Schizophrenia is treated with neuroleptic medications, also called antipsychotic medications. These medications act on neurotransmitters (chemical messengers) in the brain and can help lessen and control symptoms. Non-medication therapies can include counseling for individuals and families, behavioral therapy, patient education, and social support.

What healthcare providers do you need to work with?

Treatment for schizophrenia is typically overseen by a psychiatrist, a medical doctor that specializes in the diagnosis and management of mental health disorders. This physician will oversee the treatment of schizophrenia with neuroleptic medications.

Due to the many ways that schizophrenia can impact a person’s life and health, a person will also need to work with other healthcare providers as well.

Other important members of a healthcare team can include:

• Primary care provider
• Physician’s assistant (PA) or nurse practitioner (NP)
• Psychologists and other types of counselors, such as family counselors and providers who specialize in treating substance use disorders
• Specialists that specialize in treatment for coexisting medical conditions, such as cardiovascular disease, diabetes, or respiratory disease
• Occupational and vocational rehabilitation specialists
• Social workers
• Case managers
• Pharmacists
• Nurses

What is care coordination and why is it important?

Your medical care providers and mental health providers need to communicate with each other and share information. The term for this is “care coordination” or “coordinated specialty care.”

It is a well-documented challenge among people living with schizophrenia and other serious mental illnesses. It is considered a critical aspect of treatment. It helps reduce errors and delays, and it can lead to better treatment outcomes.

Strategies for care coordination

One of the best approaches is to work with healthcare providers who are based in a single medical office, clinic, or hospital, such as a coordinated specialty care (CSC) program.

This may not always be possible. Here are two additional strategies that can help.

Designate a point person to coordinate care

Designate one healthcare provider as a point person to coordinate care. This may be a primary care provider, nurse practitioner, or physician’s assistant. It may also be a case manager.

This healthcare provider should maintain an overview of the different aspects of your care and treatment, and they should have contact information for all providers you are working with.

Keep a personal health record

This is a file that includes all paperwork and documents related to your diagnosis and treatment for schizophrenia as well as other aspects of your health.

This file should contain:

• Copies of test results, evaluations, and workups from specialists
• Treatment records, including medications prescribed
• Contact information for all of your healthcare providers
• Insurance information
• Copies of bills, receipts, explanation of benefits documents, and other information related to the financial aspects of treatment

You can also include your own notes from appointments and information provided by healthcare providers, such as patient education materials.