Challenges faced when living with schizophrenia in the community: A narrative inquiry

Abstract

Background: Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia. Aims: To explore the challenges of people living with schizophrenia in the community. Methods: A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data. Results: Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life. Conclusions: There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community.

Association between social support and the severity of positive symptoms in rural community-dwelling patients with schizophrenia during the COVID-19 pandemic

“…However, patients living in rural China may have encountered more barriers to accessing social support during the pandemic than those living in urban areas. Patients feel that they are being helped and report feeling satisfied when they benefit from medical insurance, a disability certificate that reduces costs and a basic living allowance [ 32 ], yet rural patients receive inadequate financial subsidies [ 33 ]. Stigma can hinder a schizophrenia patient from making contact with others [ 32 ], and schizophrenia patients with internalized stigma have lower relational satisfaction, lower relational esteem and higher fears of relationships or relational anxiety than schizophrenia patients without internalized stigma [ 34 ]; additionally, stigma is more common among patients living in rural areas than among those in urban areas [ 4 ].…”

“…Patients feel that they are being helped and report feeling satisfied when they benefit from medical insurance, a disability certificate that reduces costs and a basic living allowance [ 32 ], yet rural patients receive inadequate financial subsidies [ 33 ]. Stigma can hinder a schizophrenia patient from making contact with others [ 32 ], and schizophrenia patients with internalized stigma have lower relational satisfaction, lower relational esteem and higher fears of relationships or relational anxiety than schizophrenia patients without internalized stigma [ 34 ]; additionally, stigma is more common among patients living in rural areas than among those in urban areas [ 4 ]. Furthermore, patients gain friendships and the subjective support of a sense of belonging, respect and satisfaction through community rehabilitative activities, yet such activities might stop during a pandemic [ 13 ].…”

A qualitative of stable symptomatology for patients with schizophrenia: do they have adequate post-discharge rehabilitative resources?

“…Due to the characteristics of the course of schizophrenia, community-based rehabilitation is crucial for patients. Patients shift from hospital care to community care to receive comprehensive, continuous, and comprehensive services 4 , which must integrate various resources (human, material, and financial resources from institutions, communities, and society), ultimately promoting individual rehabilitation 5 , 6 . However, there are gaps in different districts (urban and rural areas, developed and underdeveloped areas) in community mental rehabilitation services due to the unbalanced development of mental services 7 .…”