Sensitized to Schizophrenia

(January 10, 2007) -- A man cowers in the corner of a room. He hears voices that can be mere whispers or terrifying taunts.

He sees figures that are range from quiet shadows to harrowing tormentors.

The walls around him distort and twist. The sounds of the night intensify into an unbearable cacophony.

The man is in a schizophrenic episode. He is terrified. The Braintree police are called. Their response to this frightened man is crucial. They speak softly. They give the man space. They do not deny the hallucinations. They acknowledge how frightening it must be to experience these mental distortions. They offer help.

The Braintree police are taking the lead from a workshop they have recently undergone conducted by the Quincy Mental Health Center in dealing with schizophrenic patients.

As part of the workshop, each officer used a virtual hallucination machine that simulated a psychotic episode.

Jim Dunn of Janssen Pharmaceuticals assists Braintree Police Sgt. Fred Marks with the virtual hallucination machine. (Tom Gorman/Staff)

The machine is a small TV on a pole that curves around the eyes with headphones attached.

While on the machine, the officer goes on a three-minute bus ride to the pharmacy to get medication through the eyes of a mental patient experiencing a psychotic episode.

The ride begins peacefully enough but before long, there is a frightening barrage of noise and images.

The voice of the affable bus driver is drowned out by the harsh sound of shifting gears, and his pleasant face elongates like a figure in a carnival mirror.

The people on the bus become distorted, and their voices hiss and scream. Imaginary children start singing “The Wheels on the Bus.”

Out of nowhere, a bird swoops down and tries to smash the window. A chorus whispers a chant berating the person for not picking up his medicine sooner.

The end of this torturous bus ride cannot come soon enough. Deputy Chief Russell Jenkins feels the training helped his officers better understand what the mentally ill are going through.

“The training our officers received about dealing with people suffering from schizophrenia through the use of the virtual reality machine will help them to better understand just what these people are going through and why certain approaches to their problems will be ineffective,” he said.

“The training was well received by our officers as they are making more and more street contacts with individuals suffering from various forms of mental illness, including schizophrenia and bi-polar disorder.”

Lt. Kevin Ware agreed. “I thought the training was excellent,” he said. “We face mental health issues on an increasing basis every day. This training will certainly help our officers and show them how to better deal with people with disorders like schizophrenia.”

He added, “I think it’s great that we have now formed a working partnership, including liaisons, with the Quincy Mental Health Center.”

The center offered the hallucination machine as part of a program for local public safety officials about how to deal with people suffering from schizophrenia.

Janssen, L.P., a pharmaceutical firm, makes the machine available to public safety workers. The firm specializes in mental health medications.

Dr. Paul Davidson, director of Quincy Mental Health Center, conducted the workshop for the Braintree officers.

“Braintree was the first to respond. I called all the departments on the South Shore and offered the program,” Davidson said in an interview after the workshop at his office at Quincy Mental Health Center.

“It is a free service to the community as part of our outreach program.

“The hallucination machine shows how a simple task, taking a bus ride to get medicine, can become a harrowing ordeal for a schizophrenic.

“It shows what a psychotic episode is like through the eyes of a patient.

“The machine gives the police officers additional empathy of what the patient is going through so they can effectively respond.

“Some of our clients have viewed the hallucination machine. They have said it is the closest thing they could imagine to what they suffer.

“Seeing what a patient goes through in a psychotic episode, even for a few minutes, is so upsetting. Afterwards, you see the patient as kind of heroic. You see the strength they must have. It inspires you, and it’s a bit humbling. You picture yourself in their shoes.

“Mental illness tends to be misunderstood. It is a biologically determined condition. Patients do not ask for it. It is not a weakness of character or anything willful. Patients do not bring it on themselves.”

Schizophrenia is caused by an excess of the neurotransmitters dopamine and glutamate in the brain. These stimulate the auditory centers and cause a shift in the ability to think clearly. The patient hears voices and sees things that are not there.

The disease strikes one percent of the world’s population. Typical onset is between the ages of 16 and 30.

An equal number of men and women develop the disease. Approximately 2.2 million Americans suffer with the illness. Men usually develop the illness in late teens to early 20s, while women do so in their mid 20s to early 30s.

Symptoms are withdrawal from friends and family, decreased academic performance, and sleep disturbance.

The patients begin to have hallucinations, delusions, thought disorders, and disorganized behavior.

“During the workshop, we talked about how to respond to a person in a psychotic state,” said Davidson, who has been treating schizophrenic patients for 20 years.

“We emphasized how it should be treated as an illness. They are hearing voices.

“After using the hallucination machine, one officer said in disbelief, ‘They can’t even hear us!’ and she’s right.

“The voices and visions make it difficult to differentiate between reality and hallucination.

“The key is not to confront them head-on. They do not need somebody in their face. What they need is a calming voice.

“My advice to the officers was: slow your speech down rather than barking orders. Repeat yourself. Provide messages that you understand what they are going through. You understand they are scared.

“This is better than confronting the patient and telling him there are no voices.”

Davidson said that the Braintree officers “figured this out very quickly. It was like a light bulb went off in their head.

“They realized they need a different intervention, a different form of human connection.”

The psychotic episode will pass and, with proper medication and therapy, the patient “will get along fine for long periods of time living alone or with family without hallucinations,” Davidson said. “They will go about their business, rarely causing any problems.”

Despite media portrayals, schizophrenia does not usually lead to violence.

Patients prefer to be left alone and are more likely to be fearful, Davidson added.

Davidson’s research shows that 27 percent of schizophrenic patients live independently, 25 percent with family, 20 percent in group homes, 10 percent in nursing homes, and five percent are either hospitalized, homeless, or in jail.

In therapy, the key is for the patient to separate what is real and what is unreal.

He needs reality checks and needs someone he trusts to talk to, Davidson said.

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In offering the outreach program and the use of the hallucination machine, “our hope is to raise awareness in the general public about mental illness. Rarely do you find a family that has not been affected by mental illness in some way. We have a great resource to offer to communities on the South Shore,” Davidson said.

“I was very impressed with the Braintree police department. They were eager to learn. They offered their own personal stories. This was not a surprise to them. They said things like ‘This is similar to what I’ve experienced on the street.’ They were grateful for the chance to develop techniques to deal with situations in a therapeutic way.”

By: Cathy Conley
Source: Hanover Mariner

Last updated: 01/07

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