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Online map reveals true picture of schizophrenia

A new interactive map launched today at highlights key differences in the way schizophrenia is managed in England.

For the first time the Choosing Well? initiative, supported by Janssen in association with leading mental health charities Rethink and SANE, has brought together a comprehensive range of statistics providing a very broad picture of how schizophrenia is managed in England.

The initiative aims to highlight the importance of choice in helping people with schizophrenia to stay well and explores the apparent local and regional disparities in the choices people receive regarding their care, as well as showcasing best practice.

The map reveals the postcode lottery of schizophrenia management:

  • The extent of choice of medication and psychological therapies that people are being offered appears to differ throughout the country
  • When an individual's mental health declines the data suggests there are clear differences in the percentage of people being admitted to hospital as emergency cases and/or being formally detained across the country (between 0.27% and 75.65% of people admitted as inpatients).
  • The average (median) length of inpatient stay varies between 10 and 148 days.
  • In some primary care trusts (PCTs) as few as 40% of people with schizophrenia feel they are involved as much as they would like to be in decisions about their care and treatment.
  • There is variation in the amount of prescribing of injectable antipsychotic medication across England.

With all public services being asked to make efficiency savings, there is no doubt that mental health services will need to respond to the challenge by learning from areas of best practice to deliver a cost-effective joined up package of care, tailored to individual needs.

Professor Richard Gray, Honorary Nurse Consultant and Professor of Research at the University of East Anglia, explained, "Medication is an integral part of the management of schizophrenia. Getting people involved and making sure they understand their medication is key to helping them stay well for longer.

"As such, it is imperative that people with schizophrenia are provided with choice and prescribed a treatment that suits them, taking into account any personal preferences. For some this might mean oral antipsychotics whereas for others who are perhaps not so good at taking pills, long-acting injectable medications could be more suitable."

While there is clear evidence to suggest that appropriate access to the right medication and psychological therapies can help people stay well for longer, the Choosing Well? data indicate that there is currently widespread regional variation in the way schizophrenia services are provided across England.

More needs to be done to help ensure all people with schizophrenia have access to the best possible, most clinically effective and outcome based care, including real choice, to help them maintain a good quality of life and ultimately stay well for longer.

"It is important that people with schizophrenia are able to discuss and choose a package of care suited to their individual needs, including medication, psychological and other therapies and treatment in hospital if needed during an acute episode" concluded Marjorie Wallace, Chief Executive of SANE.

"This spotlight on schizophrenia care reveals a disturbingly wide variation in what treatment is offered, depending on the trust which provides mental health services. There has been a succession of reports showing that patients are not given the time from professionals essential to their understanding of their treatment, or consistent support in learning how to manage their symptoms and prevent relapse. This is why the research portraying this 'true picture' is timely to ensure that future patients are not forced to play the service user lottery."

Choosing Well?