Integration and continuity of healthcare for the person with schizophrenia and their family

Abstract

The global burden of schizophrenia is a challenge for patients, families, and society; the current compartmentalization of healthcare and the stigma associated with the disease contribute to insufficient responses. This article emphasizes the importance of person-centered care. It seeks, through reflection and debate, to make family doctors aware of the problems associated with the diagnosis of schizophrenia, and to contribute to the improvement of the care provided to the patient and his family, through the proposal of forms of clinical action that allow a greater and more effective integration and continuity between primary and hospital health care. This article emphasizes the importance of person-centered care and, through reflection and debate, proposes guidelines for the organization of services based on the integration and continuity of care for the patient and his family. First, by emphasizing the role of primary healthcare, given the privileged position they hold and which allows: early detection of cases; integrated monitoring of patient's health; supervision of therapeutic adherence; the promotion of healthy lifestyles; the understanding of the person in the sociocultural context, through proximity to the family and the rest of the community. Second, by improving the articulation with the psychiatric and mental health services, which are responsible for: checking the diagnosis; the development of an individualized therapeutic plan that includes crisis intervention; recognition of the patient and family as essential elements of the ‘team’; the shift to a paradigm of valuing non-pharmacological interventions (alongside the necessary pharmacological prescription). In conclusion, ‘realistic optimism’ towards illness and global health in psychosis is possible and necessary but requires more and better-integrated healthcare systems.