SCHIZOPHRENIA

Treatment & Referral

Guide

How to recognise Schizophrenia

The nature and causes of

Schizophrenia

Treatment Options

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(011) 262-6396
www.sadag.co.za

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About this brochure:

This leaflet is for:

! Anyone who has been given a diagnosis

of schizophrenia
! Anyone who thinks they might have
schizophrenia
! Friends and relatives of someone who
has been given a diagnosis of
schizophrenia

In it you will find:

! What it is like to have

schizophrenia
! What may cause
schizophrenia
! The different treatments that
are available
! How to help yourself
! Some information for relatives

Stigma

“Schizophrenia” is a word that many people associate with

violence and aggression. The media regularly use it in this
way, although it is unfair and inaccurate. This causes extreme
stigma and discrimination, which prevents people seeking
help.

What is Schizophrenia?

Schizophrenia is a mental disorder that affects around 1 in

every 100 people. It affects men and women equally. It is rare
before the age of 15, but can start at any time after this, most
often between the ages of 15 and 35. There is currently no
physical or lab test that can absolutely diagnose schizophrenia
- a psychiatrist usually arrives at the diagnosis based on
clinical symptoms. What physical testing can do is rule out a lot
of other conditions (seizure disorders, metabolic disorders,
thyroid dysfunction, brain tumour) that sometimes have similar
symptoms.

Symptoms of Schizophrenia

People diagnosed with schizophrenia usually experience a

combination of symptoms: positive (hallucinations, delusions,
racing thoughts), negative (apathy, lack of emotion, poor or

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non-existent social functioning), and cognitive (disorganized
thoughts, difficulty concentrating and/or following instructions,
difficulty completing tasks, memory problems). Positive
Symptoms are things people with schizophrenia have that
other people don't have; Negative Symptoms are the things
that they do not have that other people without schizophrenia
do have.

Positive Symptoms

These unusual experiences are most common in

schizophrenia but can occur in other mental disorders as well.

Hallucinations

Hallucinations are distortions or exaggerations of perception

in any of the senses - when you hear, smell, feel or see
something, but there isn't anything (or anyone) actually there.
The most common hallucination is hearing voices (auditory
hallucinations) followed by visual hallucinations (seeing
things).

What is it like to hear voices?

These voices may sound very real to you. They seem to be

coming from outside you, although other people can't hear
them. They may sound like they are coming from a particular
place, like the television set, or from many different places.
The voices may talk to you directly or may talk amongst each
other about you. It may sound as if you are overhearing a
conversation. Voices can be pleasant but are often
threatening, scary, critical, abusive or irritating.

How do people react to them?

People often feel that they have to do what the voices tell them
to do even if the voices are instructing them to do something
bad. It is sometimes very difficult to ignore the voices even
though you want to.

Other kinds of hallucinations

Hallucinations of smell, taste and touch also occur although

these are less frequent.

Delusions

Delusions are firmly held beliefs that you hold with complete
conviction although they are based on distortions or

SCHIZOPHRENIA Treatment & Referral Guide 3

exaggerations of reasoning and/or
misunderstandings of situations or events. The
reasons for these beliefs are often
unexplainable, i.e. you “just experience them”.
The common categories of schizophrenia
delusions include persecution delusions
(feelings that you are being spied on, conspired against,
cheated, drugged, or poisoned), jealousy delusions (a feeling
without just cause that your loved one is unfaithful), and self-
importance delusions (also known as delusions of grandeur -
the feeling that you have a great but unrecognised ability or
talent, or the belief that you are a very important person).

Delusions of being followed or watched are also common, as

are beliefs that radio or TV programs are directing special
messages about you or directly to you.

How do they start?

The belief in the delusion often follows weeks or months of

feeling that there is something strange happening that you
couldn't explain. Delusions are also sometimes an explanation
for hallucinations. For example: if you are hearing voices
telling you that you are bad and have done something wrong,
you may start believing that you are being watched by the
police.

Paranoid Delusions

This involves beliefs that you are being persecuted, watched

or harassed. These beliefs fall into two categories:
Unusual - You may believe that the government or police are
watching you or you are being influenced by a neighbour or
colleagues who are using special powers.
Everyday - You may start believing that your partner is
unfaithful, a conclusion you reach because of “evidence” that
has nothing to do with infidelity (like your partner bought new
shoes). Others around you can see there is no evidence at all
to suggest that your beliefs are true.
These delusions are obviously distressing for the people who
believe them but also for those seen as 'persecutors'
particularly if they are friends or family members.

Coping with Delusions:

Delusions affect your behaviour and it may be difficult to

discuss them with people because they won't understand or
you feel that they are trying to harm you. You may keep away
from people or sometimes fight back if you feel very
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threatened. If you feel persecuted, you may move from
place to place. It is important to find someone to talk to about
how you are feeling.

Other positive symptoms include:

Grossly disorganised behaviour: includes difficulty

maintaining goal-directed behaviour, unpredictable agitation,
social disinhibition, or behaviour that is bizarre to onlookers.
Catatonic behaviour: characterised by a marked decrease in
reaction to the immediate surrounding environment,
sometimes taking the form of motionless and apparent
unawareness, rigid or bizarre postures, or aimless excess
motor activity.

Negative Symptoms

These symptoms are less obvious than positive symptoms

and include:
! Your interests in life, your energy and emotions seem
to “drain away” which makes it very hard to feel excited
or enthusiastic about anything
! You may feel uncomfortable with people
! You may not bother to get up or go out
! Difficulty in keeping yourself clean or cleaning your
surroundings

Other people find it difficult to understand that you aren't just

being “lazy” which is upsetting for you and your family. Your
family want you to “pull yourself together” and you can't explain
that you just can't.

Affective Flattening

This is the reduction in the range and intensity of emotional

expression, including facial expression,
voice tone, eye contact, and body
language. You are unable to respond to
things around you or express feelings of
happiness, sadness and sometimes the
emotion you do express is inappropriate.

Alogia (Poverty of Speech)

This is the lessening of speech fluency and productivity,

thought to reflect, slowing or blocked thoughts, and often
manifests as short, empty replies to questions.

SCHIZOPHRENIA Treatment & Referral Guide 5

Avolition

This is the reduction, difficulty, or inability to initiate and persist

in goal-directed behaviour; it is often mistaken for apparent
disinterest. Examples include: no longer interested in going
out and meeting with friends, no longer interested in activities
that you used to show enthusiasm for, no longer interested in
much of anything, sitting in the house for many hours a day
doing nothing.

Cognitive Symptoms

Muddled Thinking (“Thought Disorder”)

Disorganized speech/thinking, also described as “thought

disorder” is a key aspect of schizophrenia. Disorganized
thinking is usually assessed primarily based on the person's
speech.
It becomes harder to concentrate and you often can't:
! Focus at work or finish a simple task
! Finish an article in the newspaper or watch a TV
programme to the end
! Keep up with your studies

Your thoughts seem to wander and you drift from idea to idea
without any obvious connection between them, then can't
remember what you were originally thinking about. You may
start speaking rapidly and your speech may become slurred.
When your ideas become disconnected, it is hard for people to
understand you.

Feeling of being controlled:

You may feel that:

! Your thoughts are being taken out of

your mind
! The thoughts in your head aren't yours
someone else has put them there
! Your body is being taken over or you are
being controlled like a robot

People explain these experiences in different ways. Some

people believe the radio, television or laser beams are causing
these things or that a device has been implanted in them;
others blame the “Devil”, witchcraft or “God”.

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Does everyone with Schizophrenia have all these
symptoms?

No. There are people who will only have one or two symptoms
whereas other people will have a number of both positive and
negative symptoms.

Depression:

! Before getting treatment or seeking help, about half

of people with schizophrenia will first feel
depressed
! About 1 in 7 people with schizophrenia also have
depression which is often not diagnosed because it
is mistaken for negative symptoms
! Medication can help reduce depression in people
with schizophrenia
! If you have schizophrenia and feel depressed, tell
your doctor and request appropriate treatment

Types of Schizophrenia

! Paranoid schizophrenia - These persons are very

suspicious of others and often have grand schemes
of persecution at the root of their behaviour.
Hallucinations, and more frequently delusions, are
a prominent and common part of the illness.
! Disorganized schizophrenia (Hebephrenic
Schizophrenia) - In this case the person is verbally
incoherent and may have moods and emotions that
are not appropriate to the situation. Hallucinations
are not usually present.
! Catatonic schizophrenia - In this case, the person is
extremely withdrawn, negative and isolated, and
has marked psychomotor disturbances.
! Schizo-affective disorder - These people have
symptoms of schizophrenia as well as mood
disorders such as major depression, bipolar and
mania.
! Undifferentiated Schizophrenia - Conditions meet
the general diagnostic criteria for schizophrenia but
don't conform to any of the above subtypes, or
exhibit the features of more than one of the
subtypes without a clear predominance of a
particular set of diagnostic characteristics.

SCHIZOPHRENIA Treatment & Referral Guide 7

What causes schizophrenia?

We don't know what causes schizophrenia but it is likely to be a

combination of several factors and will be different for
everyone. Experts agree that schizophrenia develops as a
result of interplay between biological predisposition (inheriting
certain genes) and the kind of environment a person is
exposed to (for example: whether their mother was sick while
pregnant, if they were sick as a baby or if they experienced a
trauma or stress).

Genetics:

1 in 10 people with schizophrenia have a parent with the

illness.

Damage to the Brain:

Studies have shown that damage to the brain due to

problematic birth that caused lack of oxygen or viral infections
during the early months of pregnancy, may predispose
someone to developing schizophrenia.

Narcotics and Alcohol:

The use of street drugs like ecstasy, LSD, tik, crack and
marijuana can trigger schizophrenia and the use of alcohol can
make symptoms worse for people who already have the
illness.

Trauma and Stress:

The onset or worsening of symptoms is often preceded by

stress or trauma such as a loss, car accident, hijacking or
everyday stress like work stress or exams. Long-term stress
like family or financial problems can make symptoms worse.

Outlook:

Many people with schizophrenia are able to work and have

lasting relationships, and need never go into hospital. 1 in 5
people with the illness may continue to experience symptoms
that interfere with their functioning.

What will happen without treatment?

Suicide is more common in people with untreated

schizophrenia.

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The longer schizophrenia is left untreated, the greater the
impact on your life and the worse the symptoms will be. The
sooner the illness is diagnosed and treated, the better the
outlook.
If the symptoms are identified early and treatment is started:
! You are less likely to have to go into hospital
! If you do go into hospital, it is for a shorter period
! You are more likely to be able to work and live
independently

Treatment:

If you have the symptoms of schizophrenia, it is very important

to be assessed and start treatment as soon as possible.

You may need to go to a hospital or clinic for assessment. If

you have to be booked into a hospital, it is usually only for a few
days or couple of weeks. Afterwards, treatment and care can
continue at home.

Medication is vital and helps the most disturbing symptoms of

the illness. However, psychological treatment and support
from friends and relatives is very important.

Medication:

Certain medications can seriously affect the way other

medications work so it is very important to tell doctors, dentists
and pharmacists what medication you are on.

Why take medication?

The aim of treatment is to reduce the symptoms of

schizophrenia.

Medication should:

! Weaken symptoms of delusions and hallucinations

gradually over a period of weeks
! Help you think more clearly
! Encourage you to look after yourself
! Help you live more independently

SCHIZOPHRENIA Treatment & Referral Guide 9

What should I tell my doctor before I start taking
medication?

Your doctor will need to know if you:

! Have had an allergic reaction to any medication

before
! Are taking, or planning to take, any other
medication (prescription or over-the-counter) or
herbal remedy as medications can negatively affect
each other
! Are pregnant or planning to fall pregnant
! Are breastfeeding or planning to breastfeed
! Drink alcohol or use street drugs
! Have diabetes or a family history of diabetes
! Have a history of liver, heart or kidney problems
! Exercise very hard or work in hot or sunny places

Are there any specific things I should know before

starting medication?

At the start of treatment, or after an increase in dosage, you

may feel light-headed or dizzy. You may also feel drowsy - this
is common and normal. If you experience any of these, get up
slowly from sitting or lying down and be careful when driving or
operating machinery.

Side-effects:

! Stiffness and shakiness, and feeling sluggish and

slow in your thinking
! Restlessness and irritability
! Problems with your sexual performance
! Persistent movement of mouth and tongue called
tardive dyskinesia

If you experience any of the above side effects, you should

discuss them with your doctor.

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Atypical anti-psychotics:
Over the last 10 years, several newer medications have
appeared that work on a different range of chemicals in the
brain.

These are less likely to cause side effects but they may cause
weight gain and sexual health problems. Many people on
these newer medications find the side effects easier to handle.
Tablets Trade Name Average Max.
Daily Dose (mg) Daily Dose (mg)
Aripiprazole Abilify 10 – 30 30
Amisulpride Solian 50 – 800 800
Clozapine Leponex 200 – 450 900
Olanzapine Zyprexa 10 – 20 20
Quetiapine Seroquel 450 – 600 750
Risperidone Risperdal 4–6 16
Injections (may Average 2 Max. 2
be given 2 -4 Weekly Dose Weekly Dose
weekly)
Risperidone Risperdal Consta 25 50

Typical anti-psychotics:
Tablets Trade Name Average Max.
Daily Dose (mg) Daily Dose (mg)
Chlorpromazine Largactil 75 – 300 300
Haloperidol Serenace 3 – 15 30
Pimozide Orap 4 – 20 20
Trifluoperazine Stelazine 5 – 20
Sulpiride Espiride 200 – 800 800
Injections (may Average 2 Max. 2
be given 2 -4 Weekly Dose Weekly Dose
weekly)
Flupenthixol Fluanxol 40
Decanoate
Fluphenazine Modecate 12.5 – 100
Decanoate
Zuclopenthixol Clopixol 200
Decanoate

How well does medication work?

! About 4 in 5 people get help from these medications

! Medication controls the symptoms but you have to
keep taking the medication even when you feel well
in order to prevent the symptoms returning
! Symptoms may come back even with treatment, but
it is far less likely if you keep taking your medication
all the time.
! If one medication isn't working, discuss it with your
doctor, you may need to try a different one

SCHIZOPHRENIA Treatment & Referral Guide 11

How long will I have to take medication for?

! Most doctors and psychiatrists will suggest you take

medication for a long time

! If you want to reduce or stop your medication,

always discuss it with your doctor first

What happens if I stop taking my medication?

! The symptoms of schizophrenia will usually come

back immediately

Is medication enough?

Schizophrenia can make it very difficult to deal with the

demands of everyday life. Sometimes the symptoms are
controlled. It can be difficult to get back to doing ordinary things
like washing, shopping or making a phone call. Medication is
very useful but it is not enough. You usually need other types of
help like psychological help and a support group to help give
yourself the best chance of recovery.

Psychological Treatment:

Cognitive Behavioural Therapy (CBT)

The CBT therapist helps you to see:

! How you think about yourself, the world and other
people
! How what you do affects your thoughts and feelings

CBT can help you to make sense of your problems by breaking

them down into smaller parts. This makes it easier to see how
they are connected and how they affect you, such as how a
problem, event or difficult situation affects your thoughts,
emotions, physical health and actions.

Most people have between 8 and 20 sessions and for CBT to

be effective you should have at least 10 sessions over 6
months.

Counselling:

This doesn't affect the symptoms of schizophrenia but can

help if you need to talk to someone about how you are feeling
and get support with daily problems.

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Interpersonal Therapy or Family Therapy (Family
Meetings):

These can help you and your family cope better with the
situation. You can discuss information about schizophrenia
and find practical ways to cope with problems. About 10
sessions are needed over 6 months.

Community Help:

There are organisations like the South African Depression and

Anxiety Group, SABDA or the South African Federation for
Mental Health who you can phone for help in your area.
Contact numbers are at the back of this brochure.

Social Life:

You may not have a job or may be unable to go back to work.

Even so, it is very important for you to get out and do
something every day. Many people go regularly to a
community centre or support group or help at a charity in their
area. These offer a range of activities that can help you keep
active and allow you to spend time with other people.

Self Help:

Learn to recognise early warning signs like:

! Not eating or sleeping
! Feeling anxious
! Not caring about your personal hygiene
! Feeling a little suspicious, starting to hear voices
sometimes, finding it difficult to concentrate

Try to avoid things that make you feel worse:

! Stressful situations
! Using drugs and/or alcohol
! Arguing with family or friends

Find ways of controlling your voices:

! Keep busy
! Spend time with people
! Remind yourself that the voices cannot hurt you
! Tell yourself the voices have no control over you
you are in control
! Join a support group and talk to other people with
schizophrenia

SCHIZOPHRENIA Treatment & Referral Guide 13

Learn about schizophrenia and your medication:
! Talk to your doctor, psychiatrist or mental health
worker
! Ask for written information and learn as much as
you can about the illness and your treatment

Look after your body:

! Try to eat a balanced, healthy diet
! Try to reduce your smoking
! Do regular exercise - even walking for 20 minutes a
day

Other things you can do include:

! Learn relaxation techniques
! Do something you enjoy on a regular basis, like
cooking, listening to music or playing soccer
! Tell someone you trust if you start feeling unwell
again
! If you feel stigmatised or ill treated, call one of the
numbers at the back of this brochure and tell them.
Don't get upset, get active and be involved

For Families:

It may be hard to understand what is happening if a loved one

develops schizophrenia, often no-one realises what is
happening until later.

How it may start:

Your loved one may become strange, distant or just seem
different to how they used to be. They may avoid contact with
other people and become less active. If they are hearing
voices, they may look away from you while you are talking as if
t h e y a r e l i s t e n i n g t o s o m e o n e e l s e . Yo u r
loved one may talk about their delusions, or may keep quiet
about them. Their sleep patterns may change so that they
sleep during the day but are awake at night. When you talk to
your loved one, their speech may be difficult to understand.

These changes often happen slowly and may be particularly

difficult to pick up during the teenage years.

Can I talk to the doctor or psychiatrist?

Families are sometimes left out of discussions about treatment

but this should not happen. It is very important for the patient to
be supported by the family and the family should have all the
information about their illness and treatment to help their loved
one most effectively. Families should ask the doctor about

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treatment and side effects as well as steps that may help
recovery.

Factors identified as keys to recovery:

1. Family Relationships: Family stress is a powerful

predictor of relapse, while family education and
emotional support decrease the rate of relapse.

2. Supportive Therapy: Positive relationships with

psychiatrists, therapists and/or treatment
teams create hope and are essential
to improvement and recovery

How to handle specific symptoms and problems

associated with schizophrenia:

Delusions: It's upsetting and frustrating to be the victim of

delusions, and often the closest family members and relatives
are the first targets of this and other hurtful behaviour.

Due to the condition, a person with schizophrenia often can't

think or reason rationally. Explaining logically why the
accusation can't be true won't work, and will ultimately be
draining and frustrating. Try talking directly with the
psychiatrist about the delusional symptoms - the current
medication may not be adequate to control them. Also, be
aware that delusions can take weeks or months to fade, even if
the person is medication compliant.

Voices/Hallucinations: The experience of hearing voices or

seeing visions are as real to the person with schizophrenia as
hearing real peoples voices are to you. Like delusions, it
usually does no good to try and refute them. On the other hand,
it's also not a good idea to just "go along with them," which
ultimately doesn't help anyone.

One thing you can do is to simply acknowledge that your loved

one is experiencing something unique to them - you can say
"I'm sorry it's bothering you" or "why don't you tell the doctor
about it," which doesn't ignore their experience but also
doesn't give false evidence that others can see or hear these
things. Sometimes the best thing that family members can do
is encourage the ill person to write down/remember their
experiences, and discuss them with their doctor.

Anger/Irritability/Mood Swings: Remember that this is the

illness talking, not the person. Some people have tried a
detached, non-reaction to their relatives' anger; others have

SCHIZOPHRENIA Treatment & Referral Guide 15

waited for the episode to pass (or calmed themselves down by
going for a short walk) and then communicated how much they
were hurt by that behaviour. If mood swings are severe, a
mood stabiliser might be beneficial. Talk to the doctor about
possible options.

Apathy/Lack of Motivation: Although many people believe

that these sorts of behaviours are due to medication side
effects or a lack of will on the part of the patient, most often they
are simply another symptom of the illness. When you consider
that schizophrenia severely distorts the way an affected
individual senses and perceives the world, it's easier to
understand why that person might avoid any sort of
stimulation, even just going out to a mall or riding on a bus.

One of the best ways to help is to actively pay attention to your

loved one's responses. If they respond positively to your
overtures or your attempts at conversation, by all means
continue. If you feel rejected or rebuffed, remember that it is
most likely a protective mechanism against too much sensory
overload; stop and try again later. Establishing small routines
or rituals can be very helpful, and a good source of shared
time. Try not to push your loved one to do things they don't
want to do unless absolutely essential, as this can cause
stress for them and make the schizophrenia worse.

Emotional Flatness or Social Withdrawal: Many family

members are hurt by a feeling that their loved one is
emotionally withdrawing into themselves, and that they just
don't relate or interact anymore with the people around them.
Schizophrenic patients often have trouble with common social
cues that most people do and recognize without thinking -
body language, eye-contact, gesturing, varying the tone of the
voice, etc. They don't realise they are missing these basic
cues, and their absence can make the person seem much
more withdrawn and cold than they intend to be.

Find other emotional outlets for yourself - make time to go out

with other friends or just you, and spend another time with your
loved one. Another thing you can do is specifically bring to the
person's attention the fact that you want to share something
with them. Sometimes you may have to simply, lovingly,
request their love and attention.

Suicidal Thoughts and Tendencies: Suicide is a real and

tragic consequence for many schizophrenic patients - about
40% will make at least one attempt, and between 10% and
15% actually succeed in killing themselves. A major factor is
depression, which is a common companion of schizophrenia
disorders.
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Family and friends can help by being very aware of depressive
and suicidal tendencies, especially in those individuals
recently recovering from an episode or a relapse. Know the
places you can call on quickly for help - find the crisis centres in
your area and know the services they provide.

5 steps to handling paranoia

1. Place yourself next to your loved one rather than

face-to-face. The side-by-side position tends to
deflect the paranoid fears away from you. Instead,
both of you are looking out at the (hostile) world
together. Don't stand directly in front of your loved
one, it may be considered confrontational.
2. Avoid direct eye contact. Direct eye contact often
makes a paranoid individual feel even more
paranoid. Look elsewhere.
3. Speak indirectly. Avoid speaking directly to your loved
one. Substitute pronouns such as "it", "he", "she" or
"they" for the words "I" and "you".
4. Identify with, rather than fight, your loved one.
Whenever possible, your attitudes and emotional
expressions should parallel his / hers. The goal is to
help the person feel understood. Express anger and
frustration with their difficult circumstances. Your own
emotional expressions should be taken up to the point
of, and perhaps slightly beyond, the persons own
emotional expression to show you are on his/her side.
5. Don't rationalise. Share mistrust. The intuitive
approach with a paranoid person is to try to persuade
him or her to be more trusting. It is often better to do the
opposite. No attempt is made to correct or contradict
your loved one, or to test reality. Temporarily, their
account of reality is accepted as reality. The assumption
behind this technique is that, in the midst of a paranoid
state, a mixture of real-life stresses and distress from
psychotic symptoms overwhelm the patient. The aim is
to tell the doctor and let the professional deal with these.

Admission to hospital without consent:

Someone with schizophrenia may not always realise or accept

they are ill. They may refuse treatment even though they
desperately need it. The Mental Health Care Act of 2002
allows a person to be admitted to hospital against their will.

This is only used if someone needs treatment and cannot or

will not accept it and:

SCHIZOPHRENIA Treatment & Referral Guide 17

 ! Their health is at risk
! They are a danger to themselves
! They are a danger to others
! They are incapable of making an informed decision
about their care

Where the person is under the age of 18, a parent or guardian

can make an application for admittance. If the individual is over
18, a parent, guardian, next of kin or spouse may make the
application or a mental health professional who has been
treating the individual for at least 14 days and has seen a
steady decline in health.

Myths and Facts about schizophrenia:

Myth: Schizophrenia is a split personality

Fact: People with schizophrenia have only ONE personality.
The word 'schizophrenia' comes from the Greek word
meaning 'split' or fragmented thoughts and this is perhaps
where the confusion started. However, schizophrenia is a split
from reality rather than a split in personality.

Myth: People who have schizophrenia are violent and

dangerous
Fact: People who have schizophrenia are no
more likely to be violent than any other group
in the community. Violent behaviour is often
sparked by using drugs or alcohol and having
hallucinations. There is, however, an
increased risk of self-harm among people
with schizophrenia often because of fear, delusional thinking
or the decision to 'no longer cope' with the illness. It is fair to
say that a person with schizophrenia has more to fear from the
general community than the reverse, as they are often on the
receiving end of quite severe stigmatisation,
misunderstanding and outright discrimination.

Myth: People with schizophrenia never get better

Fact: 1 in 5 people with schizophrenia recover completely.

Myth: People with schizophrenia have a lower than average

intelligence

Fact: People with schizophrenia do NOT have a lower than

average intelligence level. As with any population, there is a
variation, but this is not a characteristic of the illness.

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Government Hospitals with Psychiatric Care

Western Cape
Groote Schuur Hospital 021 404 9111
Lentegeur Hospital 021 370 1111
Stikland Hospital 021 940 4400
Tygerberg Hospital 021 938 4911
Valkenberg Hospital 021 440 3111

Gauteng
Chris Hani Baragwanath Hospital 011 933 8000
Helen Joseph Hospital 011 489 1011
Johannesburg General Hospital 011 488 4911
Natalspruit Hospital 011 389 0500
Pretoria Academic Hospital 012 354 1000
Pretoria Central Hospital 012 320 0346
Sterkfontein Hospital 011 956 6324
Tara Hospital 011 433 7875
Weskoppies Hospital 012 319 9500

Eastern Cape
Cecilia Makiwane Hospital 043 708 2111
Fort England Hospital 046 622 7003
Frere Hospital 043 709 1111
Glen Grey Hospital 047 878 0018
Komani Psychiatric Hospital 045 858 8400
Tower Hospital 046 645 1122

Free State
Bloem Psychiatric Hospital 051 407 9400
Boitumelo Hospital 056 216 5200
Universitas Hospital 051 405 2911

Mpumalanga
Lydenburg Hospital 013 235 2233
Rob Ferreira Hospital 013 741 6100
Witbank Provincial Hospital 013 653 2000

Limpopo
Evuxakeni Psychiatric Hospital 015 812 1138
Hayani Hospital 015 963 1071/2
Tahabamoopo Hospital 015 632 4112
WF Knobel Hospital 015 221 0041

Kwazulu Natal
Addington Hospital 031 327 2000
Grey's Hospital (PMB) 033 897 3000
Townhill Hospital (PMB) 033 341 5500

Northern Cape
Kimberley Hospital 053 802 9111
Westend Hospital 053 832 7082

North West Province

Carletonville Hospital 018 788 1700
Mafikeng Bopheleng Hospital 018 383 2005
Witrand Hospital 018 294 5221

Other Helplines
South African Depression and Anxiety Group 011 262 6396
Suicide Crisis Line 0800 567 567

SCHIZOPHRENIA Treatment & Referral Guide 19

SADAG Help Line 0800 205 076
Schizophrenia And Bipolar Disorders Alliance 011 463 9901
Mental Health Information Centre 021 938 9229
Cape Mental Health 021 447 9040
Bipolar and Related Disorders Association 012 348 6057
Viva Youth Life 011 464 3596
Cape Support for Mental Health 021 671 1573
Federation for Mental Health-Johannesburg 011 781 1852
Federation for Mental Health- Pretoria 012 332 3927
Federation for Mental Health- Cape Town 021 447 9040
Federation for Mental Health- Durban 031 207 2717
Federation for Mental Health- Bloem 051 444 0212/3
Federation for Mental Health- P.E 041 365 0502
Federation for Mental Health- North West 018 297 5270
Federation for Mental Health- Mpumalanga 013 282 7177/7846
Federation for Mental Health- Limpopo 015 307 4732

Schizophrenia Support Groups

Edenvale 011 972 2879
Roodepoort 011 674 1200
Pretoria 012 348 6057
Witbank 013 692 7478
Cape Town 021 671 1573
Cape Town 021 788 3301
Cape Town 021 940 4561
Cape Town Stikland Support Group 021 940 4452
Somerset West 021 855 3684
Port Elizabeth 041 365 0502
Durban 031 469 4668
Durban 031 701 2255
Swaziland +268 635 5152

Schizophrenia Assisted Accommodation

West Rand Ebenezer House 011 955 6595
Johannesburg Central Gordonia 011 614 6855
West Rand Moonlight Homes 011 410 6990
Johannesburg South Talisman Foundation 011 435 0727 / 8
Pretoria Yana 012 330 1797
Pretoria Cullinan Rehabilitation Centre 012 734 1038
Cape Town Fountain House 021 447 7409
Cape Town Hope House 021 689 3507
Cape Town St Anthony's 021 689 1665
Cape Town Help Jou Naaste 021 981 9850
Cape Town Abri Foundation 021 447 0562
Cape Town Hopefield House 021 854 6586
Cape Town Comcare 021 448 0760
Cape Town Claro Clinic 021 595 8500

The production of this booklet has been made possible by the

kind generosity of all our sponsors.

The views expressed in this booklet reflect the experience of

the authors, are not necessarily those of our sponsors. Drugs
referred to by the authors should be used only as
recommended in the manufacturer’s local data sheets.

Compiled by the Scientific & Advisory Board Members of the

South African Depression & Anxiety Group, and reviewed by
the MRC Research unit on Anxiety and Stress Disorders.

Kindly supported by

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