What do psychotic people do

In very serious episodes of mental illness, a person may need to be committed involuntarily to a hospital or mental institution. To involuntarily commit someone in North Carolina, it must be clear that the person is mentally ill and a danger to self or others.

If someone displays these behaviors and refuses to seek care, another person may petition the local magistrate for psychiatric evaluation. This involves signing a legal document stating the facts that indicate the person is mentally ill and a danger to self or others. If the magistrate determines there are reasonable grounds for psychiatric evaluation, a custody order will be issued and a law enforcement officer will pick up and transport the person to a mental health center or hospital for examination.

If the examining physician recommends inpatient care, the law enforcement officer will take the person to a local psychiatric unit or the state psychiatric hospital, where a second physician will perform an examination and may recommend involuntary commitment. The patient has a right to a court hearing within 10 days and the right to an attorney.

The hearing is closed to the public, and court records are kept confidential. If the judge decides the person who was hospitalized does not meet standards for inpatient commitment, the person will be discharged from the hospital, though the judge could still order outpatient commitment. If you are concerned someone is showing signs of a psychotic disorder, you can call OASIS for advice, or a psychiatric evaluation if appropriate, at March 1, Mental Health , Psychiatry.

Identifying Early Psychotic Symptoms The earliest phase of a psychotic disorder consists of nonspecific symptoms that can be difficult to recognize as serious, says Karen Graham, MD , medical director at OASIS , a clinic in the Department of Psychiatry at the UNC School of Medicine that treats young people with psychotic disorders and those who are at high risk of developing them.

These symptoms include: Moodiness Sleep difficulty Poor performance in school Social withdrawal Lack of interest Lack of enjoyment Many things can cause these symptoms, including depression, anxiety, drug use, trauma, bullying or teenage angst. You can look for signs such as: Expressing thoughts about suicide Hearing disturbing voices, especially voices that command suicide or injury to self or others Experiencing uncontrollable anxiety Exhibiting manic or otherwise bizarre behavior, severe depression, disorientation or extreme confusion Reacting unusually to psychiatric medication Feeling uncontrollable anger If the person having these symptoms is already in treatment, contact the clinic or provider immediately.

The social services team are part of the local authority. If you need help and support to look after yourself then you can have an assessment by social services. For example, you may need support so that you can:. Charities In some areas, charities will support people who experience psychosis. This may be through support groups where you can talk to other people who have experience of psychosis. Or there may be a different service available for you, such as employment or isolation support.

You can look on our website to see if we have any support groups or services in your area. If you would like us to look for you please contact our advice line on and let us know what sort of support you are looking for. There are things that you can do to help manage your mental health. You can find more information about:. The National Institute for Health and Care Excellence NICE recommend that you should be offered antipsychotic medication and talking therapy if you experience psychosis.

If you decide not to take medication you should still be offered talking therapy. NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at www. Antipsychotic medication can help with psychosis. Your doctor should give you information about antipsychotics including side effects. You and your doctor should choose the medication together.

Some people find that they do not start to recover until they get the right medication. It is important to take the medication every day to help your symptoms. There are lots of different antipsychotics to try because people respond to different medications. Some may not improve your symptoms and cause side effects. You should discuss your medication with your doctor if your medication is not working. Or you are finding the side effects hard to deal with. There might be another medication that will suit you better.

Doctors should check that your medication is working. They should also give you a physical health check 12 weeks after the start of medication and then at least once a year. Some antipsychotic medication can make you put on a lot of weight.

So, your weight should be monitored each week for the first 6 weeks. Cognitive behavioural therapy CBT CBT can help you understand your experiences and any upsetting and worrying thoughts and beliefs. You can discuss new ways of thinking about them and dealing with them. What is CBT? CBT is a talking treatment. It is there to try and help you to:. Family intervention Family intervention is where you and your family work with mental health professionals to help you to manage your relationships.

This should be offered to people who you live with or who you are in close contact with. The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions. Your family should get support for 3 months to 1 year and should have at least 10 planned sessions.

Art therapy Art therapy may be more useful if you have depressive symptoms, such as withdrawing from people or losing interest in things that you used to enjoy. You will have arts therapy with a therapist. It will usually be in a group. It is there to mix different communication techniques with creativity. Art therapy aims to help you to:.

Therapy for trauma If you have experienced trauma, your psychosis may be part of your way of dealing with this. This is something which can be treated with counselling or psychotherapy. The therapist will help you to understand the root causes of your hallucinations or delusions.

They will explore ways to over-come and control difficult voices and beliefs. The NHS do not usually offer counselling or psychotherapy to people who are experiencing psychosis. But they should listen to you if you ask for it. Especially if other therapies like CBT, family intervention and arts therapies, are not available locally. You should first speak to your doctor about your treatment.

Explain why you are not happy with it. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try.

Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis. But your doctor should listen to your reason for wanting a second opinion. An advocate is independent from the mental health service. They are free to use.

They can be useful if you find it difficult to get your views heard. There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.

You can search online to search for a local advocacy service. We will look for you. Your concerns investigated in more detail. This is where your concerns are investigated in further detail. You can ask an advocate to help you make a complaint. Advocates that do this are called Independent Health Complaints Advocates. People deal with their experience in different ways. You might need to try different things before finding something that works.

You could join a support group. A support group is where people come together to share information, experiences and give each other support. Hearing about the experiences of others can help you feel understood. This may help you feel less alone and boost your self-confidence. You might be able to find a local group by searching online.

The charity Hearing Voices Network have face to face support groups in some areas of the country. Rethink Mental Illness have support groups in some areas. You can find out what is available in your area, or get help to set up your own support group by clicking here. Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your experiences. They can help you to take control of your life and become an expert in your own wellbeing and recovery.

You can usually self-refer to a recovery college. But the college may tell your care team. Unfortunately, recovery colleges are not available in all areas.

To see if there is a recovery college in your area you can use a search engine such as Google. Or you can call our advice service on for more information. Your doctor may offer you peer support. Peer support is when you work with someone who has lived experience of psychosis. And who are now in recovery. They should be able to offer advice and support with:. Managing your condition on your own is called self-help. Health professionals may offer you help to manage your condition on your own.

They may call this a self-management programme. Talk back to them You may find that talking back to your voices helps you take control. You could set a time each day to listen to and answer the voices. Remember that the voices are a part of you, so it may be helpful to respond to them in a way that you would like to be spoken to. For example, if your voice is stressed you could try speaking to it in a calming voice. Some people find it helpful to visualise the voices.

If you are worried about talking back to your voices in public, you could pretend you are speaking to someone on the phone. Standing up to voices that frighten or bully you can be tough. You may find it helpful to have talking therapy to help you to take the power away from the negative voices.

Distract yourself Listening to music, the radio or an audiobook may help you focus on something else. Concentrating on a task such as a household chore or hobby can help to distract you from your voices. Keep a diary You could keep a diary of your voices. You may want to keep a record of the following:. Keeping a diary may help you to notice patterns and if anything you are doing is making them worse.

This may help you to find new ways to cope with them. Use a mobile app The Hearing Voices mobile app offers support and promotes understanding of the challenges faced by people who hear voices. It was developed in partnership with the Hearing Voices Network England. The app is free to download. You can find more information at:. You may feel that a mental health crisis linked to your psychosis is part of a spiritual crisis.

It may have encouraged spiritual growth. You may find support from others who share your views helpful. For example, within faith communities.

Some people feel that their mental health crisis has been positive and has caused growth in their personal lives. You may believe that psychosis can be caused by a deeper psychological distress, which can be worked through. For example, if you feel as though your life is being controlled by outside forces, this might come from feelings of lack of control in your life.

It can be very distressing if you are a carer, friend or relative of someone who has psychosis. You can get support. What is a carers assessment?

NICE guidelines state that you should be given your own assessment through the community mental health team CMHT to work out what effect your caring role is having on your health. And what support you need.

Such as practical support and emergency support. The CMHT should tell you about your right to have a carers assessment through your local authority. How do I get support from my peers? You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. Or you can call our advice service on They will search for you. What is a care plan? The care plan is a written document that says what care your relative or friend will get and who is responsible for it.

A care plan should always include a crisis plan. A crisis plan will have information about who to contact if they become unwell. You should be given information about what to do in a crisis. You can use this information to support and encourage them to stay well and get help if needed. Can I be involved in care planning? As a carer you should be involved in decisions about care planning. The healthcare team should encourage the person that you care for to allow information to be shared with you.

What can I do if my friend or family member is in crisis? If you think your friend or relative is experiencing psychotic symptoms you may want them to see a doctor. This can be difficult if they do not believe they are unwell.

If you think that your friend or family member is a risk of harm to themselves or others you can:. Your nearest relative is a legal term under the Mental Health Act. What is a Mental Health Act Assessment? A Mental Health Act assessment is an assessment to see if someone needs to go to hospital to be treated against their will. How do I ask for a Mental Health Act assessment? If you are concerned that your friend or family member is a risk to themselves or other people you could try and get a Mental Health Act assessment by contacting an Approved Mental Health Professional AMHP.

National Institute of Mental Health. Diagnosis and Tests. Treatments and Therapies. American Psychiatric Association. Related Issues. Clinical Trials. Article: Shared decision making in a semi-secluded chronic psychiatric ward: The reflective Article: Experiences of friendships of young people with first-episode psychosis: A qualitative Article: Exploring the experience of acute inpatient mental health care from the Psychotic Disorders -- see more articles.