Psychosis, especially untreated, can be considered an extreme state of mental dysfunction. Psychosis is a loss of connection with reality and a core feature of schizophrenia. Helping patients with psychosis, with or without mood instability, is invigorating. In my experience, whenever patients with psychosis ask me to help them improve the quality of their lives, they're usually genuine. Whenever they present to emergency services reluctantly or involuntarily, their lack of insight into psychosis is startling. Among the countless patients with delusions, medicated or unmedicated, whom I've interviewed, seeing a patient who has insight into being delusional is rare. In fact, I am only able to recall one such case. I'm surprised it's not part of the DSM-5 criteria. Psychiatrists and psychologists advocated for the addition of this in the development of DSM-5 to no avail.
I have no problem taking a patient-directed treatment planning approach with a patient who is high functioning and well enough to understand her or his mental illness and need for treatment. Logically, this method is deficient for other patients. When I am limited in the ability to help patients with schizophrenia because of either overly restrictive law or the absence of law, this motivates me to act abundantly on their behalf.
Our broken system sparks outrage. The greatest expression of passion for a subject matter is teaching it to others and asking for legislative reform.
To read the petition and letter to the National Alliance on Mental Illness (NAMI), attached to a video approximately ten minutes long, that I helped create with other advocates, please click on the following link: