Explaining the Clinical Key Question (Homelessness): 5

Integrating back into life in the community, outside the hospital environment can be very stressful especially for people suffering with psychotic disorders. Stress can act as a further trigger another psychotic episode. Therefore it is important that families/friends are prepared and know the best ways to interact with their returning relative/friend in order to avoid arguments that may result in the person going missing again and ending up back on the streets.

We touched on these issues when considering CBT for schizophrenia and The Case of Carol the importance of low intensity therapies for people who have suffered their first psychotic episode, especially if this has resulted in hospitalisation.

There is some interesting work on a theory called Expressed Emotion (follow the link!) that you may like to read about which demonstrates that certain family interaction styles can precipitate relapse in a family member with a history of psychoses. This theory has led to training for families which can prevent further relapse.

If more money was invested in support for families, cases of people sleeping rough who have recently returned from hospital stays could potentially be reduced.