At the Center for Excellence in Community Mental Health, our treatment philosophy is rooted in scientific evidence combined with common sense and a respect for individual preferences. We view schizophrenia and other related mental illnesses as medical disorders that affect the brain. But we also recognize that these illnesses affect the person, the family, and the community. We address issues of overall wellness, and recognize that the mind and the body are best treated in an integrated manner.
We foster a collaborative approach to treatment with our clients, and offer medical and psychosocial treatments flexible enough to respond to individual preferences and circumstances. Our multidisciplinary team approach to treatment integrates the perspective of a variety of disciplines, including psychiatry, social work, psychology, occupational therapy, and others.
A typical treatment plan for one of our clients may include medication management and psychotherapy. For individuals who have complex needs and difficulty navigating the complex service system, we offer case management focused on coordinating care and services from multiple systems.
Our treatments are relationship-based: we believe that at the core of effective treatment, there must be a trusting and collaborative partnership between doctor and patient, or client and social worker.
Our programs are treatment-based, but we collaborate closely with other community programs and agencies to develop holistic plans of care. We offer opportunities for peer support and creativity through Brushes with Life, an arts program that includes gallery space in the UNC Neurosciences Hospital.
We recognize the significant effect that schizophrenia and other severe mental illness can have on families. Our treatment approach is commonsense, flexible and humane — we meet the families where they are. We respect our patients' confidentiality, but encourage family involvement. We are available to help with crises, and we partner with families in finding the best strategies to deal with issues as they arise.
In both STEP and OASIS, we work with families using a therapeutic tool called psychoeducation. With a proven, 20-year history, this approach is one of the most effective psychosocial interventions for schizophrenia.
Pscyhoeducation can be provided to individual families or to a group of families. The essential elements of this approach include education about schizophrenia, emotional support for family members, and training in structured problem-solving and communication skills. The outcomes can include a reduced need for hospitalization, and better stress management for all family members involved.
About 1 of every 100 people develops schizophrenia; 1 of every 50 develops some other psychotic illness. People with relatives who have schizophrenia have a slightly greater risk than others: the closer the relative, the greater the risk. You are at highest risk if you have an identical twin who has it. However, not all twins who have identical genes share this illness, so that proves that genes may play a role, but they are not the only factor responsible for the illness. If it were just a matter of genes, then if one identical twin got schizophrenia, the other always would too; in reality, this only happens in about half the cases.
Other factors that may play a role in who gets or doesn't get the illness are changes in the development of the brain in utero due to exposure to viruses, toxins, or lack of nutrients at critical periods. Stressors in early adulthood can play a role, too.
We still don't completely understand what causes schizophrenia. Many researchers think it may actually be different illnesses, with different origins, lumped together under one diagnostic label. Until we understand all this better, it will continue to be very hard to determine the likelihood that any given individual will get the illness.
Founded in January 2009, the Center for Excellence in Community Mental Health is part of the Department of Psychiatry in the School of Medicine at the University of North Carolina at Chapel Hill. Addressing quality of care and workforce development issues in North Carolina's mental health system, the Center and its clinical programs are supported by a three-year grant from The Duke Endowment, as well as Cross Area Services Program (CASP)
funds. The program operates in conjunction with multiple university, state, and community-based partners.
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