In this must read three part series (links below), The Boston Globe provides an in-depth look at mental illness as readers meet Michael Bourne, a 33 year old man with a long history of mental health issues, as well as his loving mother Peggy Bourne who throughout the years still tirelessly continues to be his support and caregiver. In this powerful series, one gets a unique and important perspective, as you hear about a family desperately trying to navigate the mental health system and trying to accomplish the challenging task of getting their loved one proper treatment and keeping them safe and in recovery for more than a few weeks or months at a time ... it's a story that is all too common.

"Mike was 33 years old. He’d been in and out of institutions for half his life, since he first got sick when he was 17. His diagnosis had changed over the years — it was #schizophrenia, then #bipolar disorder, then #schizoaffective disorder — and his medications were in constant flux. Things stayed good for a while, then went bad again. Now Mike’s medications seemed to be working, and he was saying that he wanted to stay on them — a view he didn’t always take. But there had been so many days like this, so many hopeful new beginnings.

Often, when bringing him home from a hospital stay, Peggy saw again the man she knew: funny and charming, intelligent and sweet. And then she watched that man disappear, receding from her as though into the depths of a lake. He was replaced by someone else, whose thoughts she did not understand. Mike suffered at times from #delusions. His mother never feared him, but some of the neighbors did, interpreting his loudness and profanity as threatening.

Peggy had lived for years with the constant worry. She had lived with the complaints from neighbors and the calls from the police in the middle of the night; she had coped with Mike giving all his money to strangers or throwing all their food away, believing it was poisoned. She had watched his friends grow up and get jobs and get married, while he remained trapped in place. Yet she still believed that one day, the right treatment would free them. Mike would stay well, and she would have her son back."

• "Part 1 of 3: Brave and Afraid and Heading Down The Longest Road" by Jenna Russell (Boston Globe)
• "Part 2 of 3: Days of Crisis, Compassion, Faith and Futility" by Jenna Russell (Boston Globe)
• "Part 3 of 3: Desperately Guarding a Spark of Hope" by Jenna Russell (Boston Globe)

A powerful story of a family who desperately want to help their loved one who has schizoaffective‬ disorder depressive type with persecutory delusions ‬, but are unable to because of the strict involuntary commitment laws in Maryland. 

"Because he does not think he is sick, voluntary treatment is not an option. Unless he threatens to harm himself or someone else, or is so sick he cannot keep himself alive, he cannot be deemed dangerous ..."

"Behind the yellow door, a man's mental illness worsens" by Stephanie Mccrummen (Washington Post)

Put your knowledge and skills to the test with the case of a patient who is deaf and self-signing. What challenges would arise in a situation such as this? How would you interview and complete a psych assessment of this patient? 

The patient also "is withdrawn and says she is 18 months pregnant. She signs to herself; an interpreter says she uses unintelligible signs and poor syntax". Can you make the diagnosis or come up with a treatment plan?

"Deaf and Self-Signing" by Victoria Johnson and Glen L. Xiong (Current Psychiatry)

Schizoaffective disorder is listed in the DSM-5, under "Schizophrenia Spectrum and Other Psychotic Disorders".   Most simply put, schizoaffective disorder is kind of like a mixture of schizophrenia and a major mood disorder ...

Patients with this mental health condition experience symptoms characteristic of schizophrenia including delusions, hallucinations, disorganized speech, disorganized or catatonic behaviour, and/or negative symptoms (ex. lack of drive or motivation).  However, the patient also experiences episodes of depression or mania, with mood symptoms lasting for the bulk of duration of illness.  What differentiates schizoaffective disorder from a depressive or bipolar disorder with psychotic features though, is that the psychotic symptoms are present for at least two weeks during which there are no mood disorder symptoms.   

While the prevalence of schizoaffective disorder is thought to be less than schizophrenia, it is associated with a lifetime risk of suicide of 5%, and many affected individuals often are also diagnosed with anxiety disorders and substance use issues too.


To get better insight into schizoaffective disorder, how it affects someone's life, and the counselling and therapy patients can go through as part of their treatment, check out the book What A Life Can Be (more information below).

Recommended For:
Those interested in psychiatry, and those curious to know more about schizoaffective disorder.