A competent doctor will ask you many questions in order to learn as much about the patient's background as possible. Be prepared to discuss the patient's life, personality, behavior, and ability to function before the illness led to a visit to the doctor.

Find out if any relatives suffered from a mental illness. This includes schizophrenia, other psychotic disorders, bipolar disease, and depression. Ask your relatives about this if you are not familiar with the medical history of other family members.

Don't be surprised if the psychiatrist wants to meet with the patient alone before meeting together with both of you. The doctor needs to establish a rapport with the patient, and seeing him alone helps accomplish that goal. It may take several sessions for the patient to feel comfortable enough to confide in the doctor. Some patients can hide their most troubling symptoms, such as hearing voices. But if the patient begins to trust the physician, the physician will be able to approach the topic of psychotic symptoms without threatening the patient. Longer conversations are more likely to reveal thoughts, delusions, and other problems the patient may want to hide from others.

When Did This Start?

Try to determine exactly when the patient's behavior became noticeably different. Using specific examples of unusual behaviors may help you date the onset of symptoms, something that could be very helpful in making a correct diagnosis. Describe all the symptoms you have observed, as well as details of the behavior associated with any delusions, hallucinations, or bizarre thoughts. Your impressions about the changes you have observed and sensed in the patient are important too.

Keep records during treatment. Note what symptoms were present and the dose of medication the patient was taking at the time they appeared. These observations can help the doctor and patient find the most effective medication.

Your records also may help you spot troublesome episodes earlier, when medical intervention might be more effective. Stopping an episode in its early stages is much less traumatic and stressful for everyone. Since early indicators of relapse differ for each individual patient, your observations and notes may be useful in the future.

The Mind Has a Body

A recent National Alliance on Mental Illness survey found that 49 percent of people living with schizophrenia believed their doctors did not consider a patient's medical problems as seriously as they should. This perception is especially troubling since people with mental illness are two or even three times more likely than the rest of the population to die from ailments such as diabetes and heart disease.

There are several reasons people with schizophrenia do not receive medical treatment as quickly as others. First, schizophrenia's symptoms may hinder a person's ability to recognize and/or tell anyone about physical ailments at an early stage. Cognitive, psychotic, and negative symptoms may all act to prevent a person with mental illness from reporting the symptoms of a physical problem. It is also possible that some physicians unfamiliar with mental illness may discount or overlook physical symptoms, dismissing them as part of a patient's delusions.

If a patient experiences a physical problem while receiving inpatient psychiatric care, make sure he is evaluated by an internist. All free-standing psychiatric facilities are required to have internists and other medical specialists available.

If the problem is urgent, it may be better if the patient is transferred to a general hospital at which psychiatric specialists may continue to provide psychiatric care. It is common for patients admitted for inpatient psychiatric care to be hospitalized on specialty psychiatric floors of general hospitals, where other specialty care is readily available if required.

The Caregiver's Role

There are many ways you can assist the doctor as you help yourself and the person you care for, including the following: