Before reading this article, you might want to know what qualifies me to write knowledgeably about schizophrenia. First, I do have a degree in Psychology which I pursued specifically to learn about schizophrenia. Second, this exact situation happened to me during my teaching career. Fortunately for both the student and me, I have a reasonable amount of experience with schizophrenia. And third, the reason I have so much experience comes from the fact that paranoid schizophrenia runs in my family.
Supposedly, the incidence of schizophrenia is roughly equal between men and women, but on one side of my family it runs in the males. I have 2 living relatives with diagnosed paranoid schizophrenia (one diagnosed at age 7, the other was adult afternoon.), One relative who is still a question at this time, and my younger (at some time, but no hallucinations and no diagnosis) brother died in 1976 by stepping out a fourth story window. We think that his hallucination of being GOD made him believe he could not be hurt and he would gain followers from his miracle. Of course, things did not quite go that way.
I mention my brother here because it is important that everyone understands that while people who are schizophrenic have a high suicide rate, it is not appropriate to assume it is based on depression. Hallucinations often cause people to do things that are dangerous and do lead to death, but death was not their intent. This fact makes recognizing that someone is having a hallucination a reason for immediate action.
If you teach young children, the likelihood of schizophrenia is lower, and those who are diagnosed are generally already on meds, stabilized, and illegally to just go off their meds. You will need to deal with the learning issues involved which varies importantly from child to child, and you most likely will have support staff to rely on.
For older students, there are several reasons that why things may not go as smoothly. Due to privacy issues, you will probably never know you have such a student unless you notice symptoms or the student confides in you about his condition. I believe that older students are encouraged to confide in their teachers. This is a good thing.
What should you do?
1. Do not be afraid! Violence to others is unusual. (Keep in mind that very often, especially with paranoid schizophrenia, the person does not consider them ill – it's you!)
2. Contact the student's school counselor as soon as you can to find out any available information –particularly related to medication. You may also be given permission to contact the student's private doctor. If so, make contact soon. The more you can learn, the better.
3. Educate yourself. Do research into the specific type of schizophrenia with respect to the age of your student.
4. Most importantly, talk to this student. (I use he and him because that is my experience.) Get to know him. If you have known someone with schizophrenia, share that. If you know nothing, share that as well, and ask if he would be willing to talk with you about himself. If he says "No," say you understand, honor his decision, and later call the parents to get the following information. Do not ignore this student. He is just another one of your students. Treat him as you treat the others (except as I indicate below).
If your student says "Yes," set up a time (right then if at all possible).
Remember that your goal is to help this young man learn, so he might hesitate or not answer some questions. That's OK.
Things to discuss:
a. How and when was he diagnosed?
b. Is he on meds? (This means medication.) If yes, how do its meds make it feel or act? Drowsy? Slurred speech? If no, how does his condition manifest himself? Is there anything specific you might notice?
c. Does he have trouble concentrating / staying focused? If yes, get his permission for some kind of very subtle signal – maybe a touch on the shoulder or a tap on his desk – to bring his focus back.
d. Ask if there is anything that he is aware of that you can do to help him learn (stand near him when you talk, say things in a different way, etc.). Also ask him if there is anything he knows does not help . How does he feel about being called on in class?
e. Ask for his permission to have a conference with his parents to get additional information from them. (No, you do not technically have to ask for his permission, but often these students feel isolated and powerless. Give him some power.) You can still call the parents.) Whether by conference or phone call, find out if the parents have any suggestions for helping him learn or signs you should be looking for.
f. Ask if there is anything he would like to talk about.
5. Know that because these teens often do not consider themselves ill, they tend to stop taking their meds. For this reason, you must stay constantly aware of the student's "state of being." Watch his mannerisms for frustration, restlessness, etc. Listen carefully for mumbling or quiet talking to no one. Pay attention to everything he writes or draws on assignments, on notes, on notebooks, on clothing. Pay attention to what he wears. Be constantly aware.
If at any time you get a sense that he is having hallucinations, contact the counselor and parents ASAP. He is not taking his meds and is in danger!
Likewise, if you get any indication (usually from things they wear, write, or draw) that he is considering suicide or something dangerous that may cause death, again, contact the counselor and parents ASAP. Teens with schizophrenia have approximately a 50% risk of attempted suicide; and remember, that can happen with hallucinations – with no intention to die.
One thing I definitely know for sure: you do not want a student death on your conscience. It will never go away!