• Despite increased understanding of common mental health problems, complex conditions such as schizophrenia and borderline personality disorder (BPD) are still hugely misunderstood

  • Many of the people surveyed admitted they would be nervous, fearful, and in some cases stop seeing a person if they were diagnosed with such illnesses

  • Misunderstanding and stigma makes life more difficult for those living with schizophrenia

A new survey by the mental health charity St Andrew's Healthcare showed that when presented with symptoms of various mental health problems, almost 40% of respondents were able to correctly identify the symptoms associated with the depression, compared to just 6% for schizophrenia or BPD.

58% of respondents to the survey, carried out by non-profit research and marketing agency, NGI Solutions, incorrectly identified having a ‘split personality' as a feature of schizophrenia, while 1 in 10 respondents thought that being a psychopath was also a ‘symptom' of the illness.

This misunderstanding has undoubtedly led to fear and stigma around more complex mental health problems, with 1 in 4 people admitting they would be nervous if someone they knew was diagnosed with schizophrenia, compared to just 1 in 20 when asked the same question about depression. The results are even more staggering as half of those surveyed stated that they, or a friend or family member, had been diagnosed with a mental health problem, illustrating that even when someone had exposure to the issue, their understanding of the more complex conditions was still low.

What are the symptoms of schizophrenia?

Schizophrenia is often described as a psychotic illness, meaning that a person with schizophrenia may not be able to distinguish thoughts from reality. 

The symptoms of schizophrenia can be divided into ‘positive’ and ‘negative’ symptoms. 

Positive symptoms include delusions and hallucinations. The most common hallucination is hearing voices. The voices are not imaginary in the sense that they don’t exist; a person with schizophrenia does hear them, but they are created by the mind. Scans have shown that brain activity ‘lights up’ during hallucinating voices in the same way that it would if you were talking to someone. 

Negative symptoms include feeling withdrawn, unmotivated and/or depressed; these symptoms are usually longer lasting. The negative symptoms of schizophrenia can often appear years before a person experiences what is considered to be a schizophrenia episode.

Katie Fisher, Chief Executive, St Andrew's Healthcare, said:

"While we have come a long way as a society in breaking down barriers about depression and anxiety, it's clear from this research that we still have a long way to go to demystify complex mental health conditions like schizophrenia and borderline personality disorder - both of which were shown in this survey to be less understood.

"The nervousness around the diagnosis of schizophrenia may be linked to fears around violence, but someone who is living with schizophrenia is far more likely to be subjected to violence than to be the perpetrator of it. Someone who has psychopathic traits, such as a lack of remorse and empathy, is completely different to someone diagnosed with schizophrenia, yet as this research highlights they're all too often confused. These myths will have a detrimental impact on vulnerable people struggling with complex mental health problems."

Schizophrenia is a severe long-term mental health condition which can cause a range of psychological symptoms including hallucinations and muddled thoughts.  People with schizophrenia do not have a split personality. BPD is characterised by emotional instability and impulsive behaviour, it's not when someone is borderline unwell and it doesn't make someone manipulative, weak-willed, and unreliable.

As a mental health charity with a number of in-patient hospitals across the UK, St Andrew's Healthcare sees first-hand the impact this stigma has on its patients.

Bridget has been living with schizophrenia for more than 40 years. After experiencing a decline in her health, she was twice admitted to one of St Andrew's psychiatric intensive care units where she received treatment to help stabilise her condition.


Bridget said:

"My illness impacts my life on a daily basis. I find it very confusing most of the time and sometimes I'm unaware of the way my behaviour changes until someone addresses it. 

"Schizophrenia and more complex illnesses are not talked about, not understood and not exposed anywhere near enough. Sometimes people can be judgmental, but this is through lack of knowledge and understanding. My advice to people who may not have any awareness of the condition is to not be afraid of us. It's much scarier for people to live with the illness day to day than it would be for someone to accept us for who we are.

"Schizophrenia is not a choice, just like someone wouldn't choose to have cancer, so be mindful and treat us equally, just as you would if someone had a physical health condition."

Katie added:

"One of the main reasons we wanted to conduct this research was to enable us to have a more open conversation about complex mental health problems to tackle stigma. We hope that in doing so, we can help patients like ours feel more able to live fulfilling lives in the community."

Further reading

In response to the Guardian's 'personality disorders at work'

Is there a link between mental health and violence?

My experience of borderline personality disorder

How are fear and violence connected?