It’s a good idea to establish some ground rules first – ideally when the person is feeling OK. Agree between you what help they actually want, and would find useful.1,2

It’s also a good idea to agree an action plan for how you will deal with relapse into an acute episode – what responsibilities should you take on, and what power will you have to make decisions for the person if they become severely unwell.1,3

It can be hard for people with schizophrenia to organise their time. It can also be difficult for them to recognise that they are unwell and need medical help. You can help by making sure you both know when appointments are scheduled, what -if anything- needs to be done to prepare for that appointment, how they will get to and from the appointment, and who the appointment is with.4

When someone’s feeling low and has no motivation (both common negative symptoms of schizophrenia1,5 ), it can be tough for them to keep on top of everyday jobs like laundry, grocery shopping, picking kids up from school or tidying the house.

When someone is experiencing hallucinations or delusions, it can be difficult to relate to them. Their reality is so different to yours, it tempting to say, “It’s not real, it’s all in your head, this is not what’s happening.”

But this may not be very helpful.1,2,6 It could make them feel more isolated and misunderstood. Instead, you could focus on how their experience is making them feel. Remember that while the reason they feel this way may not be real, the emotions it makes them feel are very real.2,7

Schizophrenia can be really tough to live with. There are a number of factors that can make suicidal thoughts and behaviour more likely, such as:8

• Feeling hopeless
• Living alone or not having friends and family around
• Coming up against a life obstacle or problem (e.g. end of a relationship, loss of job or home)
• Having had suicidal thoughts or behaviour before
• Feeling worthless

It’s not always possible to know if someone is planning to end their life – the idea may come to them spontaneously and they may act on the thought impulsively.8 You can’t prepare for every possible eventuality, and it is not your fault if something happens you weren’t expecting. You’re not a mind-reader or a fortune-teller.

However, there are sometimes signs that may warn you something isn’t right such as: 8,9

• Talking about dying
• Talking about feeling hopeless, that the future is bleak
• Making arrangements, like a will
• Saying goodbye to people as if it were the last time
• Self-harm – although bear in mind that this is often hidden and may go unnoticed for some time10
• Suddenly feeling happier – this may be a sign that they have decided to commit suicide and feel happy that there will soon be an end to their suffering

If you notice any of these warning signs, get in contact with your local mental health service as soon as you can.

It’s not easy dealing with schizophrenia symptoms and treatment. Encouragement and praise can help someone struggling with schizophrenia to feel better about themselves.11 Remind them of the things they are good at.12 Notice when things are going well.1 Show them that you care and that they are loved and wanted.12

Feeling isolated, neglected or abandoned can make anyone miserable. Keeping the lines of communication open is vital to help your loved one feel less alone with schizophrenia.7 It doesn’t always have to be long in-depth conversations. Other ways to keep communication open might be:

• Send short notes, cards or postcards
• Send texts, emails or direct messages – you could just say hello, or send a gif or image you think they might like
• Tag or link them into social media conversations or groups you think they might enjoy
• Pick up the phone and call – you can always leave a voicemail if they don’t like to answer the phone
• Pop round/knock on their door and invite them to join you in something like a walk, a game or TV programme you both like

When someone is experiencing delusions or hallucinations, they need proper medical therapy to work through those. Shouting at them or telling them it’s not real won’t help. It won’t make them “see sense” or make the delusions go away. It’s more likely to upset them and make them feel even more misunderstood and unwanted. It’s also likely to upset and frustrate you.

A calm, kind approach is more likely to have a positive outcome. Acknowledge how upsetting it must be to have these experiences, and offer sympathy.2,7,11