Schizophrenia in Children and Adolescents — Spectrum Disorders and Other Psychotic Disorders

The chapter defines stigmatisation as a loss of social status driven by negative stereotypes that lead people associated with mental illness to be feared, rejected and discriminated against. The author divides it into two types — public stigma and self-stigma — and identifies its sources as neighbours, peers, the media, healthcare staff and even family members. An interesting finding is recalled: although knowledge about mental illness grows with age, middle-school children's desire to keep social distance from people with mental illness does not decrease and may even increase.

The section on the media is especially topical. It notes that television, newspapers and social media portray psychiatric wards as prison-like and patients as dangerous and frightening, strongly linking schizophrenia with violent crime — while the author, citing research, stresses that schizophrenia rarely leads directly to violence. There is a striking comparison: patients with cancer or organ failure are called «brave» and «inspiring», while people with mental illness are called «crazy» and seen as «dangerous», «lazy» and «to blame for their own illness». The author rightly reminds readers that there is no medical reason to think someone with schizophrenia has more control over their symptoms than someone with migraine.

The section on self-stigma is the chapter's most affecting part. Internalising society's negative view, the patient gradually comes to feel these reactions are justified: «Why bother?», «If others think I'm irresponsible, what's the point of looking for work?» Qualitative studies describe patients' loneliness, shame and sense of inferiority, and even how side effects of antipsychotics — a blank gaze, slowed reactions — push them to see themselves «in the patient role». The author keeps a balance: stigma does not undermine self-esteem in every patient, some even grow stronger; a parent's optimistic attitude protects the child, while hiding the illness increases shame.

The family section recalls that for much of the 20th century autism, schizophrenia, depression and ADHD were believed to stem from «defective parenting», which kept families from seeking help. The section on effects gives some heavy figures: one in ten children and adolescents has a mental health problem at any given time, but fewer than a third seek treatment; among people with serious mental health problems, stigma delays seeking treatment by an average of ten years. It also stresses that schizophrenia starting in adolescence — exactly when identity is being consolidated — is especially devastating for self-esteem and the sense of «normality».

The section on solutions is concrete and practical: removing words like «crazy», «schizo» and «paranoid» from everyday language; media portraying patients without the stereotype of danger; clinicians presenting the disorder as a set of symptoms a person has rather than the person's essence; parents telling children that discrimination reflects society's failings, not theirs; explaining genetic factors in language that does not make parents feel guilty; family education and support groups. The chapter's only weakness comes from the collection format: it is structured as a short paper and some ideas repeat.

In the end this chapter reflects the quality of the whole book: every claim is backed by a source, and the language is scientific yet humane. Although the book is written primarily for professionals, its chapters on stigma, family education and psychosocial interventions are also valuable for patients' relatives. Resources this comprehensive on childhood and adolescent psychosis are very rare in Turkish.

• Twenty-nine independent chapters, each by a different author
• An abstract and keywords at the start of each chapter
• In-text citations and extensive references after every chapter