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Th ese are the basic contours of the debate, as ought to be considered uncontroversial. And once we are clear about these contours, a disparity immediately emerges in the argumentative tasks facing the idealist and materialist. Th e materialist has a mountain to climb but the idealist does not. Th is is because in the very act of stating the idealist position, it becomes clear how they can approach their task. Th eir claim is that our experiences implicate the physical world, and since to talk about ‘implication’ is to characterize our minds, the idealist’s candidate for ultimate reality provides the resources needed to fulfi l their argumentative task. Th e details may be diffi cult, but we are just talking about the basic argumentative situation. In the case of the materialist, however, the idea of building up reality from its basic physical parts sounds fi ne for physical objects, but completely inappropriate for experience. Th eir candidate for ultimate reality is clearly very promising for dealing with things like boots, but barring some incredible conceptual innovation, not for experiences
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Over a lifetime, about 1% of the population will develop psychosis and schizophrenia. The first symptoms tend to start in young adulthood, at a time when a person would usually make the transition to independent living, but can occur at any age. The symptoms and behaviour associated with psychosis and schizophrenia can have a distressing impact on the individual, family and friends.
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Psychosis and schizophrenia are associated with considerable stigma, fear and limited public understanding. The first few years after onset can be particularly upsetting and chaotic, and there is a higher risk of suicide. Once an acute episode is over, there are often other problems such as social exclusion, with reduced opportunities to get back to work or study, and problems forming new relationships.
Th ere is a physical world out there which exists independently of us. It obviously does, because things don’t disappear when you’re not experiencing them – they have a life of their own, as you notice when you accidentally bump into something. Science provides an incredibly accurate description of that independent world, and by breaking it down into its subatomic components, it has managed to get the whole thing within its description. Some philosophers and religious people think that in addition to all the physical stuff science describes, there are non- physical minds, souls, spirits, gods, etc. But this is obviously old- fashioned, superstitious nonsense: there aren’t any spooky, immaterial things fl oating around in the physical world. People only ever thought that way because, being afraid of death, they wanted to have eternal souls and because they didn’t know that our brains make our experiences. If experiences weren’t physical, paracetamol wouldn’t work!
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In the last decade, there has been a new emphasis on services for early detection and intervention, and a focus on long-term recovery and promoting people's choices about the management of their condition. There is evidence that most people will recover, although some will have persisting difficulties or remain vulnerable to future episodes. Not everyone will accept help from statutory services. In the longer term, most people will find ways to manage acute problems, and compensate for any remaining difficulties.
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Early intervention in psychosis services should be accessible to all people with a first episode or first presentation of psychosis, irrespective of the person's age or the duration of untreated psychosis. [2014]
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Assess for post-traumatic stress disorder and other reactions to trauma because people with psychosis or schizophrenia are likely to have experienced previous adverse events or trauma associated with the development of the psychosis or as a result of the psychosis itself. For people who show signs of post-traumatic stress, follow the recommendations in the NICE guideline on post-traumatic stress disorder. [2014]
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