I'm a MH nurse and absolutely agree.
Public understanding of SMI (particularly things like Schizophrenia) is very poor, and stigma remains high. People on the SMI register are significantly more likely to have poor health outcomes, poor work outcomes, be socially isolated, experience financial hardship, and so on. People absolutely do not understand that these are often relapsing illnesses which make people very poorly indeed. People do not understand that the drugs required to keep people stable are really quite horrible medications with high side effect burden for many people. Also what 'well' looks like is a huge spectrum for people with SMI. One person with Schizophrenia might be stable on meds for years and hold down a job, run a house, etc. Another may not have psychotic symptoms, but might experience a lot of the negative symptoms and therefore has a low level of functioning. Others may be quite impaired due to years of antipsychotic use and need supported living and carer support. Same with Bipolar- you get some people who get very cyclical depressive episodes, but very infrequent manic periods. You get people in and out of hospital due to have very stress sensitive manic episodes. I have a patient who roughly every 3 months is bed bound due to her depressive episodes. She has been that way for years, and unfortunately, despite treatment, that just appears to be how she will always be. I also think there are a lot of misconceptions around delusions etc- people only think of paranoid delusions about others (which is fuelled by the media imo). Other psychotic symptoms like hallucinations (auditory, tactile, olfactory, etc) and things like disorganised thoughts are poorly understood.
Unfortunately I also sadly think people still associate Schizophrenia with violence towards others, when in reality most people are more a risk to themselves (either due to suicidality or significant self neglect). I work with older adults, and in my experience, Schizophrenia also makes some adults far more vulnerable to harm from others in terms of exploitation, etc.
Also, employment is not always accessible. I get angry when people moan about people with mental illness getting PIP etc. In reality, who is going to employ someone who many need to attend Clozapine clinic once a month, who needs time off to see their mental health nurse, who needs later starts due to heavy sedative medications, who may have long periods off if their illness relapses, etc etc?
I think it's great there is acceptance of depression, anxiety, etc, now, however I still think acceptance only goes as far as 'it's okay to feel your feelings' and all the other diluted insta type fluffy stuff around self care. The reality of depression might be not brushing your teeth for days, lashing out at others, drink problems, chronic suicidal thoughts, and so on.
There really needs to be a good public health campaign around different types of SMI. I also think this would be very helpful for carers/loved ones. These illnesses are also hard on family a lot of the time.
Anyway. I could go on forever 😂 good on you OP for making a thread about paranoid Schizophrenia. I think that takes a lot of courage, and things like this encourage people to ask questions and breaks down stigma.