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Psychosis (young people)

Being in school, college and university with psychosis

Many people we spoke to experienced psychosis while they were studying at school, college or university and some were still in education. Andrew X was training to be a social worker and Nikki was training to be a Mental Health nurse. A few had left school and started work when they first experienced psychosis or ended their course early because of their psychotic experiences. People talked about how psychosis had affected their studies and about the help they received in the early stages of experiencing psychosis. Some also talked about the stigma and discrimination they had experienced from their peers and from school teachers and administrators.
 

Hannah had a positive experience of support from her school but still struggled to study because of her psychosis.

Hannah had a positive experience of support from her school but still struggled to study because of her psychosis.

Age at interview: 19
Sex: Female
Age at diagnosis: 15
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It was difficult. I only had like a very small circle of friends. And they were the ones who knew about it, knew what was going on. It was difficult to keep up with everything because everyone was doing all of their work and I was missing so much. But it's okay.

And in terms of sort of missing school, who was it that informed the school then?

My mum spoke to them about it. And to my head of year and they allowed me to drop some subjects so that I could keep up with the other ones, which was very helpful. 

And was there any sort of counselling services at the school as well or any nurse involved?

No.

Right, okay. Did they just not have a nurse or?

I think they had a counsellor there. But I never used them.

Is that because you didn't want to or just wasn't offered.

I don't think it was offered, but I wouldn't have wanted to, I don't think, because I wouldn't want to take more time out to see them.
 
But while you were at school, you were getting support outside it sounds like, anyway. 

Yeah, yeah.

From them. Was that kind of enough?

I think so. 
 
And tell me a little bit more about the school head of year and how important their input was

 I was really grateful for their help. How they would make sure I was okay and they gave me an exit card, so that if I was in my class and I was overwhelmed with thoughts or visions, I could walk out and then I would go sit in their office and just calm down and—
 
Did you ever use it?

I did. That was really useful. 

Brilliant. It sounds like an amazing idea other schools might usefully used as well. 

They should.

And was that something that they just offered to you or did they ask you about it?

They told me about it and I said, yes, please.

Okay. And they had to obviously let the teachers know what it would be and everything. Brilliant. And how did the experiences affect your study? What was it about the experiences that most affected your study?

That I wasn't able to attend the school. I didn't leave the house very much. So I wasn't getting the proper teaching and that sort of thing.
Difficult experiences in school in the lead up to psychosis  

Being in school in the lead up to their first experience of psychosis was a very difficult time for some of the young people. Tariq, Nikki, Andrew X, Barry and Sam experienced bullying in school and felt it had contributed to their psychosis. Some felt that teachers and those in positions of authority had not intervened, and blamed them instead of the bullies. This caused them to feel frustrated and angry and some began to blame themselves, which also fed into their psychotic experiences.
 

Andrew X describes how difficult it was for him when he believed that others could hear his thoughts.

Andrew X describes how difficult it was for him when he believed that others could hear his thoughts.

Age at interview: 24
Sex: Male
Age at diagnosis: 14
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But I'd say the first, the first phenomenon, if you will that I remember in particular, a particularly difficult one. Something I think is called 'Thought Broadcast' and this was, out of everything I experienced out of the voices, out of the self-harm, out of the depression, out of the suicide ideation this was the most difficult to deal with. So I'd be sitting here and I'd be you know, just thinking, as people do and you know their mind is their sanctuary. They should be able to think what they want. But I felt as though people would be able to, that my thoughts would be broadcast to other people. So people sitting in the room with me would be able to read what I was thinking. So let's say, I thought, oh, you know, [friend’s name] has some really terrible shoes. I would feel as though [friend’s name] would be able to hear that. So that's really difficult, because then your thoughts don't become your own. So you're guarded about what you're thinking and you're stopping yourself being able to think. That's horrific. And that's really difficult to sort of manage and particularly when you believe it's true. And then you get paranoid about what people think about what you've been thinking about them. That's, that, that, that, that really destroyed me that did. That was a really difficult experience. And that's probably the most powerful memory from that, you know, the first memories. It took me a while to actually resolve that. Took a lot of counselling or therapy, whatever. 
 

When Tariq was attacked by another student, the teacher did nothing and blamed Tariq. He began to think he was at fault. He couldn’t get the voices and faces of the bullies out of his mind.

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When Tariq was attacked by another student, the teacher did nothing and blamed Tariq. He began to think he was at fault. He couldn’t get the voices and faces of the bullies out of his mind.

Age at interview: 21
Sex: Male
Age at diagnosis: 18
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So what happened during that two years, the bullying was, was so bad, what really stopped me from going to school was in the last nine months, it was an assault that had taken place during a physical education, we call it PE, where I was attacked with a base, with a cricket bat. It wasn’t very hard hit but it was someone had hit me right on my legs and it was, they’d hit me and the person who was the teacher during the lesson was my form tutor and he was a PE teacher at the school and he did nothing to intervene or stop the violence. And when I did approach him and asked him he said that I was responsible and that if anyone had come to him, if the head teacher had approached him he would say that it was me that assaulted the student. At that point I was amazed that I was being blamed for something I didn’t do but what I did notice is that every time that these bullies were subjecting me to these assaults and every time I did report it nothing was done about it. Nobody was spoken to, no action was ever taken and I was the one that was being held back in detention, I was the one that was being told off, you know, stop making trouble, when I was just coming to school as normal. But then at that period I, because I was young I was vulnerable, I didn’t know what… I couldn’t think straight as well I thought to myself, it must be my fault that all these people are bullying me because I must have done this, done something.

But then every night when I went to sleep I started recounting what happened to me during the bullying and everything came flooding back. 

And the thing is that even the faces came flooding back, every face, you know, if I was to see all the bullies today I would know their faces. If I was to see all the teachers today I would know their face. It all flooded back, everything flooded back, even the traumatic, the pains that I was going through when I was having my surgery everything all came back. And it, and I couldn’t put it behind me, and it was like when I tried to think of something I couldn’t, it was just right at the front.
People could be acting unusually at school, or dealing with other health issues such as depression and anxiety. At the time of interview, teachers did not have specialist training in mental health and many young people we spoke to felt that school staff didn’t recognise that they were struggling, or appreciate how unwell they were, and some didn’t realise themselves what was happening. There were rare occasions when a teacher noticed that things weren’t right.
 

Before his psychotic experience Luke, who was later diagnosed with bipolar disorder, suffered from depression. He struggled to concentrate in lessons and only one of his teachers noticed.

Before his psychotic experience Luke, who was later diagnosed with bipolar disorder, suffered from depression. He struggled to concentrate in lessons and only one of his teachers noticed.

Age at interview: 21
Sex: Male
Age at diagnosis: 19
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And I'd work until three in the morning. I'd suddenly find this energy. I, I'd read the last weeks of syllabus. I'd go back, and I'd be like - I didn't even pay attention in class. I mean, it was pointless me going to school. I would just go to the lesson, I would, you know, just sit there just to show my face. I couldn't concentrate. You know, ten minutes to go, I'm rolling up a cigarette. And I'd go straight home and have a nice coffee. And it was pointless being in school. And I remember I got - the teachers were onto me all the time. You know? You can't expect, you can't expect teachers to be psychiatrist level of understanding. But there's a massive, massive issue in schools at the moment, I think, with kids and stuff. From, from a first hand experience, the teachers really didn't understand depression. You know? They, they just thought 'ah, it's just a teenager, he's going through - thinks he's going through a tough time, wait until he gets to the real world and, and has all these difficulties'. But, no. I got quite angry at school. I got angry at myself. Angry at the teachers who would sort of say, "Oh, why aren't you turning up to lessons? Why don't you buck, buck your ideas?"

The only person that picked up on it was my English teacher. There was a - I remember vividly. There was a lesson that - I was always really vocal, I'm a vocal guy, like to make, to crack a joke or two. And she asked me a question. And I said "I don't have an answer." And she was like "Okay." And she was smart enough to realise something was up. And at the end of the lesson, she said "Can you stay behind, can we have a chat?" And I cried. I started - I burst out in tears in front of her. And I said to her, "Ah, something's - it's just something wrong and I don't know what it is." And it was almost that despair, of not having an answer for why I feel so low. When throughout - a lot of childhood had been idyllic, you know. You have that naivety of youth. 

And that wasn't long before I was diagnosed. I sort of managed to get through sixth form. And I managed to get the grades I needed for the job offer. I sort of skirted through. I mean, my attendance was awful. I couldn't go to school, half the time, because I'd been up until five the morning the night before, and I'd slept through to one in the afternoon. I kind of felt this peace at night time. When everyone else is asleep, and everyone else has switched off, it's just me alone, with my music, with my thoughts. You know, I'll sit in - I'll sit in my conservatory for hours, listening to music, having a smoke. Yeah, and just - just relax, with no pressure. And then suddenly you go to school, there's seven hundred, eight hundred kids around. You know, you've got all your mates. They want you on top form. They want you to be making, cracking the jokes, and. It was just a horrible time for me, sixth form. So in a way, you know, once I'd got over the fact I was diagnosed really short into my - when I was 18, at work. Once I got over that, I was kind of relieved that I finally had a diagnosis.
Experiencing psychosis at school/college

Some people were in school or college when they had their first experiences of psychosis. Nikki, Emily and Sam remember hearing a voice while they were sitting in lessons and asking others if they had heard it.
 

When Emily first heard a voice, she was sitting in a classroom and turned around to ask her friends if they had heard it too.

When Emily first heard a voice, she was sitting in a classroom and turned around to ask her friends if they had heard it too.

Age at interview: 23
Sex: Female
Age at diagnosis: 21
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I remember like it was yesterday, 'cos it was so weird. I remember sat in a classroom, I think we were doing religious education and I was sat with my friends and all of a sudden out of nowhere, something just said to me, kill yourself. And I sort of, it didn't, it's not, it wasn't my voice, it's like a different voice, female voice. And I thought it was my friend messing around or being nasty. Looked around and everyone was sat down still writing and I said to my mate, did you hear that? She went what? And I said, did you not hear what they said? Thinking someone was picking on us. And they just went, looked at me as if I was like on a different planet. So I was just sort of sat there for a minute and I ended up getting told off, because I was so distracted, they thought I was just messing around. But I just remember a feeling. So, like strange and sort of thinking, oh god, you know, it's happening to me. 'Cos I knew what it was like with my dad, you know, when he got ill. So I just sat there and thought, oh, no, you know, not me I don't, I don't want that. But obviously I had no choice, it just happened. 
When people were unwell other young people could be judgemental and unkind. This made it difficult to talk about what was happening. When Luke, who was diagnosed with bipolar disorder, was in sixth form college he said everyone was very “fickle”. He was offered counselling but refused because he didn’t want to be labelled as “the kid that sees the counsellor”.
 

After Nikki told a school friend about her psychotic experiences the friend started spreading rumours.

After Nikki told a school friend about her psychotic experiences the friend started spreading rumours.

Age at interview: 19
Sex: Female
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I think people were mainly confused as well. The first person I told was a friend. She wasn’t she was okay at the time. She was just like, ''Oh, I, I don't understand it, but you know, I'm here for you.'' But then she started to spread rumours around my school like, oh, Nikki is like a bit, you know, weird, crazy. You shouldn’t be friends with her. Like she's just too weird. Just don’t be friends with her. And I just suddenly noticed like people not talking to me and avoiding me. And then I was just like, you know, must be something I've done and I didn't really know until someone told me that the rumours had been spread. I just thought it was something I did. And then I was just like this is ridiculous and you know, but I just kind of accepted it, 'cause I felt like she was my only friend. So, that was difficult. 
A few stopped attending school because they were not coping well. Aside from the psychotic experiences themselves, lack of concentration, difficulties socialising with their peers and managing with little or no sleep all affected their performance. Emily stopped going to school and worked from home instead. She tried going to college but only stayed for a month because, although she could understand the lessons, her mental health “got in the way”.

Special support from schools

Before people had been given specialist support for psychosis some people said their schools had offered them counselling and allowed them to do their work in a tutor room away from their peers, or given them extra time to complete coursework. When Joe struggled to complete his work on time, his tutor gave him extended deadlines. A few people, like Hannah, had been given a “time out” card (see Hannah talking about her experience at the start of this section), which they could show the teacher when they needed to be alone. Luke said his time out card was the first “coping mechanism” he had and that it allowed him to “get away from everything”.
 

When Sam started to experience psychosis she would run out of the school. Her teachers allowed her to sit with her tutor and choose which lessons she would attend.

When Sam started to experience psychosis she would run out of the school. Her teachers allowed her to sit with her tutor and choose which lessons she would attend.

Age at interview: 18
Sex: Female
Age at diagnosis: 17
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But it wasn't until year 10 that I realised I was just sat in. That's when I sort of got merged, I sort of started refusing going to my lessons because of it. Because I started like, I'd have like an object on the table and I’d sort of hear it like having a conversation with me and one or more times in beginning of year 10 I'd had a full conversation with a pencil case and I know it sounds stupid, but I'd be the only one sat on that table and people just looked me like, who are you talking to. And then, I’d just not say anything and I'd just walk out. And then, I've started sort of when I was in certain classes I started refusing to go to my certain lessons like science for that. 

And then I decided like after I'd been in put in, head a house office to do my work, they tried to reintroduce me. But because that time it sort of escalated and I’d start- my depression would come back and I'd started to see things which I knew was a sign of depression. Because I have family members that have it, but only have depression with that. And I'd started to like see shadows, stood outside classroom doors, then come in- through walls I couldn't stay in the—like classes like that. And I used to just run out and like I'd get my stuff, pick up my stuff, not saying anything and just walk out and go home. Or go somewhere else like go out of the school, 'cause the gates were always open. I'd go out of the school into the park, get the bus home or go see my friend who was in college. And just sort of run away from my issue.

And what did the teachers do? Were they sort of?

Well they were sort of confused why I kept running away and first off I kept running away and then I'd have weeks where I'd be, had a house officer like for a week doing—normally in the lessons. Then when I came back I'd start sort of running away from their lessons or not turning up to their lessons and just sort of sitting in my tutor room and talking to my tutor. And then they sort of permanently said, ''you know.'' They looked at my timetable and sort of just said, ''What lessons do you wanna go to?'' with my friends that I would go to that I sat and made sure that I was sat next to her. So I would stay in those lessons and that was mainly like English and tutor and that was about it. 

English and what sorry?

Like your tutor room. They're called Tutor. So your classroom like where you go like in the morning with my tutor. And that was like, that was it, like basically.
 

Andrew Z had an Asperger’s mentor and thinks that this type of mentoring scheme would be the best support universities could provide.

Andrew Z had an Asperger’s mentor and thinks that this type of mentoring scheme would be the best support universities could provide.

Age at interview: 23
Sex: Male
Age at diagnosis: 20
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Yeah, I mean, they kind of, you go to them with problems and they kind of say, they, they're supportive but they are not, I think it's better to have a mentor like I've got a mentor scheme and I'm also signed up to be a peer mentor myself. Helping other people that I mean, it's not a peer mentor, it’s a paid mentor through my Disability Student Allowance. I had one beforehand. This is because of Asperger's and not psychosis. But you can get one for psychosis as well.

So who pays for the mentorship?

The student finance. You don't have to pay it back either. So it's not a loan. So you don't have to pay it back and you don't have to pay for it. Just need to go through a need's assessment.

What's it called?

It's just a mentoring scheme.

A mentoring scheme. Okay.

It’s a national thing. Every university in the country will offer it. And you can go to kind of somewhere you can actually feel you can actually discuss problems with. You can actually, you know, discuss psychotic stuff with. You can discuss symptoms. You can discuss issues you're having. Someone to talk to kind of when you've got a problem, you know, it's always nice to go to a like a friend, but you don't have to, you can go to see your mentor, if you get what I mean. 
Most schools did not have the resources or specialist knowledge to support people through experiences of psychosis. School, college and university counsellors typically only had expertise to help with low mood and depression, but did know to refer people on. Apart from some counselling and the help of a few key staff Andrew X didn’t get much help from school and felt they saw him as “just some lazy kid”. Fran thinks school teachers should have basic training about mental health and they should treat people with compassion.
 

Luke thinks mental health should be part of the school curriculum.

Luke thinks mental health should be part of the school curriculum.

Age at interview: 21
Sex: Male
Age at diagnosis: 19
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In school - we had more assemblies on kiddy fiddlers than we did on mental health. You know, it was like, "Don't get in the back of this guy's van." And we had a policeman to come in to tell us about it. And I said "Fair enough, I'll go and get my lolly at the sweet shop." 

But you know, I don't remember one thing about mental health. I never remember in school there being any education around mental health. There was one lesson in, in - it was - learning for life. Or PH - PSHE, or - Every school has a different name for that, don't they, you know.

And we just had like one lesson on mental health. And you had to put your hand up, and they went round the class saying "How stressed are you, from a level of one to ten?" And obviously I did – I was like “I'm one, I'm not stressed at all.” Because I was one of the cool kids at the back. But, yeah. It does - I've got a sort of bit of anger about, about school.

Yeah. Do you want to say more about that? About the school thing? And what you think should have happened? Because that's sort of been in the press again lately, as well, hasn't it - about they're now saying schools should be given more kind of control - diagnosing, and all that sort of thing.

Yeah, there just should be a little bit more than - It just seems very old-fashioned to have a counsellor, and a few referrals to that. And just to tick a box, we're going to have a class where we talk about how stressed we are.

You know? Apparently, the average high school student in America has higher stress levels now than a psychiatric patient in the 1960s. Like the world is a lot more stressful these days. We're all more stressed out. The world - the World Health Organisation say - are saying like - I can't remember - it was by 2050, or 2020 by, not by - Depression is going to be the most, one of the biggest issues we've got in health.
Having to leave school

A few people left, or were made to leave, school or college during or after their psychotic experiences. Andrew X was made to leave university because he’d fallen behind with his work, and this “tipped” him “over the edge into quite a bad psychotic episode”.
 

When Fran was having delusions and thought that others were trying to kill her, her school thought she was just being “naughty and aggressive” and expelled her.

When Fran was having delusions and thought that others were trying to kill her, her school thought she was just being “naughty and aggressive” and expelled her.

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With, I mean it sounds really crazy now cos it’s ten years ago as well, but I was really getting ill. Nobody understood that I was getting ill. So at school, I was in school, I was in the sixth form at school and they expelled me. Cos they were like, “Your behaviour’s out of control. What do you think you’re doing?” And they didn’t understand. Then they had to apologise later, but that’s a different story. 

No, they always thought I was being like kind of really cheeky and naughty. And it’s like when you go in to school and you genuinely think that people are trying to kill you and stuff, you’re going to be a bit naughty and aggressive. And it got completely misconstrued. And they expelled me and they expelled my best friend as well. And they had to apologise. They had to, like, write a formal apology for it. Which made me feel quite good. 
 

A friend of Sameeha’s was “kicked out” of school when she was experiencing mental health difficulties. Sameeha talks about why it’s important to take people seriously when they say they are struggling.

A friend of Sameeha’s was “kicked out” of school when she was experiencing mental health difficulties. Sameeha talks about why it’s important to take people seriously when they say they are struggling.

Age at interview: 22
Sex: Female
Age at diagnosis: 21
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And the school had still kicked her out. And they were just like, ''Oh but the, the resources were available to you.'' It's like, ''You're not, you're not completely be understandable then, are you. You are not completely being open to what you are saying that you stand by and you believe in because you're saying that you can only be ill from a certain standpoint. 

You can only be ill if you like write down and go to the doctors and do the right things at the right time. People don't work like that. People, it takes a while for people to figure out what they're going through. To figure out what they're feeling. To figure out, 'cause there's constant stimuli in this world and people constantly trying to stay busy. But, when they actually recognise that they're suffering and then people are telling them, no you're not. It, of course they are gonna go inwards, of course they are not gonna want to talk. Of course they are not gonna wanna connect or whatever resources you have available. They are gonna just wanna stay silent and stay within themselves. And, for example, this is something similar that happened to me. I, I was like, no, no-one's gonna understand and no-one's not going to, everyone is going to call me lazy. Everyone's gonna be like no, you just don't wanna do your work. You just don't wanna do your essays. You just don't wanna do this. And I'm just like, no, it's how I feel at this moment and nothing you can say can change that. Nothing you can even if you want to kick me out or if you want to do this, nothing you can write down or choose or, 'cause the whole precedent with the whole uni thing is, nothing you can say, that, I feel the way I feel. I'm standing by it. I'm no longer feeling shame or anything for it, because that's what a lot of people they feel the shame, they feel the guilt. That contributes to the whole bad feeling. So, it's just allow people. If they're saying and they, they seem genuine and they seem honest about whatever situation they're going through, whether it's mental or abuse or anything. Just take their word for it and don't say they have to go through a certain channel for it to be real for it to be genuine, because it's the worst kind of feeling to go through where you feel, feel like you're not going, not being taken seriously simply because you didn't do it the right way, whereas what is the right way – there is none. 
 

Sam experienced discrimination when she joined a college. She chose not to continue studying there.

Sam experienced discrimination when she joined a college. She chose not to continue studying there.

Age at interview: 18
Sex: Female
Age at diagnosis: 17
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Do you remember any particular incidents around that sort of stigma?

There was last year getting in, trying to get into college. I got into college just about the place an hour out from here. And they, I, that was my induction week. And I basically went to my tutor and said, ''Look, I'm experiencing this that and the other, seeing this, telling me this.'' 'Cause by then, they'd started telling me to hurt other people. But I told him that in confidence and said, ''I've never acted on it.'' Which I haven't. You know, I've never acted on it. I said, they had the number, the number of my CPN worker and I said, you know, ''You can ring her.'' And I spoke to someone else who was really nice about it and didn't know I was with EIS and that. And she said, you know, ''Yeah, we'll speak to her and that about it.'' They let me go home. But turns out, I got home, got a phone call from them saying that I couldn't, they said, ''Oh we’re worried about you.'' But it was like, I could tell they weren't. They were just trying to be nosy. And it was the way they said it. It was the way the woman said it, I could tell. And my mum came in just that time and she said, ''Can we speak to you mum.'' And I said, ''Yeah, fine.'' It's like they didn't say it to my, to me. They said it to my mum and literally said the exact words that I was gonna kill everyone.

And this was the college?

This was the college safe guarder said, “I'm ringing up from such and such a college that, you know, your daughter goes to and she said, this this this”. And half of it was what I was misinterpreted what I said and my mum said, ''She can't go back to college then?'' They said, ''No, not until the hospital that she's at say that she's safe to be around people. 

And how did they become aware of it?

Because I had a support meeting in the August before I started there in the September last year. And I told them that I was still switching over at the time. And I gave them literally every single person whose ever dealt with me, I gave them every single contact number, everything. Email, phone number, everything. The addresses and they just didn't bother contacting anyone and they was like, ''It's fine. We won't judge you. We don't judge you. It's fine and everything”. And then as soon as they found out that it was like, at the time it was borderline psychosis. As soon as they found out that it was like could be that. They was like, they just didn't wanna know me as a person any more. They just took me as someone who was gonna kill everyone. And they were all nice to my face and that. And then basically my mum said yeah, but that's like that's what she doesn't act on it. That's what she hears. It's a psychosis. And then they, she said, ''You need to ring her.'' I rang my CPN worker and just told her what happened and she said, ''Why didn't they phone me.'' And I said, ''Exactly.'' My mum told them to and they said they would. Next- two hours later, I got, about two o'clock I got a phone call from my doctors saying that they'd made an appointment for me with my doctor. 'Cause they were telling my mum that I need to see my doctor and she said, ''She don't even go to the doctors about it. She sees a different doctor at the hospital. And they took no notice of that. Rang my doctor and my doctor said when I got there, ''I don't know why you are here, because you won't hurt anyone.''

So why do you think they did all that?

And it turns out because they'd never had a meeting with my CPN worker. So my CPN worker was off at the time, she couldn't do a meeting. So she made a meeting and they tried to basically say I was lying. 

Are you still planning to go to that college?

No, 'cause I transferred like literally on that day I said to them, ''I don't wanna come back. You've really put me off now. I don't wanna come back and you judge people with.'' Like the worser end of mental health conditions. I and you know, they said, ''Oh no, no, don't be like that.'' I said, ''Look, I don't want to.'' You know, 'cause everyone'll—they told the whole class as well. And so the whole class will just sort of judge me. So I said, ''I don't wanna come back.''
Studying with psychosis

Studying with psychosis was very challenging. Those who had managed to leave school with qualifications were often surprised at what they’d achieved. Luke completed his A-Levels, but said it was difficult. When he received his grades and found they were good he felt as if he’d “achieved something massive, by getting through those issues”. 

Being able to study was seen as very important for some, not only because having no qualifications would affect their future opportunities for employment, but also because of the friendships and extra curricula activities available at university. Nikki was in and out of hospital during her GCSE’s but has managed to get into a good college where she is studying mental health nursing. Making new friendships and being asked to speak publically about her mental health experiences helped give her a purpose and helped her to live with her voices. Those who missed out on qualifications were often worried about their future. Sam who was rejected from a college because of her mental illness worries that she won’t get a college place and that this might impact on her whole future. 

It was not only the experience of the psychosis itself, but other factors such as attending medical appointments and the side effects of medication, that affected people’s ability to keep up with study. For example, Joe found that medication he was taking made his brain foggy. Many were also experiencing psychosis and low mood and anxiety and were not sleeping well or at all.
 

Tariq finds that the medication he takes can cause short-term memory loss which affects his ability to retain what he’s been learning.

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Tariq finds that the medication he takes can cause short-term memory loss which affects his ability to retain what he’s been learning.

Age at interview: 21
Sex: Male
Age at diagnosis: 18
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On occasions it affects the way I learn because people have methods of working and when you take medication it’s sometimes blocks out what you’ve learnt in the last ten hours or eleven hours or if, let’s say I’ve taken medication and I want to get some work done by 12 midnight, it will put you to asleep, it will put you to sleep by within an hour, basically it’s gone, every time I take the medication in the morning it will put you to sleep or completely block everything out and that’s why I tend to take it after 11 o’clock at night so that I can take it when I go to sleep and when I wake up I’ll be fresh and everything will come back. That’s the thing is that when you take your medication it will block everything out then when you wake up suddenly everything is there again so I tend to take it at night when I’m just about to go sleep and etcetera so yeah.
People mentioned missing or feeling too unwell to attend lessons, and becoming isolated as friends moved on. Joe had to take time out of lessons to attend medical appointments and counselling and had little energy for his study because he was “fighting to get rid of the voices”. Luke tended to study at night time when there was no pressure from peers or parents. But this meant he was very tired and struggled to concentrate in lessons during the day.
 

Andrew Z loves socialising but when he has periods of psychosis his “buzzing thoughts” means he can’t concentrate on his studies or on socialising. Being unwell at the start of college meant missed out on a critical time for making friends.

Andrew Z loves socialising but when he has periods of psychosis his “buzzing thoughts” means he can’t concentrate on his studies or on socialising. Being unwell at the start of college meant missed out on a critical time for making friends.

Age at interview: 23
Sex: Male
Age at diagnosis: 20
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Whenever I've had psychosis, I can't concentrate on my work and I can't concentrate socialising. You know, I mean the buzzing thoughts mean I can't sit still. I can't concentrate on conversation. Often sometimes the thoughts would be so concentrated fully on my head that I kind of will start reacting them. So, I would be talking to someone and suddenly my facial expression will start smiling or something and obviously becomes or comes across as a bit peculiar. It was just a bit frustrating, because obviously I kind of the only thing I really enjoy doing in life is kind of socialising and talking to people. And I go through periods when I've got psychosis and I kind of can't really do that, which is quite frustrating. And I kind of like the people contact.

I think being out of it for a while can make it quite difficult to get back into it, if you get what I mean, yeah. And it's quite frustrating when you are like you've had a psychosis episode and you know that lots of people have got to know each other in new accommodation and stuff and you've been out of it. So you kind of and they can end up assuming maybe he has been out of it because he's not interested in getting to know us, if you get what I mean. Kind of feels like it's too late, you know, over several months, he's never talked to us and therefore he's kind of maybe he's not interested. Obviously, how do you communicate to people that I have just had a psychosis episode and I am interested and I am even if you did do that and can still be several months where you haven't, where they've all got to know each other and you haven't. 

As I said, it's quite, it's quite frustrating knowing you've missed out on stuff. But it's also quite difficult because you need to get like an episode and also you can develop anxiety you haven't experienced before, because of that.
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