The Devil You Know: Encounters in Forensic Psychiatry

by Gwen Adshead

Auditory verbal hallucinations (AVHs) are probably one of the most familiar symptoms associated with psychotic illnesses. It’s a fascinating phenomenon, and not well understood. It’s not the case that AVHs are always an indicator of enduring mental illness, and they can be positive and comforting in religious contexts

A dear friend of mine who experienced the tragic conjunction of her husband’s serious cancer diagnosis and her teenage son developing symptoms of schizophrenia similar to Sam’s described to me the stark difference in their experiences as patients, and the hollow meaning of ‘care in the community’ in practice. Health service providers rallied around her husband, with fulsome provisions for treatment and assurances that these would be available for as long as he lived, for which the family were grateful. Meanwhile, her son, whose mental state was disintegrating fast, had almost no options for treatment, and those that arose were limited and ineffective.