How to Deal with a Schizophrenic Colleague

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In the movie “A Beautiful Mind,” Russell Crowe portrayed John Nash, a brilliant economist who overcame schizophrenia to win a Nobel Prize. In real life, however, most people with schizophrenia face a lifelong battle. Most aren’t able to put on a façade of “normalcy”…at least not long enough to keep family, friends, and co-workers from noticing their struggles. If you have a co-worker who’s schizophrenic, the chances are pretty good that you’ll see some things that seem odd. Do you know what you would do if a co-worker started seeing things that aren’t there, or insisting that the owner of the coffee shop down the street is controlling her thoughts?

Schizophrenia is a biological disease, and, in many countries, people with schizophrenia are protected by employment laws. So it’s important to check with HR if you suspect – or know – that a co-worker has schizophrenia. The human resources department will be able to guide you through handling the situation without violating anyone’s rights. However, there are a few things you can do to make things easier:

Know the facts.

Schizophrenia is one of the most misunderstood mental illnesses. Although the word literally means “split mind,” it’s not about multiple personalities. The “split” refers to the inability to tell what’s real and what isn’t. Here are some important facts to know:


  • Schizophrenia is a biological disease affecting approximately 1% of the population.
  • Schizophrenics are no more able to voluntarily stop exhibiting symptoms than somebody with cancer or diabetes.
  • Most schizophrenics are not violent. In fact, they’re usually more of a danger to themselves than to others. The suicide rate is high – about 10%. When violence does occur, it’s usually when drugs are involved or when the victim thinks he’s in danger.
  • Because schizophrenia is a biological disease, most people need medication to function normally. Very few people can cope on therapy alone. This becomes a problem when patients on medication begin feeling better. They think they’re cured and stop taking their medications.
  • Some of the most common symptoms of schizophrenia include:


o   Hallucinations: Despite the way schizophrenia is portrayed in “A Beautiful Mind,” most schizophrenics don’t have realistic visual hallucinations. “Hearing voices” is much more common. When schizophrenics do have visual hallucinations, they’re usually distorted rather than realistic.

o   Delusions: People with schizophrenia often have a very distorted perception of reality. They may be absolutely convinced of things that anyone else would recognize as unrealistic – like thinking they work for a secret government agency or are being pursued by aliens.

o   Disorganized thoughts: People with schizophrenia often have illogical thought processes. They may have trouble concentrating or remembering things. They may have trouble planning their work. They often have trouble with social interactions.

What you can do

Any substantive action – anything that could affect your co-workers’ rights, privacy, or career – needs to go through HR. But there are some things you can do to make daily interactions a bit easier:

  • Be neutral: Never confront a schizophrenic with his hallucinations or delusions. His delusions are as real to him as your reality is to you. But you don’t have to feed into them, either. The easiest response is a simple “I see it differently.” If pressed, you can respond that everyone has the right to view things in their own way.
  • Be respectful: Never mock or belittle a co-worker with schizophrenia, no matter how bizarre her statements or actions may seem.
  • Be an active listener: It’s important for someone with schizophrenia to feel heard. You can do this with statements like, “So you feel that…”
  • Accept what is: Sure, it can be hard to listen while a co-worker talks about things that are obviously not real. But you can’t change the situation. It’s much more effective to learn how to respond to your co-worker than it is to try to convince her that her view of reality is wrong.
  • Know what to do in an emergency. While most schizophrenics aren’t violent, it’s extremely important to take any suicidal or homicidal comments very seriously. Report any comments like that to HR. They’ll be able to handle the situation in a way that protects your co-worker’s rights.

Working with a co-worker who has schizophrenia is never going to be easy. But with a clear understanding of what the disease is and an awareness of the victim’s rights, you can work with your human resources department to find a solution that works for everyone.