A delusion is a false belief which cannot be swayed by concrete evidence. The term psychosis is used when a person loses touch with reality and they may be suffering from hallucinations and/or delusional beliefs.
A hallucination is not a delusion or a false belief. Hallucinations are sensory perceptions involving any of the five senses. One of the most common being hearing voices. Hallucinations are evident in a number of mental health conditions but also occur when people have infections and very high temperatures (especially in the very young and elderly) or withdrawing from alcohol and drugs.
When someone is expressing strange beliefs, delusional thoughts or hallucinations, we would recommend that you:
- Do not dismiss the delusion - recognise that these ideas and fears are very real to the person but do not agree with them. For example say "I do not believe ........... is out to get you but I can see that you are upset about it."
- Do not act horrified by bizarre words or unfinished sentences. Instead say"I don't really understand what that means". Remind them of the conversation you were having and bring them back to current situation.
- Do not let others laugh at the delusion, hallucination or strange beliefs. This can increase the person's agitation.
- Acknowledge their distress, saying something like, "I can see you are very upset. How can I help you?". This is reassuring and gets a rapport going.
- Aim to be positive and comforting rather than negative and emotional.
- Do not show annoyance or criticism.
- Do not promise that everything will be okay. Acknowledge there is a problem but reinforce that help is always available.
- If possible, have a contingency plan for when such a crisis occurs. Having a plan will enable you to calmly deal with the situation.
- If you think the person is suicidal or there is a change in their usual behaviour let someone know. Contact the person's Support Worker, Care Coordinator or the CRISIS team.
- If the person is hearing voices, do not ask the person to try and force the voices to stop.
- Do act calm.
- Do try to distract the person by involving them in something they find interesting. Talk about everyday things and involve them in activities with close family and friends.
- Do give the person time and space if they do not want to talk. Say something like: "I can see that you do not want to talk now but I'll be here if you want to talk later". Allow them time to gather their composure, thoughts and pride.
- Do find someone for yourself to talk to and to let off steam. This could be another Carer, support group, professional or whoever you feel comfortable talking with.
