A diagnosis of schizophrenia can feel frightening — for the person living with it and for the people who love them. Here is what we want you to know first: schizophrenia is a treatable medical condition, it is no one’s fault, and with the right care many people live full, meaningful lives. You are welcome here.

What schizophrenia is

Schizophrenia is a brain condition that affects how a person thinks, perceives the world, feels, and relates to others. It affects fewer than 1 in 100 people (roughly 0.25–0.64%) and usually first appears in the late teens to early thirties (National Institute of Mental Health, n.d.). It is not a “split personality,” and it is not caused by anything you or your family did. It is a health condition, like any other, that responds to treatment.

Signs and symptoms

Symptoms usually fall into three groups:

• Positive symptoms — experiences added to reality, such as hearing voices (hallucinations) or strong beliefs that are not based in fact (delusions), and disorganized or hard-to-follow thinking.
• Negative symptoms — things that are reduced, such as motivation, emotional expression, speech, or interest in being around others.
• Cognitive symptoms — trouble with attention, memory, or organizing thoughts.

Early warning signs can be subtle — pulling away from friends, slipping at work or school, unusual thoughts, or sleep changes. If you notice them in yourself or someone you love, it is worth reaching out; getting help early makes a real difference.

Why early treatment matters

The sooner schizophrenia is treated, the better people tend to do. For a first episode of psychosis, team-based coordinated specialty care — combining medication, therapy, family support, and help with school or work — improves quality of life and outcomes compared with usual care (Kane et al., 2016). There is real reason for hope.

How it is understood and evaluated

Schizophrenia is diagnosed through careful clinical evaluation over time, ruling out other medical and substance-related causes. When it is helpful, we can use objective neurocognitive testing to understand and track thinking skills as part of your care.

How it is treated — and how we approach it at OhanaPsych

Treatment works best when it combines antipsychotic medication with psychosocial support — therapy (including cognitive behavioral therapy for psychosis), family education, and help with daily life, school, and work (American Psychiatric Association, 2020). For many people, long-acting injectable antipsychotics make staying well easier and lower the risk of relapse and hospitalization (Kishimoto et al., 2021) — and through our pharmacy partnerships we can arrange for injectables to be delivered and given in your own home, on any island.

We hold this work with aloha and without judgment, using person-first language and partnering with your case-management team. Our goal is to restore lōkahi (balance and harmony) so you can stay connected to your ʻohana and community and live the life you choose. (You can also read more on our Serious Mental Illness & Injectables page.)

Getting care by telehealth

Much of this care can be delivered by secure video, and injectable medications can be given at home, so distance does not have to stand between you and steady treatment. Some parts of care — such as certain controlled medications — still follow the federal Ryan Haight Act and DEA rules and may call for an in-person step; we will tell you clearly if that applies to you.

Lasting access by telehealth

As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. For our patients, that means dependable, lasting telehealth access to the care you need.

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

When to reach out

You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.

If you or someone you love is thinking about suicide or self-harm, or is losing touch with reality and may be unsafe, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.

References

American Psychiatric Association. (2020). The American Psychiatric Association practice guideline for the treatment of patients with schizophrenia. American Journal of Psychiatry, 177(9), 868–872. https://doi.org/10.1176/appi.ajp.2020.177901

Kane, J. M., Robinson, D. G., Schooler, N. R., Mueser, K. T., Penn, D. L., Rosenheck, R. A., … Heinssen, R. K. (2016). Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE Early Treatment Program. American Journal of Psychiatry, 173(4), 362–372. https://doi.org/10.1176/appi.ajp.2015.15050632

Kishimoto, T., Hagi, K., Kurokawa, S., Kane, J. M., & Correll, C. U. (2021). Long-acting injectable versus oral antipsychotics for the maintenance treatment of schizophrenia: A systematic review and comparative meta-analysis of randomised, cohort, and pre–post studies. The Lancet Psychiatry, 8(5), 387–404. https://doi.org/10.1016/S2215-0366(21)00039-0

National Institute of Mental Health. (n.d.). Schizophrenia. https://www.nimh.nih.gov/health/statistics/schizophrenia