Schizophrenia is often misunderstood. It’s a serious, lifelong mental health condition, but it is also one that many people live with successfully. With the right support, individuals can thrive in their careers, contribute meaningfully to their teams, and enjoy a high quality of life. So why is it still so misunderstood? Let’s start with the basics.

What is Schizophrenia?

At its core, Schizophrenia is a mental health condition that affects how a person thinks, feels and behaves. It doesn’t mean having a “split personality” as is often wrongly assumed. Rather, it involves disruptions to a person’s sense of reality.

People with Schizophrenia may experience hallucinations (seeing or hearing things that aren’t there), delusions (strong beliefs that are not based in reality), disorganised thinking and changes in motivation or emotional expression. These symptoms can be deeply unsettling, not only for the individual but also for those around them who may not understand what’s happening.

Despite its severity, Schizophrenia is not uncommon. It affects about 1 in 100 people, often starting in late adolescence or early adulthood. With the right combination of treatment, usually involving medication and therapy, many people manage the condition well. But stigma remains a significant barrier.

What are the symptoms of Schizophrenia?

Symptoms can vary from person to person, but they generally fall into three categories: positive symptoms, negative symptoms and cognitive symptoms.

Positive symptoms include hallucinations and delusions, experiences that add to a person’s mental landscape. Imagine hearing a voice criticising your every move while trying to focus on a spreadsheet, or believing your colleagues are plotting against you. That’s the kind of distortion Schizophrenia can cause.

Negative symptoms, on the other hand, take things away. These might include reduced motivation, flat emotional expression, or difficulty in maintaining relationships. A colleague might seem distant or disengaged, not because they don’t care, but because they’re struggling to connect.

Then there are cognitive symptoms, which can be particularly tough at work. Issues with concentration, memory and decision-making can make everyday tasks feel overwhelming. This can lead to misunderstandings, missed deadlines and frustration for the person experiencing this.

It’s important to remember that these symptoms don’t define the person, they’re part of a medical condition, not a character flaw.

What are the signs that someone is struggling?

Now here’s where things get tricky. Schizophrenia can manifest in subtle ways, especially when someone is trying hard to appear “normal” at work, early signs are often missed.

You might notice a co-worker becoming unusually withdrawn or anxious. Maybe they’re suddenly paranoid about others talking behind their back, or they’re making connections between unrelated events, like believing a printer error is a personal message. Perhaps they’re struggling with tasks they used to handle easily, or their speech becomes disjointed or hard to follow.

In some cases, a person might experience a relapse even if they’ve been stable for years. Stress, lack of sleep or medication changes can all play a role. Spotting these signs early can make a big difference in helping someone get the support they need before things escalate.

What can employers do to provide support?

This is where proactive, compassionate leadership matters. Employers don’t need to be mental health experts, but they do need to create an environment where conversations about mental health aren’t taboo.

Creating flexible working arrangements can ease the pressure on workers, whether that means adjusting hours, providing quiet workspaces or allowing time off for medical appointments. Training managers to recognise mental health red flags and to respond sensitively is equally vital.

Crucially, supporting someone with Schizophrenia often means simply asking, “What do you need from us to do your best work?”. Empower the individual to be part of the solution. They usually know what helps them stay well.

And don’t forget about legal obligations. Under the Equality Act 2010, Schizophrenia is classified as a disability. That means employers must make reasonable adjustments and avoid discrimination, something that’s both a moral duty and a legal requirement.

How can colleagues play a part?

Let’s face it, colleagues often spend more time with each other than with their managers. That means they play a key role in creating a supportive atmosphere. Support doesn’t always require grand gestures. It can be as simple as listening without judgement, offering help without pity and showing respect even when you don’t fully understand.

Avoid assumptions or gossip. If a co-worker discloses their diagnosis, thank them for trusting you and ask how you can support them. Try not to take changes in behaviour personally. A withdrawn colleague isn’t being rude, they may be coping with inner turmoil. A little patience and kindness can go a long way.

Where do occupational health providers come into this?

The role of occupational health is to bridge the gap between health and work, to help both employees and employers navigate mental health conditions like Schizophrenia. Most providers offer assessments that don’t just look at symptoms, but at how those symptoms impact someone’s ability to work.

They offer guidance on reasonable adjustments, strategies for managing stress and plans for phased returns to work after time off. Providers often have their own in-house psychotherapists and provide a range of counselling services. They act as advocates, ensuring  that workers with Schizophrenia are treated fairly and that employers have the knowledge they need to support them properly.

What can we all do to create more inclusive workplaces?

It starts with education. Misconceptions about Schizophrenia persist because we don’t talk about it enough, or when we do, the narrative is negative. Challenging those ideas, even in small conversations, begins to change the culture. Inclusion is not just about policies or training sessions. It’s about attitudes, language and empathy. When we create workplaces where people feel safe to be themselves, productivity increases, teams grow stronger and innovation thrives. So, whether you’re a team leader, a new hire or an executive, we all have a role to play in shaping healthy workplaces. A little awareness can spark real change.