Objectives: To examine willingness to adopt protective behaviours, and perceived barriers, during a pandemic influenza, in people with schizophrenia. Methods: A cross-sectional study using a questionnaire was conducted exploring the responses of 71 adults with schizophrenia and 238 adults without schizophrenia attending a general practice setting, regarding willingness and perceived barriers to adopting protective measures against the 2009 swine influenza pandemic in Australia. Results: The majority of participants with schizophrenia reported that they would be at least moderately willing to be vaccinated (74.2%), isolate themselves (73.2%), wear a face mask (54.9%) and increase hand washing (88.6%). However, 71.8% were concerned about “catching” flu from vaccination. Predictors of willingness to adopt protective actions included self-efficacy (vaccination, face mask, isolation), perceived likelihood of contracting swine flu (vaccination), educational status (face mask) and perceived overall risk from swine flu (face mask). Key modifiable perceived barriers to adopting protective measures were identified, including cost and need for transport assistance for vaccination. Conclusions: People with schizophrenia report being generally willing to adopt protective measures, especially increased hand washing, during a pandemic influenza. Understanding perceived barriers may enable development of effective interventions to increase uptake of protective measures.

Objective: To explore the role of affect in risk perception and intention to adopt protective measures against pandemic swine influenza in people with schizophrenia. Methods: A cross-sectional study was conducted exploring the responses of 71 adults with schizophrenia and 238 adults attending general practice settings without schizophrenia. Participants completed a questionnaire that included items relating to: self-predicted affect (affective forecast) were they to contract swine influenza; perceived risk from swine influenza; and willingness to adopt protective measures against swine influenza. The 10-item Kessler Psychological Distress Scale (K10) and a single-item Self-Rated Health Question (SRHQ) were also included as measures. Results: In people with schizophrenia, higher levels of predicted fear were associated with increased likelihood of perceived substantive risk from swine influenza and self-reported willingness to adopt protective measures against it. However, higher K10 anxiety subscale scores, reflecting greater concurrent anxiety, were associated with reduced likelihood of perceived substantive risk from swine influenza in people with schizophrenia. Conclusion: Affect appears to play a role in risk perception of influenza and willingness to take protective measures against it in people with schizophrenia.

Objective: We reflect upon the bleak experiential landscape of psychiatrists working in underfunded, under-resourced and demoralised public mental health services through the metaphorical narrative of Joseph Conrad’s Heart of Darkness. Conclusion: It remains difficult to navigate through the Heart of Darkness. We suggest some navigable markers that may stave off metaphorical running aground.

There are significant differences in the reported utilization and trust of health information sources between people with schizophrenia and attendees at general practice settings. Those with schizophrenia are less likely to trust and obtain information from a doctor, and less likely to access the Internet. Further research is required to explore this disparity. This is critical given the high rates of comorbid physical illness and reduced longevity in people suffering from schizophrenia.