How does private psychiatric care support schizophrenia management? Five expert insights from Dr Serena Lai

Dr Serena Lai, Consultant Psychiatrist 

Dr Serena Lai, Consultant Psychiatrist at Harbor London, has an array of expertise in complex mental health presentations – including psychotic disorders like schizophrenia. In this Q&A, she addresses some of the most common questions we receive from clients and those supporting them surrounding schizophrenia – particularly for individuals from high-profile families, or those in high-stress roles. She also shares how Harbor’s one-at-a-time, medically-led model supports condition management with discretion and depth.

What is misunderstood about schizophrenia in high-performing or high-profile people?

“Schizophrenia is still widely misunderstood. This is especially true for those with high intelligence, creativity, or previous successes. Some may assume that success or intelligence and schizophrenia can’t coexist, but this is simply not true. While schizophrenia often leads to a decline in functioning, many individuals come from high-profile families and may have been highly articulate, academically gifted, or artistically creative prior to illness onset. This is something that most find hard to reconcile, as families and peers may struggle to recognise the signs, particularly when the person continues to ‘function’ publicly in some areas, despite underlying deterioration.

Behavioural changes – like mistrust, withdrawal, or emotional volatility – can also be misattributed to personality rather than recognised as symptoms of the illness. This is partly due to the broader societal difficulty in accepting mental illness. Many want to believe they can control their own minds, and that suffering is something they can think their way out of. But schizophrenia – like any illness affecting the brain – is not something that can be managed through willpower alone.

One of the most damaging myths is that individuals can recover without treatment – when in fact, treatment is crucial to stabilisation and recovery. While the illness can lead to significant challenges and disability, outcomes improve with the right support, and many can regain stability, re-establish meaningful roles, and experience improved quality of life.”

How does Harbor’s model support people with complex conditions like schizophrenia?

“Harbor’s one-at-a-time model is uniquely suited to managing complex conditions like schizophrenia – especially those whose personal or professional circumstances require an additional layer of confidentiality. Every care plan is deeply designed around the individual’s needs, and delivered in total privacy.

Our approach is also medically-led. This means care is driven by psychiatric expertise from the start, ensuring accurate diagnosis and medication planning. But this also extends to a multidisciplinary team of psychologists, therapists, and wellness professionals. What sets Harbor apart is the integration of medical excellence with deep, relational support. From the very first session, we focus on understanding the person in front of us as a whole – not just the diagnosis or a set of symptoms. From there, we personalise a recovery plan that fits their world.”

What does schizophrenia look like day-to-day– and what do people get wrong about risk?

“Schizophrenia does not look the same for everyone. For some, schizophrenia may involve hearing voices, disorganised thoughts, or delusional beliefs. For others, it can look like emotional flatness, low motivation, or difficulties with concentration and processing information. Relationships often become fractured as a result of symptoms and withdrawal.

There are many myths about schizophrenia – and one of the major misconceptions is around risk. While some individuals may present with elevated risk – particularly during acute episodes – most with schizophrenia are far more likely to be vulnerable than dangerous. Untreated illness brings higher risk of isolation, self-neglect, or suicide … and while there can be risks to others in certain contexts, these are far less common than public perceptions suggest. But one of the most damaging misconceptions is the idea that recovery is not possible. While recovery may not mean the absence of symptoms, many individuals can return to work, study, or family life with the right support.”

How can families better support loved ones with schizophrenia?

“Families can feel lost, isolated, or ashamed – especially in communities where stigma is strong. They often carry enormous emotional burden. That’s why, at Harbor, we start with psychoeducation. We help families understand the illness, treatment pathways, how recovery actually happens, and what ‘wellness’ looks like.

We involve families from the very start by giving them tools for communication, space to process their own emotions, and guidance on how to be part of a stable recovery environment.

Most importantly though, we meet families where they are emotionally. When shame or fear is a barrier, empathy and education – and a bit of time – can make such a big difference.”

Why is early diagnosis and personalised care so important in schizophrenia?

“The earlier treatment begins, the better the outcomes. “Duration of Untreated Psychosis” is a key predictor – where delays in care are linked to more severe symptoms and poorer long-term recovery.

That’s why rapid, accurate assessment is essential. But, of course, diagnosis alone is not enough. It must be followed by an utterly curated care plan that blends psychiatry, psychology, lifestyle support, and family involvement.

At Harbor, this approach allows individuals not just to stabilise, but to reconnect with their identity and goals, and re-enter life on their own terms.”

While schizophrenia can cause progressive difficulties if untreated, effective management helps maintain skills, support functioning, and foster recovery.

Schizophrenia is not a life sentence. With the right care, recovery is possible. At Harbor London, we offer discreet, one-to-one psychiatric treatment and management that’s grounded in clinical expertise and personalised, compassionate care. Whether you’re seeking help for yourself or supporting someone you care about, we’re here to guide you.

Explore our full treatment offering or speak to our team today.