Medical experts and indeed non-medical folk of the world who have encountered people with deep-rooted delusional thinking, how did things work out? Was there a treatment that helped to improve matters or did it prove incurable? If there were effective treatments, can you say what they were?

So I've been a psychiatric technician and seen people at their most delusional (working in an ER) and also relatively stable (working in a group home). Most delusions were managed with medications, antipsychotic oral tablets for daily use and injections like Haldol or Invega for maintenance or acute use.

The stable clients varied greatly - some, you'd never know they were mentally ill. Others still believed aliens were landing in the yard even if they were otherwise stable in terms of things like self-care and whatnot. With those clients, the nursing staff would play with their meds but for the most part we just reassured the client they were safe. Some staff would try to combat or dismiss the delusion but I didn't find that helpful, I just remained neutral and let them know they could come to me if they were worried and we would protect them and help them with any questions. Some clients would recognize their delusions weren't "real" and you could validate that for sure but others couldn't tell at all.

If a person is delusional because of dementia, like when I worked in an old folks home, I would play along. Betty doesn't want to come to dinner because the train is coming? Let her know you heard the train was delayed and wouldn't it be good to have a nice meal before the long journey? Betty would understand this and join us for dinner.