One recurring problem that I observe in the practice of family law is when a person who suffers from mental illness stops taking medication. With this problem in mind, I began to search for solutions. This is what I found:
- About one-third of people with schizophrenia say that they stay on medicine primarily because other people think it’s important. For them, the influence of other people, rather than believing the medication is needed, is the key factor that promotes compliance.
- Persuasion is better than coercion. Forcing someone to take medication by threats is, at best, a temporary solution that is best left for acute (emergency) situations. It is better to try to find a way to persuade a person to take medication.
- Families should be genuinely sympathetic about the side effect problems and the distress they can cause. Ignoring the side effect complaints won’t make them go away; indifference may make a person feel neglected or misunderstood.
- Prescribing clinicians frequently do not often detect or ask about noncompliance and are not always good at recognizing when patients stop their medication. They may not recognize noncompliance until the person becomes psychotic and starts reacting to hallucinations. Therefore, you cannot rely solely on a doctor’s assessment of the situation. Nonetheless, if possible, it is important to maintain routine contact with the doctor to discuss, among other things, compliance issues.
- When someone relapses, it may be very hard to tell whether the biggest problem is that the medicine doesn’t work well enough (nonresponse) or the person is not taking the medication (noncompliance). It is very important to clarify the true cause of relapse because nonresponse to medicine would be handled very differently than noncompliance.1
The failure of individuals with schizophrenia and bipolar disorder to take prescribed medications can often leads to relapse of symptoms, re-hospitalizations, and homelessness. It is important to have an awareness of the problem of mentally ill people who tend to stop taking medication. We should apply these strategies to help these valued members of our society.
by Patrick Gafney
1 Weiden, Dr. Peter. “How to help someone who stops taking their medicines”. Retrieved from: http://schizophrenia.com/.
