Why mental health patients tend not to stay on their medications

by Colin King

Persons comprising the public, family members, friends and the Vincentian society at large have observed the phenomenon of patients of the Mental Health Centre, on and off the streets, in and out of the institution, with what seems to be a tragic cycle for which there is no solution.{{more}}

The explanation is indeed very simple – patients tend not to stay on the psychotropic medications to which they are prescribed. The circumstances characterizing this trend, are however very complicated.

(1)Taking medication carries with it a stigma that something is wrong. (2) The treatment on the outside from society which articulates the positive integers that may work for the patient however briefly – i.e. ‘You just had a nervous breakdown, you are (I am) not crazy therefore you (I) don’t need to take medication. (3) The medications don’t help but destroy your mind (especially the famed injections) and your body.

(4) willpower and/or an allegiance to God can take care of the problem altogether.

According to a source associated with the treatment of patients, her comments presented here seem to indicate a conflict with the correct ‘psycho-education’ given to patients here, against the powerful misconceptions and myths perpetuated by the mechanism of ‘patient meets the family, bigots, social framework’, which would seem in such cases to mobilize anything good offered by the understaffed mechanism at the MHC for such patients.

Our source says (In preliminary sessions with patients) they are given psycho-education. The patients are fully informed about diagnosis, treatment options (involving medications and their appropriateness for the individual client). The social workers and counselors also assist in this psycho-education process.

Our source has heard the medicine described, labeled as ‘crazy-people medication’ which, as she points out, discourages the patients from taking them. (This point is juxtaposed by many outpatients who take the medications and function effectively; some of whom I have interacted with. However this is the minority.)

Our source also indicates that friends and family routinely discard patients’ medications.

The horror story has to do partly with the side effects of the medications, somewhat – these side effects however are treatable and fade within a short time especially if the drugs to counteract the side effects are taken at the scheduled times. Artane, a raw miracle drug – somewhat more expensive than the mainstay for years, Cogentin; is a drug caregivers at home should look into, for extreme effectiveness in treating the side effects.

Patients should report side effects, the solution to which can be provided by trusted dialogue with doctors, nurses and social workers who can recommend alternatives.

Our trusted source comments in a general way, on the young men with intelligent minds and bright futures in the wave of proper handling of the medication, and the outreach being established by Senior Nursing Officer Diana Bailey (whose comments feature later), if the public embraces the truth about mental illness and interjects more in an empathetic helpful way, and there are some that do.

She says: Compliance with the medication will ensure these patients remain (without symptoms), return to previous levels of functioning in society.

She adds the powerful addendum: patients who substitute/augment medicine for/ with marijuana are indeed inviting permanent problems with their mental health.

SNO Bailey says: “to support medication adherence, (clients) need counseling – to help to give them insight to their illness, identify barriers to treatment and ways to overcome these barriers to sustain medication adherence.

“I must say that the lack of insight by patients/clients into their illness further exacerbates the prognosis of staying well…. put yourself in the patient/client’s place, what would you have wanted in that person’s place? Family need to stay connected, committed in support of their loved one when they are at the MHC, demonstrate a higher level of commitment.

SNO Bailey adds: ‘family think often, when a patient is ill (irrational behaviour), [they think] of them as, lazy, bad, worthless – especially the ones who display aggression. Family need (to understand), to remain supportive…

“We need to have more programmes designed to reach families more for them to be involved and supported by the Mental Health Centre and Community.

On those fine words we close, asking Vincentians to have compassion and acceptance as regard ‘the most forgotten sector of society’.