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Why don't people take their medication?

The Chowan Herald - 3/16/2017

Dear NAMI,

I work in law enforcement and frequently deal with individuals who struggle with mental illness. Time after time, we receive calls from the same residence concerning someone in the household who is in crisis.

This usually means there is a life threatening situation, either with the person who has a mental illness or a family member. We usually have no choice but to transport the individual to the hospital emergency department.

If it is determined that this person needs a placement in a psychiatric hospital, we will later be called to transport them to that hospital (sometimes this may be in the western part of the state).

When the patient is stabilized a few days later, we are called to transport them back home. The problem is that frequently these individuals do not take their medications once they are home. In a few weeks, the whole cycle repeats itself.

I wonder if you can address the issue of why individuals suffering from mental illness do not take their medications when clearly, they help to keep them stable and out of the hospital! Exasperated

Dear Exasperated:

Of course, the most obvious reason a person is not taking their medication is because they cannot afford to pay for it or they do not have transportation to pick it up from the pharmacy.

Perhaps the sneakiest form of non-compliance comes when the medication works and the person is feeling better. The patient suddenly starts feeling like himself again. For the first time in a long time, he is happy, stable, sane. And of course, as everyone knows, sane people don't need medication. So they stop taking their medication. Why should they take it if they feel good? The fact that it was the medication that caused this feeling is overlooked.

Conversely, some individuals do not give the medication time to take effect. Many of these medications take weeks before results are evident. When the patient feels it isn't working, she/he will stop taking it without consulting a doctor.

Many of the medications that treat symptoms of mental illness have side effects.

People get tired of gaining weight, or hand tremors, or unstoppable hunger, or sleeping 12 hours a day or constant nausea and they stop taking the drug.

This is often an immediate discontinuation of the drug without a taper as they are doing it without talking to their doctor.

Most people do not like to take medication. As one man with schizophrenia wrote: "Being medicated involves the admission of needing someone else's help?It is an admission of some degree of helplessness; an admission that one is not all-powerful, and some may believe it is an admission of weakness."

This man then added: "The only thing worse than taking medication, in my view, is to have an uncontrolled major psychiatric illness that runs its course, and in the process of doing so, destroys the mind and spirit."

Family members and caretakers should be encouraged to be advocates for their loved ones. They can do this by:

1) Learning as much as possible about the specific mental illness

2) Become familiar with the medications/ dosages

3) Assist in obtaining the meds and putting them in organizing trays

4) Act as liaison between patient and doctor when side effects indicate a possible change in the medication prescribed.

Advocates should always encourage patients to take their medications as prescribed unless a doctor is consulted.