Surviving Schizophrenia, 6th Edition: A Family Manual by E. Fuller Torrey

Author:E. Fuller Torrey [Torrey, E. Fuller]
Language: eng
Format: epub
Publisher: HarperCollins
Published: 2014-05-27T00:00:00+00:00

The doctor–patient relationship can be improved if the psychiatrist is willing to accept the patient as a partner, not as an underling to carry out orders. Changes in medication or dose and attention to side effects are essential. Having the patient keep a daily diary of side effects and giving the patients some autonomy to increase or decrease medication dosage as needed can both be helpful. Medication should be approached as a joint venture with risks and benefits weighed against each other. The risks of medication noncompliance include rehospitalization, violence, jail, homelessness, and suicide, whereas the benefits include no medication side effects. The risks of medication compliance include side effects, whereas the benefits include living a more normal life and achieving a modified form of some of the person’s original life goals.

For individuals who lack awareness of their illness, none of the above may be effective in persuading them to take medication. Positive reinforcement is always worth trying, and coffee and cigarettes are sometimes sufficient. A higher stakes positive reinforcement is to have the clinic or case manager become the representative payee for the person’s Supplemental Security Income (SSI) or other benefits, which will be discussed in the next section as one form of assisted treatment.

Additional information on medication noncompliance can be found in the briefing papers on the website of the Treatment Advocacy Center, www.treatmentadvocacycenter.org.

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