Skip to main content

mental health mondays :: a share of the blame

one of the trickiest parts of treating mental illness is the sheer number of patients who are "non-compliant". that means that once their doctor prescribes a regimen of treatment and medication, it isn't followed and, unsurprisingly, the patient doesn't improve.

there are a lot of reasons given for the particularly high rate of non-compliance, including a lack of tangible results, intolerable side effects and the stigma of being on psychiatric medication and/ or being told that the problem is psychosomatic. other reasons include not being able to afford prescribed medications [particularly in the united states] and simple forgetfulness, particularly if the regimen is complicated.

these all seem pretty straightforward, but i was interested to find a slightly different perspective reading this article from 2007, that takes a slightly different perspective. while acknowledging that most patients are responsible for their own patterns of non-compliance, the article also apportions some of the responsibility to the doctors treating them, citing studies that show that the poorer the communication between doctor and patient, the less likely the patient is to take their medications.

it seems that simply having regular follow-ups helps in keeping patients compliant, and establishing an empathetic relationship is even more important. given how brief and automated most check-ups can be, this last part is a real challenge, because empathy requires careful listening and giving a the patient time to express themselves- something which is often difficult for people who have mental disorders.

with waiting times to see psychiatrists stretching into the years, making more time for individual patients is going to be a longer term project. but i am happy to see an acknowledgment that there is more at issue with non-compliance than just the patients' intransigence. and clearly, the way to deal with mentally ill patients is not simply to medicate them, but to treat them. there's an important difference.

Comments

as long as you're here, why not read more?

don't speak

you might think that it sounds dramatic, but linguistic genocide is something that happens. people in power will go to great lengths to eradicate certain languages, not just for the sheer joy of making the world a lesser place, but as a way of beating down the culture that's associated with it. language has a unique reciprocal bond with culture, and every group that has attempted to break down another has recognised that forbidding a cultural group from communicating in their own language is an extremely effective way to tear apart their culture.

there are lots [and lots and lots and lots] of examples of this sort of thing, some successful, some not, but far too many to cover in one blog post. however, i thought it was worth looking at some languages that have been the subjects of active repression, and what the political consequences of that have been.

devastation :: the native north american languages :: it should come as no surprise that the largest genocide in history [by a ma…

losers?

just a short time ago, i waxed prosaic about trump supporters who felt betrayed by their candidate pursuing in office the exact things that he said he would. short version: i have no sympathy.

today is a bit different. in the wake of america's bombing of a syrian air strip, in response to a chemical weapons attack by the syrian government, my facebook and twitter feeds were peppered with plaintive shades of "we believed you". these are the people who heard trump say that he wanted the united states to step back and focus on defending its own. indeed, trump did say such things, over and over; america cannot be the policeman of the world. even arch-liberal cynics like me had to admit that this was a refreshing argument to hear from someone outside the paul family, and, could easily have been turned into trump's greatest argument against hillary clinton. [he chose to go another way, which also worked.]

trump also said, repeatedly, that america needed to invest heavily …

long division

after the united states election last year, there were the usual calls for the country to unite behind the new president. that never happens anymore, because, since george w. bush scored a victory in 2004, having launched the country into a war in iraq for no reason, the people on the losing side of a presidential election have been pretty bloody angry about it. democrats hated bush 43. republicans really hated obama. democrats really hate trump.

it didn't help that trump didn't make the typical conciliatory gestures like including a couple of members of the opposite party in his cabinet, or encouraging his party to proceed slowly with contentious legislation. barack obama arguably wasted at least two and as many as six years of his tenure as president trying to play peacemaker before he felt sufficiently safe to just say "screw you guys" and start governing around the ridiculous congress he was forced to deal with. not-giving-a-shit obama was the best president in …