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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.

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