Schizophrenic won't take her meds--

  1. Help, Psych nurses!

    I'm clueless with psych stuff. Recently a very close friend whose daughter has been dx'd with schizophrenia has asked me how to make sure her daughter is taking her meds.

    She suspects that her daughter is not taking them. The daughter is in her 20's and lives on her own, and has been hearing voices again.

    The Question: is there some way to get her daughter to take her meds? She's been hospitalized three times so far, and the last two have been because she doesn't take her meds.
    •  
  2. 15 Comments

  3. by   sjoe
    Used to be that we could take these people down the floor and give them an injection, whether they wanted it or not.

    In these days, however, even children as young as 5 or 6 can refuse their medications and we can't force them to take them, even when they are already hospitalized. The same holds true for jail inmates who have mental problems. So much for "individual freedom" (which often comes down to the "freedom" to live in dumpsters).

    There is no way, except by persuasion, you can get this person to take her meds if she doesn't want to. And, of course, it is not your responsibility anyway.

    By the way, failure to take prescribed medications is the main reason chronically mentaly ill people are readmitted (usually repeatedly) to hospitals, so this is a typical, rather than a rare, situation.
    Last edit by sjoe on Nov 3, '02
  4. by   Sleepyeyes
    welp, i guess that's all there is to that.

    Thanks, sjoe, for responding.

    Are there any communication techniques to try to talk her into taking them?
  5. by   Heidi
    Interesting. I know in NZ that we can enforce medication on someone who is under the Mental Health Act especially if they historically do not take medication. Of course it can only be enforced if it is a depo injection (cant enforce roals meds as you could imagine). Things must work differently where you are. What I will say is WHY WHY is it left up to the girls Mum or yourself to monitor. Do they not offer community support/followup from mental health services for a mental health clinician to monitor warning signs or clinical indicators of decompensation of mental state. There are many communication strategies to use however these will likely not be very effective initially if the person has no insight. It is a long process and TLC will help along the way.

    A really good book about a personal experience of someone with schizophrenia/bipolar is:

    The Quiet Room: A journey out of the torment of madness. Lori Schiller and Amanda Bennett. 1994. Warner books inc. New York.

    I would recommend this book for anyone who would like to learn more. In stating this I suggest you read it and then decide if it is appropriate for the Mum to read. I imagine it would be quite frightening to know what could happen and the journey that they may face. On the other hand it may help her understand?
    Hope this helps.

    The above is only a suggestion, for your information only, not an answer to your question or the situatoin your friend is in
  6. by   CliveUK
    Non-compliance is as much an issue in physical health as it is in mental health. 40% of people with myasthenia gravis do not comply with their medication regimes. How many people actually complete the whole 7 days of a course of antibiotics? It seems that most people can't get their heads round the idea of taking medication when they are feeling OK.

    There is no ONE WAY to ensure compliance, and I wonder, like Heidi, why it is being left up to her mother alone to monitor her medication. One way that might help is motivational interviewing. The technique was, I believ, originally devised for helping substance users, but the principles - i.e. getting this young woman to identify for herself the pros and cons of taking/not taking medication - could be helpful. Here is a link: -

    http://motivationalinterview.org/index.shtml

    One other thing - perhaps this young woman is having major trouble with being labelled "a schizophrenic" - it is quite a stigma, as I'm sure you are aware. I find it is more helpful not to talk about people as "schizophrenics" because they are more than just their diagnosis after all.
  7. by   maureeno
    if daughter has told mom she is hearing voices, mom can offer feedback making association between no meds seems to result in voices. she can express hope her daughter is able to remain out of the hospital connecting past history of quitting meds to problems requiring hopitalization. mom can also check out if side effects are bothering daughter. weight gain especially bothers many. mom should try to keep non-judgemental 'this is what I see but it is your life' attitude. mom can also look up her local [state name] association for the mentally ill [-AMI] to talk to other parents for support and information.
  8. by   sanakruz
    1) Sometimes the meds dont work
    2) sometimes the sideeffects are unbearable
    3) Sometimes ( often) an individual will not comply because of a fear of "loss of self" ( This is me this is how I am, these meds make me feel different) Kinda like "invasion of the body snatchers". I know this would scare me! This young woman and here mom need community support. It's out there.www.ca.nami.org is where I would suggest starting. One can recover from schizoprenia.This is the ca website but I'll bet theres links to the Nat'l site from there
  9. by   sanakruz
    That links NG. Here is the Nat'l one.
    www.nami.org
  10. by   researchrabbit
    Sometimes the patient has delusions about what the medications are for, as well (for example, "someone is trying to poison me with these pills). I highly recommend the National Association for the Mentally Ill, they are a great group. And if mom can get one of the community mental health centers involved, that might help. Some patients do well with "reminder calls" to take the medication if they are just so disoriented that they may not otherwise remember.
  11. by   sanakruz
    Clive thank you for that link.-relevant to us at this rural outpatient mental health clinic.
  12. by   caroladybelle
    The vast majority of people with chronic illnesses/conditions have some ambivalence about taking their maintenance meds. It is a human nature thing. Add in the antigonistical attitude that our society has toward mental illness ("you are just being weak", etc. and therein lies problems.

    No one would dispute a friend taking insulin for diabetes, but just tell your friends that you take antidepressants.... and watch the attitude come out.
  13. by   Sleepyeyes
    Wow, thank you all for the insight and the suggestions!

    I'll pass along as much info as possible, and definitely get my bud hooked up with nami.

    From what I've been told, I see a few things happening here, so all of your advice has been very helpful.
    thanks!! I'll let you know what happens.
  14. by   patadney
    There is a decanoate injection which can be given every 2 weeks if the pt is on a committal . This typically lasts 2 weeks and the opt does not have to take meds. Her Mom should talk to her psychiatrist.

close