Medication noncompliance is an issue with about 70% of schizophrenic patients. There are a number of reasons for this, including:
- Lack of awareness (I'm not sick, so why should I take medication?). This is biological.
- Denial (patient knows he is sick but refuses to believe it). This is psychological.
- Side effects which doctors often underestimate.
- Delusions of grandeur (I'm all powerful so I don't need medication).
- Delusions of paranoia (You are trying to poison me).
- Fears of dependency or addiction.
- Perception of a stigma attached to the medication.
- The medication removes delusions, and makes the patient feel less important.
To encourage compliance, it helps if you can figure out what is causing the noncompliance. Some ideas to consider:
- The patient needs to understand why it is important to take medication. Try to tie it to a desired outcome. If you want to get to [go to the mall, hang out with friends, ride your bike, stay at home instead of the hospital] you need to take your medication to make sure your stay well to do that thing.
- Pill containers with compartments simplify drug-taking.
- Medication can be taken via injection, which assures compliance to a greater degree - some injectable medications are longlasting and only have to be take once or twice a week.
- Make sure the doctor listens to any complaints of side effects.
- Bribery.
- Meeting peers with the same condition.
- Education - teach the child about the disease through books and videos.
Sources:
Torrey, E. Fuller. Surviving Schizophrenia: A Manual for Families, Patients, and Providers
Francell, Terry G., Jr. "Medication: The Foundation of Recovery." Treatment Advocacy Center
Born Schizophrenic: Jani's World Discovery Channel Series