To think the mentally ill have a personal responsibility to take their medication?

[ABD091G6]

For the umpteenth time a close relative has stopped taking their medication, a choice they made whilst medicated and stable, and now we're all dealing with the fallout from that and treading on egg shells waiting for the malicious phone calls and harassment to start

If somebody relies on antipsychotics and mood stabilizers to be stable and able to function, they have a personal responsibility to remain medicated.

AIBU to think that they are expected to take responsibility for themselves.

What does annoy me is a mentally ill person killing another person, sometimes a total stranger, and getting away with it

How often does that happen~?

They don't get away with it at all @Daphnise ,but if someone,s mentally unwell it better for them and everybody to be treated in a special hospital than prison and despite what the media would have you beleive special hospitals won't be a walk in the park I had a placement in a medium secure unit as a student and it was a grim imposing place .

thats harsh, antipsychotics take it out of you. some are very very bad for you and they can cut your life expectancy by years.

@ABD091G6

They do receive alot of support. They have a CPN and community MH support workers, two of which visit regularly to monitor med compliance.

They come several mornings a week to check in, have a chat and watch my relative take their morning dose of meds.

The afternoon dose is, unfortunately but understandably, entrusted to them to take themself.

Relative gets around this by taking the morning meds then throwing away the afternoon ones. After a period of time the inconsistent medicating starts to trigger a relapse and my relative then stops complying full stop.

MH services are unable to intervene until relative gets to crisis point and then will be sectioned again.

They'll comply with meds when in hospital then repeat the cycle when they go home.

My relative has actually said on multiple occasions that they want to go into hospital "for a break and to save money" so I do believe, to a degree, that the non compliance is deliberate sometimes and they have a goal in mind.

There has also been several occasions where med non compliance has coincided with somebody else in the family having a hard time/having a baby/getting married/needs support in one way or another.

My DM has said herself (regrettably) that sometimes she believes our relative uses their poor MH and decision to be noncompliant to manipulate situations and have people rush to their beck and call.

This supports what I have said for last 15 years. Care in the community is not working and a complete cop out to save loads of money. Individual mental health professionals are in the main very good but it is the system and funding. People with mental health problems don’t have a community. They only have “dumped on “ family who get a label as Carer whether they want it or not. They get no training for this. NICE guidelines state family intervention therapy should be offfered - good luck trying to get that. Even when we had children at home my DH and us were told it was not available. Your relative is getting a lot of visits by CPNs ( which is great and needed), so I assume is very sick and quite honestly, yes, should be in hospital. My DH who has a diagnosis of schizoaffective sees a CPN for 20 mins once per year and the psychologist for 10 mins once per year. That’s it. They completely rely on the backbone of care in the community which is dose someone up and dump on family. They wait until I scream crisis once every few years and then we get an extra appointment which is always just tweaking medication. Never any therepy. My DH has no friends, he has no family outside of me and my 2 sons. He has no community. He has never been “ observed” for longer than 2 hour at a time by a professional- he has never been “unwell” enough apparently to be admitted to hospital to be properly observed and diagnosed. I gave up banging my head against the brick wall that is mental health services 7 years ago because I ended up depressed myself and on medication ( sadly the statistics bear this out that caters of metal health patients end up with mental health problems themselves) The old mental hospitals had many many problems and a good deal of horrors historically. But, they did provide day care for people living with these types of sever long term illnesses , to be treated properly, to receive regular therepy, to be monitored and to have social interaction. Somewhere there is a better route- care in the community is a disgrace.

You might try talking to people on heavy medication for severe mental problems, about the side effects it causes.

Many of them will tell you, the relationship between severe mental illness and the medication required, can be as grim as that between cancer and chemotherapy drugs. The treatment side effects can be as distressing as the symptoms it's meant to control.

It's a double whammy, to have a conditions whose symptoms include confusion, delusion, paranoia (fear and dread) and on top of that to require medication that makes you feel numb, confused, doped, and a host of physical discomforts. (tremor, weakness, pain)

Oh, and please don't believe that any MH medication, even if taken correctly,  produces a permanent  stable benefit . The very nature of such powerful  drugs is that some of the undesirable  side effects  are longterm and cumulative.

 Its no wonder many MH patients struggle  with the treatment ; but that's  a factor of both  the illness and the medication.

YANBU in the sense that this must be absolutely exhausting and frustrating. I don't think you have any duty whatsoever towards this person, put yourself, your happiness and safety first always. I think it's easy to say YABU when you are talking generally about an abstract concept. Unfortunately, the behaviour of mentally ill people have a huge detrimental effect on their families. It's utterly exhausting supporting them and sometimes they are just selfish people crying for attention, in addition to being ill, but it becomes impossible to distinguish the two. All you can do is try and support them but there is a limit where you don't really owe them any sympathy anymore.

@NoOneOwnsTheRainbow

Bipolar meds (antipsychotics and mood stabilizers) knock about 20 years off your life. When people mention "the side effects" they truly are horrific, like, if you had those as symptoms of an illness the doctors would be bending over backwards to help but since it's viewed as less bad than being stable, you're basically left to it.

Additionally, with most psychotic illnesses these days, even the medical practitioners no longer advocate medication for life. The goal now is to get stable then taper off them because of the length of time between episodes for most people.

I understand where you're coming from, having a relative who wouldn't co-operate or take their meds. But as someone who has taken these, I can honestly say if you haven't taken them, you can't know what it feels like that you one day wake up and think "actually, the suffering and mental turmoil was BETTER than these side effects".

Unfortunately one of the defining characteristics of mental illness is profound loss of insight and inability to be responsible (hence they can be sectioned for their own safety at times). We don't medicate people with such heavy shit for nothing.

Absolutely Agree with first paragraph - can’t confirm strongly enough that these drugs are serious beasts- the very way they act of the brain produces dreadful side affects . It is simply the lesser of 2 evils. Second paragraph is not true for all psychotic disorders. Maybe true where first episode that is short lived. But for those diagnosed with “severe and enduring” psychiatrists prefer low dose long term Maintenence as less risk of crisis which are hide to destabilise form .

Hard to re-stabilise from...fat fingers today. Sorry

What is your point OP? By taking responsibility do you mean there should be consequences if they do not? What do you think those consequences should be?

There are a lot of stigmas still around being medicated for mental ill health as well. Many people have hang ups about taking medication that mean there is a thought process of 'if I get better, I can stop taking the (whatever it is)', which leads them to stop taking it just as it really takes effect properly. Then, of course, they spiral back down and it becomes a case of needing the medication to 'fix' them again

If you have never been a MH patient or advocated for a MH patient, it is easy to underestimate how you are completely inundated with the message that "of course it is unfortunate that you should take medication, but it's only for a limited time, you must absolutely not become dependent on it, dependence of medication is a BAD THING". You get it from friends, employers, teachers- but also from the doctors themselves. Being permanently dependent on medication is seen as a Bad Thing and the sign of a Failed Human Being.

It's not long since one of dd's teachers told her that a life on medication would be a Tragic Life. (dd, who becomes suicidal and confused without medication, listened politely and muttered to herself "Well, at least I'd be alive")

Of course medication is not perfect either. It's perfectly possible to have a dip whole on medication which impairs your judgment and makes you move vulnerable to the overall society message about medication.

I do truly empathize with the frustration but one key point is that meds do not wipe out the condition , they manage it. So for our family member , part of his condition is control and over analysing things. He is highly intelligent and genuinely knows more than most doctors about medication down to the absolute base level. However he is incapable of making rational risk balanced decisions.

So when on meds it manages his most severe symptoms and he can function but it doesn't wipe out his obsessive research and "tweaking" to make himself even "better". In his case he is autistic as well as having severe mental health concerns.

So he researches when he feels better and invariably comes off of his meds. Or changes them ,or something or other. Cue a spiral we have all been down time and again. Inpatient admittance.....the whole rigmarole starts again.

It is not his fault we know that , but time again we have flown in rescue teams so to speak to spare his dm. It is DP relative and he has been doing this since he was 14. More than a few dark times we have both expressed frustration. We know however the condition isn't gone on meds , it is just more stable so we know he simply cannot help it. The poor sod got the shortest bloody straw in genetics and brain chemistry so we all support whenever we can.

Saying that I do think people forget lots of people do it for physical health conditions. My DM regularly stops taking a medication because she thinks she knows better , or is just suspicious of taking medication based on no actual medical knowledge (her ...not the med) then winges when her symptoms reoccur...I have less patience with her as she has no mental health issues (well....in theory ) and just does it for attention.

People with mental health issues are not the only ones who do this and they have far more of a reason than others.

It is exhausting ,I really do understand.

@Whatisthisfuckery

What is your point OP? By taking responsibility do you mean there should be consequences if they do not? What do you think those consequences should be?

Hospitalization, where they can receive the help they need and so the wider family don't feel the repercussions of noncompliance. It can be frightening, especially for my DM who is around it much more than I am but also for other innocent parties like my children who don't understand and aren't equip to deal with an unwell relative turning up unannounced and making a scene.

My youngest is terrified of them despite them never being anything but nice to her.

Funding/lack of bed space means this isn't feasible as a long term prospect.

Its no fairer on the families than it is the ill person.

Oh sorry and sometimes it is other peoples influence. I could have strangled the sorry excuse for a waste of breath who told my family member that they should become vegan and remove toxins and chemicals from his body and touted the biggest load of wellbeing claptrap. It promptly convinced him (bearing in mind his vulnerability) to come off his meds. Which this idiot encouraged him in ,to detox and wasn't it a pity he couldn't remove his vaccinations (I am not exaggerating I wish I was)

Cue giant spiral and when I got hold of said sorry excuse for breath they cried " but I was hheeeelllllpppoing ,he was polluting himself"

I am not in general a violent person but by god it crossed my mind for a second with that person .

@Daphnise

If the personal responsibility fails, would the next step be compulsory administration of medication by the State?

I don't know.

What does annoy me is a mentally ill person killing another person, sometimes a total stranger, and getting away with it.

It’s not responsibility I think you mean. Goodness knows we all behave irresponsibility. I think you mean mental competency. If someone in uk looses mental competency, the mental health team will try to treat the individual in “ the community” relying on family/friend carers and regular visits by CPNs ( like district nurses). There are not enough beds for all patients who don’t have mental competence. General they will be admitted only if there are safeguarding issues. Eg. They are unsafe to themselves or someone else. They would be admitted ideally voluntarily, or if not sectioned.

“Killing another person, sometimes a stranger”. This is extremely rare. Some people with manifestation of psychosis can become aggressive and confrontational which lands them in trouble in fights etc- but that can equally end up with them being a victim . Random killings by people suffering from metal illness are so rare compared with number of people that have sever illness ( estimates 1 in 200 people so actually quite common), you always end up hearing about it and hence your perception it happens more often. And most of the time it won’t be a random stranger to the ill person- the victim will be part of their delusions. They may “know” this person well ( they believe) or they may perceive that this person has threatened them. Or they may, in very extreme cases, being told that they have to kill this person by another person ( their voices). It is not that they just decide to go out and kill a random stranger.

Compentency? 😱😱
Sorry, brain melt...I mean CAPACITY... mental capacity.

If someone knows that they become violent when they are not on medication, then yes I think they should take responsibility if someone gets hurt if they stop taking it. Thier mental health condition should not mitigate in those circumstances.

Looking after someone who is extremely poorly is exhausting, both mentally and physically. I have been there with a relative and truth be told there are only so many times I would come to thier aid if they stop taking the medicine that is keeping them well. So yes I do expect them to take some responsibility for themselves, I can't force the meds into them.

@Notmoreuodates5

It’s not just metal health. A lot of people don’t take their medicines for various reasons. I think lack of understanding and underestimating how important medicine is.

This is a unique issues with patients with psychotic illness. Yes, most people don’t want to take meds. They have metal insight though to understand

1. That they are ill
2. And then way up risks and benefits.

And choose to actively continue or stop because of whatever.

With these illness the patients don’t know they are ill. There is no comprehension that what they are experiencing is not normal. Not because they are in denial- it is caused by Anasognosia.

Would you even think about taking a medication for an illness you don’t have, especially when you have to take it for life.

In that way they are at least sane- I wouldn’t even.

@DaisyHeadMaisy

If someone knows that they become violent when they are not on medication, then yes I think they should take responsibility if someone gets hurt if they stop taking it. Thier mental health condition should not mitigate in those circumstances.

Looking after someone who is extremely poorly is exhausting, both mentally and physically. I have been there with a relative and truth be told there are only so many times I would come to thier aid if they stop taking the medicine that is keeping them well. So yes I do expect them to take some responsibility for themselves, I can't force the meds into them.

But they don’t know that they become violent without. Even if they are told. Look up Anasongnosia. That’s the point of why they’re not deemed responsive ly due to mental incapacity

Anasognosia

Oh..fgs..auto correct

ANOSOGNOSIA

SORRY😳😳

Here is the link to Anosognosia.
www.nami.org/About-Mental-Illness/Common-with-Mental-Illness/Anosognosia

It explains the issue well. It is caused by frontal cortex problems

It explains why these disorders will almost always result in cycles of medication non compliance.

Please do read OP

YANBU...

I have a paranoid schizophrenic relative who I have basically cut out. I help from afar, but only to support my parents. Were my parents not around, I'm not sure I would.

I have lost all empathy for said relative. They are nothing but a drain on the family - financially and mentally. They are dangerous (threaded to kill people, purchased weapons off the internet etc), and highly aggressive when relapsing. They have threatened my parents, who continued to stick by them. Not only are they mortgage free thanks you, but unlike, my parents, annually they have a habit of clocking up debts that my parents then pay off when collectors arrive.

They only now live in the community as during their last period sectioned, they agreed to regular medication injections administered by the hospital. Even while on what is quite strong medication, they still hear voices and hallucinate.

After 20 years of their ways, I decided they're a blackhole for other people's happiness and I wasn't going to allow it in my life anymore. Some might think that's unreasonable, but if they don't want to help themselves, neither do I.

• Mortgage free thanks to, but unlike my parents...

People do need to take responsibility for themselves and their health, whether mental or physical. I have some physical health issues that l need to take medication for, l don’t like the medication or the side effects but it’s just one of those things. Most medications have side effects. The paranoia, mania etc does add an additional dimension of complexity for mental health though

The be kind bleating isn’t helpful. OP sounds quite burned out and she has some legitimate concerns l think

Unfortunately they can’t
They are mentally ill !
Hence the issue ....