The self-management of psychiatric medications: a pilot study

This paper reports on a pilot study where a scheme for the self-management of medication has been devised as an intervention strategy, where the mental health nurse and the mentally ill client work together to improve the client's knowledge of prescribed medication and medication-related issues. Aspects of non-compliance and the various factors involved in the non-compliance of psychiatric medications by the person who is severely mentally ill are discussed. When non-compliance to psychiatric medication is briefly examined, the complexity of the phenomena becomes increasingly apparent, confounding single intervention strategies, therefore as the phenomena is multidimensional, so must by any response. A review of the literature, and from the past clinical experience of the authors, suggests that when there is an involved therapeutic alliance, and the active participation of both the client and the mental health nurse in a rehabilitation orientated self-medication management scheme, a difference can occur for the client where their understanding of, and compliance with, psychiatric medication can improve. This could possibly improve the overall quality of life for the mentally ill person. Within a psychosocial rehabilitation setting, a self-medication management scheme has been developed that gradually facilitates the client's responsibility for managing their own prescribed medication, and in conjunction with this increased awareness of their medication and related issues, the focus eventually leads to the client having complete responsibility for managing their own medication. This self-medication management scheme consists of several graded stages that are contractual in nature, in which the clients and nurses are active participants. A rating and self-reporting scale has been developed within the scheme and is used by both the nurse and the client to assist in gauging the client's understanding and knowledge of issues related to their medication use. This self-medication management scheme has demonstrated that when severely mentally ill persons are given the opportunity to practice and manage their own medication as a component of the rehabilitative process, a self-medication management scheme does make a difference.