Let's talk LIFE: How to handlenon-compliant schizophreniac

Yvonnie Bailey- Davidson, Gleaner Writer

Dear Counsellor,

My sister has schizophrenia and does not always take her tablets. She relapses sometimes and has to be admitted to hospital. What can I do to encourage compliance?

- Joan

Dear Joan,

Non-compliance with tablets and office visits is a perennial problem with people who have chronic diseases. Patients who have diabetes mellitus and/or hypertension are also non-compliant.

Even though we have to encourage people to take their medication, we have to empathise with them. Non-compliance from the patient's point of view is a mechanism to deal with the fear of side effects. Individuals are afraid of side effects, some of which can be detrimental.

Many times, it is a choice between a rock and another rock. The medication will control the symptoms of the illness, but cannot cure the disorder or the disease. Learning to live with a disorder is not an easy task. She needs to consider the risk versus the benefits. She needs spiritual support, so she should let go and let God be in charge. The medications are available to help people with their illnesses. The illness and the medication cause anxiety in people.

These days, some medications are available in liquid form and it is easy to take with orange juice or apple juice. There are several injections available which can be given instead of the tablets. These various preparations can improve compliance of your sister. Education about the complications of schizophrenia should be emphasise. The complications of schizophrenia like homelessness, loss of job, suicide, homicide and poverty are very serious ones.

She needs to be on preventative medication to prevent relapse. Many patients with schizophrenia stopped their medications when they are well. This is a bad practice because they can relapse without being aware of it.

Medication necessary

You need to emphasise that to keep a job or her children, she needs to take the medications daily. Many relationships have been destroyed because of non-adherence to the medication. It is very stressful when a partner is sick so often. The family suffers from compassion fatigue and becomes angry with the patient and sometimes put them out into the streets.

We encourage caregivers and co-workers to educate themselves about the illness as this will make them more competent to deal with the sickness. Relatives need to be in contact with the doctor to get guidance on management of their relative.

Do not feel alone because non-compliance is the greatest problem for both relatives and mental health practitioners. Non- compliance is the common thread with all illnesses. Be of good cheer. There is a support group for families call Mensana.

Dear Counsellor,

I have a job that is very stressful. I am considering resigning and seeking another job.

- Monica

Dear Monica,

Most jobs are stressful, so think carefully before you resign. Jobs are hard to find and you will need to network extensively to pick up something in the field that you like. Try stress management and see if you can stick with the job. Manage your workload and time so that you can get some time to rest in the days. Get enough hours of sleep and eat nutritious meals. Use a diary to organise yourself daily, weekly, monthly and yearly. Learn to prioritise your activities so that the most important thing is done each moment.

Know yourself and your trigger points so that you can exercise self-control. Self-control is important as we will be at the whim and fancy of others. Manage your emotions, especially your anger.

Spirituality is important so you need to have a special relationship with God who will guide you.

Email questions and feedback for Dr Yvonnie Bailey-Davidson toyvonniebd@hotmail.com or call 978-8602.