If you are a mental health professional or have a family member with severe mental illness, then you would understand the struggle that one goes through to convince them to take medication even when they are aware that it helps in managing their symptoms.
This can be explained by the fact that the person denies having a problem.
Denial is a defence mechanisms people use to cope with distressing feelings and it involves not acknowledging reality or ignoring its consequences. People refuse medication because they have experienced side effects or their friends and family are reinforcing common beliefs that psychiatric medications are addictive even when this only applies to a small group of medication.
Some doctors might cause their patients to refuse medication by not thoroughly explaining the benefits and drawbacks of the medications, while others use an authoritarian style when communicating with their patients.
This interruptions in medication leads to worsening of the patient’s symptoms which affects the person’s social functioning and quality of life leading to repeated hospital admissions. The book “I am not sick, I don’t need help” by Dr Xavier Amador, a clinical psychologist from the US presents a new way of improving communication with people experiencing severe mental health problems.
Dr Xavier invented this method after years of frustration when dealing with his younger brother who had schizophrenia but refused taking medication. The module he suggests is summarised in the acronym ‘LEAP’ short for Listen, Empathies, Agree and Partner.
This module stems from the fact that people experiencing severe mental health problems such as delusions and hallucinations believe their thoughts to be true and may act on them. So the person who believes that people can read his thoughts by looking him in the eyes may stop going out or wear sunglasses all the time and becomes very distress when those around him don’t believe him or laugh at him so listening to the person in a non judgmental way is the first step to take.
The second step is to show empathy by understanding and sharing the feelings of another person, which can help build trust and rapport. Use statements such as ‘I can see that this is really difficult for you’ or ‘It sounds like you're feeling very frustrated.’
The third step is to find common areas of agreement to reduce conflict and build a sense of collaboration. Try focusing on shared goals and values, such as wanting the person to feel better or to achieve certain personal aspirations.
The fourth step is collaborating with the person and involving them in their own treatment and care. Finaly using the above approach is likely to improve communication and reduce conflict between the patient and his family member, but we need to remember that it is not a magical solution to all problems and may not work for all patients.
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