Medication as a treatment for mental illness has both challenges and opportunities and its role in recovery is complex and often polarising. For these reasons, medication can be associated with health risks ranging from the mild to the significant, but alternatively,
it can also improve people’s quality of life and prevent complications.
Medication and prescribing sits within the realities and challenges of health and mental health systems and practices: the system pressures on clinicians, challenges of information and communication, record-keeping; continuity of care and mental health expertise;
multiple medications, monitoring and review, withdrawing, stigma, consent and costs. Additionally, consumers often present with a variety of complex social issues. Needless to say, it’s an incredibly complex space to navigate.
The effectiveness of medication is the result of interactions between clinical practice, biological determinants, social factors and relationships. When not working well, practices such as inappropriate polypharmacy, consumers
not being informed about side effects, carers excluded from discussions about treatments, and a lack of regular medication reviews can work against the recovery of the consumer.
As Victorian mental health consumer and advocate, Wanda Bennetts says, “there is a public perception around mental health that everything will be fine if the person takes their medication.”
But for many people living with mental illness, medication can be detrimental to both physical and mental health, particularly when they are legally compelled to take medications and/or don’t get the information they need about dosage, combinations and potential side effects.
These issues were explored at a packed workshop during the Equally Well symposium, titled “A Spoonful of Sugar”, run by Wanda at the Equally Well national symposium. They were again raised in other sessions by keynote speakers including high profile NSW mental health champion, Fay Jackson.
We heard from both consumers and clinicians that medication as a treatment for mental illness has both challenges and opportunities and that its role in recovery is complex and often polarising until we address critical issues of rights and care.
They include human rights obligations around informed consent and shared decision making, system pressures on clinicians that favour medication over therapy, and silos between services and sectors that prevent proper record-keeping and continuity of care.
Equally Well Implementation Committee Co-Chair Dave Peters summed up the challenge for people with mental illness with medication that can bring benefits but also debilitating side effects:
“Do I look after my mental wellbeing by taking medication or do I look after my physical health and risk getting into a risk space of mental unwellness?”
For best results, people want holistic care – treatment and support that is other than medication play an essential role in recovery-oriented mental health practice. While this view is increasingly recognised by mental health practitioners, there is still some way to go before holistic mental health care plans – with medication being just one of the options – become a broad reality.’
To be most effective, choice and practices around medication must include consumers, carers, families and clinicians, including general practitioners, psychiatrists, and pharmacists.
For more information go to Medicine and Mental Illness – resources to share