Download Issue of Non-compliance in Mental Illness

NON-COMPLIANCE IN
MENTAL ILLNESS
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PARTICIPANTS
Presenting author: Karishma Karim Halani
 Authors: Rabia Qasim Ali
Salima Karani
Reema Roshan Ali
Husnia Jumma Khan
Azada Hussain
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ROAD MAP
Basic concepts of non-compliance
 Causes of non-compliance
 Interventions and Recommendations to reduce
non-compliance
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DEFINITION OF NON-COMPLIANCE
“Noncompliance is a deviation form or cessation
of a treatment recommended by the provider.
Noncompliance is more common in mental illness
than other physical illness as mentally ill
patients are often depicted as unusual and less
proficient.”.
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(Weiden & Rao, 2005)
TO WHOM IT IS A CONCERN?
Noncompliance is a crucial community health
concern and may cause relapse and rehospitalization.
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(Weiden et al., 2005)
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CAUSES OF NON-COMPLIANCE

Self-stigma - it is defined as “a devaluation of the
self by internalizing negative stereotypes they
attribute to themselves or/and attributed to them
from external sources”. This stigma de-motivates
person, bring low self confidence and reduces
compliance.
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(Fung et al., 2007)
CONT..

Poor insight – it includes awareness of the
disorder, need of treatment, specific signs and
symptoms and the attribution of symptoms to
disorder and understanding of the social
consequences.
(Chakraborty & Basu, 2010)
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CONT..

Improper persuasion techniques and lack of
family support. This brings feelings of
detachment, isolation and negative attitudes.
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(Rodgers & Butterworth, 2008)
CONT..
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Side effect of medications - a person who takes
anti-psychotics can undergo drowsiness,
restlessness, blurring of vision etc. Noncompliance also occurs due to difficult timing,
delay in recovery and pessimistic approach
toward medicine.
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(National institute of mental health, n.d.)
CONT..

Cost burden - noncompliance of medication and
treatment occurs due to poor financial status.
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(Lama, Lakshmi, Shyangwa, Parajuli, 2012)
CONT..

Imperfect communication and client’s feeling of
depersonalization - due to the power of control by
healthcare workers.
(Schultz & Videbeck, 2009)
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Health care workers should deal stigmatized
patients on individual basis instead of drawing
conclusions through uniform experiences
(Pandya et al., 2010)
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Psychoanalytic and psychodynamic therapists
generally spend time listening to patients talk
about their lives. The therapy provider will look
for patterns or significant events that may play a
role in the client's current difficulties.
 Psychoanalysis therapy helps to increase selfunderstanding and expand insight.
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American Psychoanalytic association, (n.d.)
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Interpersonal therapy that helps patients to
develop their social interactions.
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Psychiatrist should conduct workshops for family
and healthcare workers to promote problem
solving skills and appropriate persuasion
techniques.
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CBT is "problem focused" (undertaken for specific
problems) and "action oriented" (therapist tries to
assist the client in selecting specific strategies to
help address those problems). CBT helps clients
overcome their troubles by altering their ideas,
behavior, and emotions.
Goals of cognitive therapy (n.d.)
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DBT plans to build ‘acceptance techniques’ with
‘change techniques’. Acceptance behaviors
encourage patient to identify negative behaviors
from self and on the other hand, change
behaviors encourage patient to modify that
negative behavior
(Making sense of dialectical behaviour
therapy (DBT), n.d.)
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Nurses should assist patients to make
association
between
noncompliance
and
exacerbation of symptoms as it may help client to
jot down benefits of compliance.
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Support client to verbalize feelings about illness
and allow client to make some decisions related
to his treatment as this can be a positive step to
acknowledge his health condition.
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REFERENCES
Chakraborty, K., & Basu, D. (2010). Insight in
Schizophrenia – A Comprehensive Update.
German Journal of Psychiatry.
 Goals of cognitive therapy. (n.d.). Beck institute for
cognitive behavior therapy. Retrieved from
http://www.beckinstitute.org/cognitive
behavioraltherapy-goals/
 Making sense of dialectical behaviour therapy. (n.d.).
mind for better mental health. Retrieved
from
http://www.mind.org.uk/help/medical_and_a
ternative_care/dialectical_behaviour
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Psychoanalytic Psychotherapy. (n.d.). American
psychoanalytic association. Retrieved from
http://www.apsa.org/About_Psychoanalysis/
sychoanalytic_Psychotherapy.aspx
 Psychoanalytical and Psychodynamic Therapies.
(n.d.). Counselling directory. Retrieved from
http://www.counsellingdirectory.org.uk/psyc
oanalytical.html#PsyhodynamicTherapy
 Schultz, M., & Videbeck, L. (2009). Care plans. In
Lippincott's Manual of Psychiatric
Nursing Care Plans (8th ed., p. 53).
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