Call to pay schizophrenics to take medication

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Call to pay schizophrenics to take medication

03.01.07

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http://www.thisislondon.co.uk/news/article-23380291-

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Paying schizophrenics to take their medication could help sufferers

stay out of hospital, a study has controversially claimed.

The authors of the report said the benefit of adopting such a

practice " seemed beneficial " and no harm was " intended or caused " .

They conceded that the ethical aspect needed further consideration,

but added that the incentive may increase the number of people taking

their medication properly.

" Money for medication may be an effective option to achieve

medication adherence in otherwise non-adherent assertive outreach

patients, " the authors wrote.

The report, published in the Psychiatric Bulletin, was co-written by

psychiatrists including Dr Dirk Claassen, consultant psychiatrist at

the East London and the City Mental Health Trust, and Professor

Stefan Priebe, professor of Social Psychiatry at Queen

University, London.

It said schizophrenics not taking their medication posed a " major

obstacle to effective treatment " .

Between 20 per cent and 50 per cent of people in general adult

psychiatric services do not take their medication.

This figure was thought to be even higher in areas where patients

live in the community and rely on " assertive outreach " services,

where patients are visited at home and encouraged to take medication.

As part of the study, five outreach mental health patients in east

London with a history of not taking medication were offered between

£5 and £15 for each treatment, in the form of single depot injections.

Four accepted the deal and managed to continue living independently

with fewer problems with police and neighbours.

Three did not need to be re-admitted to hospital while the fourth saw

the number of days in hospital drop from 319 in the two years before

the scheme to 37 since March 2005.

A questionnaire was also sent to 150 assertive outreach teams asking

if they used financial incentives and what they thought of such

practices.

Although only 47 per cent responded and none had offered money, 10

per cent said they had used food and other indirect incentives to

improve " treatment engagement " .

More than three quarters (76 per cent) objected to the idea of

financial incentives while 42% thought the practice unethical.

Dr Claassen said: " The results in terms of reduced hospital

admissions for the patients who accepted the offer seem beneficial.

" There is no harm intended or caused, the service user can revoke the

offer at any time, and the treatment is generally available.

" Some team managers feared a negative impact on their therapeutic

relationships, but the researchers said they did not see this in

their clinical practice, and their results in east London are

encouraging. "

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I know where this will end up - with people faking mental illness

until they are " prescribed " money to take drugs. Then they'll throw

the drugs in the bin, never hear any voices again " because the drugs

are working " , and have a nice little earner for life.

- Nigel, London

Are they stupid? they are treating a serious mental illness as though

it is something that can be switched on and off by a few quid.

- Pat, sussex

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