Mentally ill patients are being paid by the NHS to take their drugs

[Guest guest]

Mentally ill patients offered cash incentive to take drugs

Wednesday, January 03, 2007

By nce

http://www.belfasttelegraph.co.uk/news/local-

national/article2121994.ece

Mentally ill patients are being paid by the NHS to take their drugs

in a radical experiment to improve compliance.

Four patients suffering from schizophrenia are receiving between £5

and £15 each time they have a " depot " injection - a long acting drug

which is normally given once a month.

The payments handed out by the Newham Centre for Mental Health in

east London have dramatically improved the patients' adherence to

treatment and reduced the time they spend in hospital suffering

relapses, and problems with neighbours and the police.

But the scheme has been attacked by mental health managers who say it

is unethical, coercive and could have a negative effect on the

therapeutic relationship.

Persuading mentally ill patients to take their drugs is one of the

big challenges in psychiatry, with non-adherence rates ranging from

20 to 50 per cent. Many of the inquiries into killings by people with

mental illness have shown that the crime happened after they stopped

taking their drugs.

In the US, financial incentives have been used to persuade other

types of patient to take regular treatment, specially where it has

unpleasant side effects or involves pain or effort. Findings from 10

of 11 studies found offering payments from $5 (£2.50) to $1,000

produced favourable results.

In the first British study, published in the Psychiatric Bulletin,

Dirk Claassen, a former consultant psychiatrist at the East London

and City Mental Health Trust, and Stefan Priebe, professor of social

psychiatry at Queen , University of London, say their findings

are also " rather encouraging " .

The four patients in the study were cared for by an assertive

outreach team and had a history of stopping their medication and

getting into trouble. That changed when they were paid, with three of

the four needing no hospital admissions, compared with between 80 and

362 days in the previous two years.

However, a survey of 150 team managers of assertive outreach teams

revealed widespread distaste for the approach. Three-quarters said

they objected to payments on ethical grounds - some objected because

of the impact on NHS budgets.

Edit Message Delete Message Lock Thread Respond to this

message

Responses