For people with SMI, refusing treatment is unfortunately part of the process. It’s important for clinicians to be aware that this is frustrating – and frightening – for the family as well. Share the following information with the families you are working with so that they can feel supported as they try to assist their loved one returning to treatment–
While you may care for someone’s well-being and believe you know what’s best for them, adults have the right to make decisions about their treatment. There could be many reasons why a person decides to not engage in treatment or rely on only some treatment options. Some people make a decision to not take psychiatric medication because of unpleasant side effects or decide to manage their symptoms on their own. Some people don’t think therapy helps. What’s important is that the person is living a life that brings them satisfaction and happiness.
However, without treatment some people aren’t able to achieve the type of life they’d like to have. In this case, a relationship built on trust will put you in a better position to discuss the benefits of participating in treatment and how it may help them achieve their life goals. Some people become overwhelmed with accessing treatment, managing appointments, transportation, finances, etc. You can play an important role by helping to make treatment more accessible.
Your NAMI Affiliate can help you identify resources and options that can be helpful for you, including understanding your state’s laws and procedures around assisted outpatient treatment and other options available. It may also be important to have an honest discussion about how their treatment decisions affect your relationship with them. Set clear expectations and discuss the possible outcomes of both accepting and not accepting treatment. Some mental health professionals believe a related condition, anosognosia, or a person’s inability to recognize their own mental illness, contributes to an unwillingness to take medication or participate in treatment. When a person has no insight into their condition, it can create a difficult situation where they may not believe that treatment is necessary.