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Mental patients don't take their pills, poll shows

More than half the nation's psychiatric patients do not take their medication regularly, thereby placing themselves at risk of relapsing into mental disorders, a group of psychiatrists reported yesterday.

In a survey sponsored by the pharmaceutical company Johnson & Johnson last year, 190 psychiatrists in 58 hospitals nationwide collected questionnaires from 759 patients and 673 caretakers to study patients' adherence to treatment involving long-term daily medication. The report showed that more than half of the psychiatrists who were interviewed suspected that their patients forget to take their prescription medication or stop taking their pills within one month after being diagnosed with a psychiatric disorder.

"There are high levels of non-compliance. Over 80 percent of patients do not think they are suffering from mental problems, a relatively high rate compared with the 66 percent in European countries. As might be expected, many decide to stop taking drugs and seeing doctors," said Su Tung-ping (蘇東平), the head of the psychiatry department at Taipei Veterans General Hospital.

Su said that, unlike patients in European countries, who have access to the services of full-time health professionals in halfway homes or sanatoriums, Taiwan's psychiatric patients do not have a strong support network in their communities. It is usually employed, elderly family members who shoulder the responsibility of looking after them.

"Most of my patients are middle-aged and depend on their parents. Sometimes the aged parents do not have the energy to incorporate daily medication into their normal routines. Or they are simply unable to force patients to swallow pills," Su said.

Apart from patients' insufficient awareness of their own ailments and a lack of adequate health care, memory problems also contribute to their deviation from medication schedules. The survey indicated that more than 50 percent of psychiatrists feel that memory impairments or cognitive disorganization lead to declining patient compliance levels.

Another factor is the social stigma surrounding psychiatric patients, according to the survey. Although most patients and their families said they believe that regular medication helps to promote recovery, 63 percent of the interviewed patients said they feel embarrassed about taking medication.

"Many patients halt their medication after about a month, as soon as they feel slightly better. Yet all those delusional or anxiety disorders will slowly re-emerge," Su said.

The consequences of poor adherence to medication schedules could be grave, doctors warned.

"The patients who stop medication are four times more likely to commit suicide than those who take their medication regularly," said Chiu Nan-ying (邱南英), director of the psychiatry department at Changhua Christian Hospital.
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