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lokiez
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Default Feb 21, 2019 at 10:27 AM
  #1
There are times when people dont take medication even when they need it most. This is probably the hardest part of Mental Health issues.

One way is to provide covert medication and the person becomes sober then counsel them to take medication.

Any thoughts on this approach? What would be the concerns in using covert medication?
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Default Feb 21, 2019 at 10:51 AM
  #2
How would it be covert?

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Default Feb 21, 2019 at 11:02 AM
  #3
I would have serious ethical issues with that. As long as a person has the capacity to make their own decisions, it is up to them to decide whether or not to take their meds. If they come to a point when they no longer have that capacity, then they should be admitted as an in-patient.
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Default Feb 21, 2019 at 11:03 AM
  #4
Quote:
Originally Posted by sarahsweets View Post
How would it be covert?
Covert in a way like mixing it in food or any eatable, which can help in consumption of medicine.
If somebody is not taking medicine then this is one possible way but i am sure of any adverse effects of this approach.
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Default Feb 21, 2019 at 09:18 PM
  #5
I’m not sure this would even be legal....

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Default Feb 23, 2019 at 04:53 PM
  #6
This would really tick me off for lack of a less PC word.

But at the same time, I can be pretty stubborn and for me- the longer I dont take medication the more ridiculous reasons my brain creates to make it even harder for me to start taking it again. Like- just as an example of how that could work... lets say...At first Ill think I dont need it, that Im doing fine without it. And a couple of daya without it Ill start thinking Im cured. Then a few days later Ill start to think that the doctors are out to get me to force me to take it. Then around that same time Ill start hearing voices telling me that. Then Ill start thinking that the voices have given me the power to fly out windows and see the secrets (hallucinations) that “other people are avouding”. And then Ill start talking aboht all sorts of crazy things that make no sense shaking and hallucinating so badly that I dont know whats real at all and what isnt and my brain feels like its just on fire and I am so so so scared. So confused. And in so much pain.

So really, as my psychosis gets worse- my reasons NOT to take the medication compound and it becomes harder and harder to get me to do it. It becomes more and more terrifying for me too because the worse I get the more people push and the more I feel... trapped and the more agitated I get. And its just very unpleasant and the thought that it could be avoided through covert medication when Im at a place BEFORE things get too out of hand... I dont know. I hate the idea, I hate the thought that just because Im mentally ill I should have to sacrifice my autonomy... but I just dont know.

I would prefer really someone to TALK to me before things get out if hand. But the thing is- I have a hard time trusting people and dont like to burdon anyone so I... let it get worse than it should.

So can I understand covert medication- yes. Do I think it should ever ever ever be considered anything more than the absolute last option- no. Options to include the mentally ill individual in their own treatment should be attempted first and foremost.

I personally think the rule of “danger to self or others” is fair. Beyond that- things become very ethically blurred in my opinion.
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Default Feb 23, 2019 at 11:10 PM
  #7
yea I agree with others saying no, its not right, not to mention its a crime in the USA to medicate someone with out their knowing they are being drugged. here where I am located in order for a caregiver to administer meds against their patients wishes or with out their knowledge requires a court order and a physician and psychiatrist stating the patient is not able to make their own mental and physical health decisions and someone is court appointed to be that patients court appointed guardian that makes their physical and mental health decisions.

my suggestion to the original poster... if you are a caregiver contemplating this, please contact your patients treatment providers who can do a physical and mental health assessment to see if your client is competent to make their own decisions and if not petition family court to appoint that client a court appointed guardian. the court appointed guardian is usually a family member that the court has done a thorough background check and they have been deemed physically, mentally and financially capable of being another adults guardian. if there is no family members then the court appoints a lawyer and law firm to over see the persons best interests, mentally, physically and financially.
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Default Feb 24, 2019 at 01:01 AM
  #8
I full agree with your point and i also know that it is a very debatable topic.
As i understand after discussion with Psychiatrist that most of major Mental Health issues cannot be cured but need to be managed via medication and counselling.
So if a person starts taking medication on its own and starts working with Psychiatrist then that person can lead a productive life.

But then it brings me to another point, people who start taking medication on their own, just stop taking them all of a sudden. Medication compliance is a major issue in treating mental health cases. Reason for not taking medication can vary from side effects to feeling so good that you feel its not required anymore.
Everytime medication is stopped, it comes with a huge risk of relapse.

And every relapse can just change the life of caregiver and family drastically and can be so much draining.

Probably in such a scenario, covert medication to control the situation and then counselling them to start medication? or another option is forced hospitalisation and then again counselling to start medication?

I really don't know which approach is good but it will boil down to forced hospitalisation vs covert medication.

Another point which comes up is, will hospitalisation when person is not willing, impact relation between caregiver and person with mental health issue?

I really don't have an answer for this and i understand all points but as a caregiver it is soo much draining to go through these cycles that you wish there was a magic button to fix everything.


Quote:
Originally Posted by Under*Over View Post
This would really tick me off for lack of a less PC word.

But at the same time, I can be pretty stubborn and for me- the longer I dont take medication the more ridiculous reasons my brain creates to make it even harder for me to start taking it again. Like- just as an example of how that could work... lets say...At first Ill think I dont need it, that Im doing fine without it. And a couple of daya without it Ill start thinking Im cured. Then a few days later Ill start to think that the doctors are out to get me to force me to take it. Then around that same time Ill start hearing voices telling me that. Then Ill start thinking that the voices have given me the power to fly out windows and see the secrets (hallucinations) that “other people are avouding”. And then Ill start talking aboht all sorts of crazy things that make no sense shaking and hallucinating so badly that I dont know whats real at all and what isnt and my brain feels like its just on fire and I am so so so scared. So confused. And in so much pain.

So really, as my psychosis gets worse- my reasons NOT to take the medication compound and it becomes harder and harder to get me to do it. It becomes more and more terrifying for me too because the worse I get the more people push and the more I feel... trapped and the more agitated I get. And its just very unpleasant and the thought that it could be avoided through covert medication when Im at a place BEFORE things get too out of hand... I dont know. I hate the idea, I hate the thought that just because Im mentally ill I should have to sacrifice my autonomy... but I just dont know.

I would prefer really someone to TALK to me before things get out if hand. But the thing is- I have a hard time trusting people and dont like to burdon anyone so I... let it get worse than it should.

So can I understand covert medication- yes. Do I think it should ever ever ever be considered anything more than the absolute last option- no. Options to include the mentally ill individual in their own treatment should be attempted first and foremost.

I personally think the rule of “danger to self or others” is fair. Beyond that- things become very ethically blurred in my opinion.
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