the long view

Working in social services, dealing with a psychotic ex, seeing people fall apart. The mantra of the industrty is “Treatment Works.” But we all knew that for some people (or even most people, some of the time) it abolutely doesn’t. Or maybe “Works” is a little too vague. Getting rid of command hallucinations, yes, is important, but there are other factors that impact quality of life, public safety, ability to maintain employment.

I understand why people refuse medication. They can feel that long term damage being done. The numbness, weight gain, blood sugar problems, digestive problems, tardive diskenesia. Drooling. Diminished capacities and diminished life span. And although we keep saying “Treatment Works” we also insist that treatment should never be manditory. Coercive treatment traumatizes.

What it really means is that treatment CAN work, but people are rightfully afraid of it too. Drugs have changed over the past few decades, but that means we haven’t studied the full long-term impact either. And we can’t learn more about other options if we keep insisting that what we have is working. Instead of partnering with friends and family members who could help monitor symptoms on a day to day basis, we actually drive them away by denying the problem, denying the need for help, refusing to talk about the reality of living with medication.

I undersand the arguments, but I would NEVER argue against medication where safety is concerned. The man who talks about killing my daughter periodically refuses medication because he’s self conscious about his weight. Every single time he’s been unmedicated he’s ended up being arrested, hospitalized, etc. Even medicated he’s unable to mantain employment or relationships. He’s still dangerous. But his story is not typical of others with his diagnosis. He’s a bad person with or without psychosis, with or without hallucinations. For some people choosing recommended medications really is a lose-lose situation. But no one wants to talk about that. We just smile quiety and insist that “Treatment Works.”