Expert Insights

Latest news stories and opinions about the Dental, GP and Care Industries. For your ease of use, we have established categories under which you can source the relevant articles and news items.

08th November 2013

‘Keep taking the tablets’

There’s just been some research published showing effective outcomes in quality of life for a group of patients with long term severe mental health problems, who were paid money to keep taking their medication as part of a clinical trial.The idea is superficially attractive. One of the main protective factors for people with major mental illnesses, like schizophrenia, is medication used to manage symptoms. If people stop taking the medication because they don’t feel they need it anymore, then symptoms can re-occur, people start to become unwell, and this may precipitate an admission back to hospital. Mental health policy over the last twenty years has in many ways been about trying to keep people on their medication, for example by developing teams of mental health professionals to work assertively with people who might otherwise drop out of services, and by using the law with such measures as community treatment orders. The recent study into the idea of paying people to keep up with their medication estimated only half of patients stick to their prescriptions. So if paying people (not a lot by the way, £15 per injection in the research study) can keep them out of hospital and out of medical crises, surely the rewards will pay for themselves.

Well, I think there’s a few things wrong with such a suggestion. Psychiatric treatments are often controversial by nature. They can be a protective factor, but there are plenty more things that can help, like having supportive family and friends, regular support and monitoring from mental health teams, reducing stress in people’s lives, and providing meaningful daytime occupation. Can’t we invest more in these factors?

Some anti-psychotic drugs carry risk of side effects like weight gain, if all the incentives are about just taking the tablets (or getting the injections) where is the incentive to have regular reviews of medication, and managed reductions in doses of medication?

People with mental health problems are not alone in sometimes being reluctant to take medication. Many people with physical health problems are equally unhappy about taking medication, or saying they’ll do it to keep family and doctors happy, and then throwing away the tablets. Will there be a demand for payments to encourage everyone to take their prescriptions?

Sometimes clinicians get diagnoses wrong. Patients and their families might be reluctant to query their diagnosis if it means losing the right to medication bonus payments.

There’s a huge pressure on psychiatric in-patient beds at the moment. The House of Commons Health Select committee recently heard evidence from a doctor, that people were being ‘sectioned’ into hospital because beds were in such short supply that hospitals were not admitting people in mental health crisis situations on a voluntary basis.

If paying people to keep taking their medication is shown to keep them out of hospital, I suspect the idea won’t go away soon.

References:

Priebe, S. et al Effectiveness of financial incentives to improve adherence to maintenance treatment with antipsychotics: cluster randomised controlled trial British Medical Journal 7/10/2013

*All information is correct at the time of publishing

Topics: Mental Health

David Beckingham

Mental Health Specialist

David Beckingham is a self-employed independent trainer, and is also an honorary lecturer with the University of Cumbria. His professional background is as a social worker and he has worked in care homes for older people in Cumbria. David’s main area of expertise is in mental health. Prior to becoming self-employed he was a Staff Development and Training Officer with Cumbria County Council, both commissioning and delivering training to mental health workers and others in statutory and independent sector organisations. Read more

Leave a Reply

Join over 26,000 users already using the QCS Management System!
Start Free Trial
Back to Top
FOR TODAY ONLY, we have extended the offer, Save £350 when you buy before 5PM
Find out more
Introducing Our BIGGEST AUTUMN SPECIAL OFFER EVER - Save £350 when you buy before Wednesday 30th Nov 2016
Find out more

Register here for your FREE TRIAL

  • Try our unique Management System, or any of our individual packs
  • PLUS! Gain FREE trial access to our Mock Inspection Toolkit
  • Over 2,300+ pages of easy to use guidance and 300+ policies & procedures

Simply fill out the form below and get full access for 24 hours to a QCS Management System of your choice.

Start FREE Trial Click here