A spoonful of something
Ian handed me a fascinating article on ‘Should patients be paid for taking their medication?’. (He also said it was high time I wrote a blog. )The story described a trial where patients with mental illness were paid £15 for each fortnightly visit to their clinic where they were administered their depot.
My immediate answer was to say, of course they bloody shouldn’t be paid! Treatments are prescribed to make people feel better and help them function in the world, surely that is incentive enough?
Hold on, I thought – it’s plainly not enough. Poor compliance is a fact of mental healthcare. It’s easy to speculate on why these patients would avoid their medication. We need to ask about the conversations they are having with their HCPs. Are professionals helping patients reach an informed decision about treatments?
Well, at least one survey says not really. Here, 59% of patients taking an antipsychotic reported that other treatment options had not been discussed. Almost two thirds said that they hadn’t been given written information prior to starting their medication. And 46% said hey hadn’t been warned about its potential side effects.
The NHS and HCPs need to look at the way they are engaging with patients. How many have read the NICE guidance on patient adherence and choice, published in January? And how is the NHS supporting them in implementing change?
Of course, it’s not easy for anyone. The befuddling thing about informed choice is that patients can refuse medication, and the professional’s obligation is to respect this decision. But what if the individual is antisocial, or a danger to self or others? Why are we paying these guys, really – what are the savings down the line? To make a judgment on this pilot, we need to know more about these patients other than that they are poor compliers.
If the scheme sees the light, bitter laughter will accompany jokes about kids being paid to go to school and likewise to adults for behaving on a night out. No-one’s going to like the idea of a pay-for-peace society. Whatever happens, let’s hope these patients get something positive out of it.
