Monday, September 8, 2008

theage.com.au: Medication alert on mental illness

by Kate Benson

HALF of all people with schizophrenia and bipolar disorder who stop taking their medication will attempt suicide and 40% end up in prison, placing a huge emotional and financial burden on their families and society.

An international study of more than 1800 psychiatrists and carers, to be presented tomorrow in Melbourne at the Fifth World Congress on Mental Health and the Prevention of Mental and Behaviour Disorders, has found that about 80% of people with severe mental illness stop taking their medication at some point in their lives because they forget, cannot tolerate the drug's side effects or feel well.

About 50% of people with psychotic illnesses have anognosia, a condition where sufferers do not feel that they have an illness and feel no need to be medicated. Almost all who do stop will relapse, resulting in a cascade of problems such as depression, erratic behaviour, hostility, mania, threats of suicide and self-harm, the study found. Most are admitted to hospital.

"Carers are hurting from a number of problems endemic in the Australian system.

These include a lack of co-ordination in treatment plans at points of discharge from hospital, a drastic shortage of subsidised housing, few supported work programs and limited availability of psycho-social rehabilitation," the executive director of the Mental Illness Fellowship of Australia, Margaret Springgay, said yesterday.

"The failure to have a holistic mental health service linked to the broader life needs of people with mental illness can see many people discharged into the community without the support needed to keep them well."

Ms Springgay said that less than of 20% of Australians with severe mental illness were employed, compared to more than 50% in most other OECD countries, adding to sufferers' feelings of isolation and stigma.

"Research has shown time and again that about 50% of people with psychotic illness can be employed, but we have far too many on disability support pensions," she said, adding that mental health cost taxpayers more than $2.7 billion a year.

The study, called Keeping Care Complete, also found that about 73% of patients said they struggled to stay on their medication because of negative reports in the media about severe mental illness and 87% of psychiatrists believed that inaccurate portrayals in the media of people with schizophrenia and bipolar disorders negatively affected their patients.

"We may have moved away from institutions, but we haven't really broken the shackles for people with major mental illness," Melbourne University professor of psychiatry David Castle said.

"Medication is not the complete answer but it must be seen as the key to keeping these people well and it's a major challenge for psychiatrists because there is a very, very high chance that people who stop taking their medication will end up in hospital."

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