Daily Archives: September 17, 2013

Schizophrenia & Consent to Treatment

One day a mother of a 17-year-old patient called, said her relatives have been calling her, asking about her daughter. She posted several status on her Facebook (see? social media is what an important tool?!), saying she was going to kill her parents, and she has a plan about it (e.g. will chop father into how many pieces, then…). As patient has already blocked her parents on it, so they couldn’t see the status, but other relatives noticed it so they called mother.

This is a girl with Schizophrenia, having various kind of hallucinations about god, devils, aliens, thinking she is special, different from everyone else; isolating herself, easily agitated, bad tempered… She doesn’t sleep at night (well, most schizophrenic patients that I’ve come across don’t sleep at night). She has two younger brothers, she gets along ok with them. She thinks the youngest one is special like her, but he isn’t aware that he is special yet, at one point he will reach her stage.

Do you think someone like her will come for treatment, take medicine, go through treatment willingly?

If the answer were No, do you think we should then give up on her, and many people who aren’t well out there like her?

I guess many people understand the importance of consent to treatment (e.g. the surgeon is going to operate your brain, you or your family will have to sign a consent or else what if the surgeon is merely operating because s/he thinks this is the way s/he can earn the most?! Opps), but in the field of mental disorder this may not always be the case. It is not always possible to get the patient’s consent, the abovementioned is an example.

So maybe the parents can consult on behalf, then dispense medicine to the girl somehow… Till one point when the patient herself has the insight about her problem, she can then come for treatment personally!

There are some overly anxious parents or family members, who cannot accept “consult on behalf”- I’m not sick, why should I see the doctor?! Right, but your ill family isn’t coming either, how can we help her?