Addressing non-adherence to antipsychotic medication: a harm-reduction approach

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  Many people decide not to take prescribed antipsychotics once they are discharged from the hospital.
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  Stopping antipsychotics suddenly without support may result in harmful reactions and possible re-admission to the hospital.
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  The ‘Non-Adherence Harm Reduction’ approach aims to reduce the harm of stopping antipsychotics, by informing and supporting those who make this personal decision.
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  This approach values personal autonomy and may reduce the likelihood of harm and re-admission in those who choose not to adhere to prescribed antipsychotics.

This paper discusses the evidence base for interventions addressing non-adherence to prescribed antipsychotics. A case study approach is used, and the extent to which adherence improvement interventions might be used in collaboration with a specific patient is considered. The principles and application of harm-reduction philosophy in mental health are presented in a planned non-adherence harm-reduction intervention. This intervention aims to acknowledge the patient’s ability to choose and learn from experience and to reduce the potential harm of antipsychotic withdrawal. The intervention evaluation method is outlined.