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When a mentally-ill person decides not to take the medication.

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  • 24-01-2024 6:34pm
    #1
    Registered Users Posts: 4,560 ✭✭✭political analyst


    In this case, before the killings, the perpetrator had been advised to take medication but, obviously, didn't take it.

    As far as I know, heroin addicts who are prescribed methadone swallow it in pharmacies in the presence of pharmacists. So why can the same not be done with schizophrenics who are prescribed medication that is necessarily for the treatment of their condition? After all, both heroin addiction and schizophrenia have led to fatal violence.



Comments

  • Registered Users Posts: 607 ✭✭✭Yeah Right


    Heroin addicts aren't made to swallow the physeptone (known colloquially as 'Phy' in Ireland) in front of the pharmacists because they're afraid they won't take it.

    They make them do it there and then to prove that they're not selling it to some other junkie so they can buy more heroin.



  • Registered Users Posts: 620 ✭✭✭scottser


    Firstly, the most common medical treatment for long-term schizophrenia patients is delivered via intramuscular injection which lasts for a 10-12 weeks. For medical staff though, forcing anybody into any treatment is legally and ethically unenforceable unless they are a danger to themselves or others, in which case involuntary admission to a secure hospital is for three weeks only. One of the primary symptoms of schizophrenia is intense paranoia. It's a horrible affliction and the medical treatments are difficult to manage and take - it dulls senses, libido, saps energy etc. It's no surprise then that many schizophrenia sufferers will self-medicate with drugs or alcohol, resulting in case management by doctors and support staff being far more challenging.

    You should be very careful in advocating that any group in society be medicated against their will.



  • Registered Users Posts: 4,560 ✭✭✭political analyst


    He was already known to the police for violent offences before he did the killings. Those 3 victims would still be alive if that schizophrenic had been sectioned. So much for care in the community!



  • Registered Users Posts: 40,291 ✭✭✭✭Gatling


    To me it's the equivalent of getting behind a wheel locked out of your bin ,if a psychiatric patient is a known Violent offender and refuses to take their med then they have to be detained



  • Registered Users Posts: 620 ✭✭✭scottser




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  • Registered Users Posts: 40,291 ✭✭✭✭Gatling


    I think they possibly could, sectioned and then detained until doctors are satisfied they wouldn't be any danger to the public,

    There was a case a few years ago involving an Italian lady who visited the UK for a business conference and had a manic episode due to her being bipolar and pregnant, she was detained in the UK until she gave birth and then had her new born child taken into care and adopted, before being released and returned to Italy they wouldn't even let her family to take care of her child there grand child...


    But yet they can't detain a violent and psychotic offender who won't take meds



  • Moderators, Category Moderators, Social & Fun Moderators, Society & Culture Moderators Posts: 23,637 CMod ✭✭✭✭Ten of Swords






  • On the “bad old days” unfortunates with various conditions affecting the brain/mind were locked up, from merely having autism to having severe schizophrenia refractive to treatment. It’s kind of gone in the extreme opposite direction where people in great danger to themselves and others are free to do that harm.

    I remember the Sicilian man who killed the poor man in a horrific way he was staying with in Castleknock when a chess game, was it, didn’t go his way, or he had visions or heard voices. That man is now locked up for life. He had been told by his psychiatrist in Sicily that he must always comply with medication, which he did, and understood the importance of it. However when he came to Ireland and responsibly signed up with our own psychiatric services, he had his medication withdrawn by the doctor and immediately became very unwell, having been stable up to that.

    Sometimes psychiatric services don’t always serve patients or society well, even those who would be willingly compliant.

    Also psychoses can have origins in organic disease. The lovely husband of a relative began to get increasingly severe psychotic episodes and he very much complied with taking medication, going into hospital where he felt safe, and asking to be committed if he became unreasonable due to his condition. He was diagnosed at first with bipolar, veering into schizophrenia but in fact the final diagnosis was organic brain disease affecting many lobes of the brain, hence medication becoming less effective as time went on.

    With Brain studies, imaging etc, it’s becoming increasing clear that pathological processes are very often visible on these cases, and maybe disease modifying drugs may become available as they are in some other neurological diseases.



  • Registered Users Posts: 620 ✭✭✭scottser


    The difference is that someone would have to very unwell to be sectioned. Bring off meds is a big red flag but it's not grounds for detention under law.



  • Registered Users Posts: 16,227 ✭✭✭✭Grayson


    And we allow bodily autonomy. Forcing someone to take meds has rarely been good when it's been done throughout history.



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  • Registered Users Posts: 23,703 ✭✭✭✭pjohnson


    Well letting people with well flagged previous issues keep running wild isn't great as this (and our own multiple conviction wanderers) shows.

    Take the meds or be sectioned for everyones safety. If you prove you can't take the meds then you get sectioned.



  • Registered Users Posts: 620 ✭✭✭scottser


    That is a very archaic way of thinking about mental health, and an attitude you'd expect to find in the comments section of the Daily Mail. Give your a head a wobble and think for a minute about the ramifications of what you're suggesting.



  • Registered Users Posts: 3,637 ✭✭✭Montage of Feck


    "Care in the community" is a complete con job when it comes to public healthcare.

    🙈🙉🙊



  • Registered Users Posts: 3,019 ✭✭✭Ezeoul


    That is for those who are on what is colloquially known as "dailies". Some addicts (those who are considered more stable) are given a weekly amount.



  • Registered Users Posts: 620 ✭✭✭scottser


    Those cases where a patient is off their meds and becoming unwell is probably the most challenging for their clinicians to address. It's the most time-consuming, resource-heavy and often the least successful component of their treatment plans. The response system in place between MH services, Gardai, accommodation providers and other stakeholders to these patients is often disjointed, arbitrary, inconsistent and in most cases not beneficial to the patient. Essentially, doctors are too busy, there's not enough outreach, gardai don't want to get involved until a criminal act has been committed, keyworkers and support staff too keen to exclude 'difficult' patients etc. The punitive approach to mental health crises, in the vast majority of cases, means that the patient gets all the blame, the care systems continue being too expensive and ineffective and outcomes become less and less positive for everyone.



  • Registered Users Posts: 16,227 ✭✭✭✭Grayson


    You want to essentially imprison someone without a trial? Because they won't take meds? You can see how dodgy that is. If someone doesn't take their meds and then acts in a way that is a danger to themselves or others, fine. But to preemptively say that everyone on meds has to take them or else they'll be locked up is completely different.



  • Registered Users Posts: 1,614 ✭✭✭WrenBoy


    Brutal murder of 3 people and attempted murder of more. And is given manslaughter, same as wreckless driving !?In my opinion this was seriously mismanaged and I can't imagine how the families are feeling after this miscarriage of justice. The murderer had previous arrests for violence against police so at the minimum he should have been hospitalised then, not just released when they knew he was a danger to the community. Blood on the hands of the Bristish legal system.



  • Registered Users Posts: 726 ✭✭✭Slightly Kwackers


    So forced medication is acceptable for people who are not sectioned, not under the care of the state?

    That is a dodgy one and would be treatment on the cheap with the usual disasterous consequences.

    Mentally ill people killing is not unusual in the UK. They are often targeted by "religious" group and indoctrinated into terrorism.

    The UK has cut down on welfare, healthcare, just about everything that was supported by public spending is cut to the bone and there is a cost.

    The other slight problem in addressing this is the blame culture that is now endemic in the UK. If someone needs treatment at a hospital it's their fault for being overweight, smoking, drinking etc.

    Like so many other criminals and mentally ill threats to society the bloke in the post was known to the police, yet nothing was done.

    Of course now the IQ zero's don't quite understand the implications and are doing exactly what Brit's are absolutely brilliant at, thirst for revenge and whinge about the subject of the sentence rather than the system that allowed him the opportunity.

    It's the Btritish way now and will not change. In GB News this morning, [a popular nationalist source of drivel and employment for British MP's that should be working but are too incompetent], they are running a headline about France having it in for Brits over not giving them a visa waiver because of "Brexit punishment rules".

    So all the poor numpties that screwed their country will blame the "new" EU "Brexit rules". Of course it does not occur to them that France is controlling it's borders something they thought the EU did not allow their government to do :-)

    Such is the mindset and blame culture now and blame or vengeance will not replace care or justice even if the soma is shovelled down the "patients" throat.

    Maybe they could bring lobotomy's back if the baying mob were not worried about undesirables getting freebies on the NHS :-)



  • Registered Users Posts: 25,979 ✭✭✭✭Mrs OBumble


    This is not a discussion about mental health.

    It's a discussion about diagnosed permanent, mental illness.

    Medication is essential in some cases, and should be mandated.



  • Registered Users Posts: 726 ✭✭✭Slightly Kwackers


    I often thought that maybe there was a flaw in the logic when it was announced decades back. Were they not in the community when first afflicted anyway?

    My "community" in my UK city consisted of drug dealers and an above average number of criminals. Not really the best kind of people to provide care I would think.

    Frankly I would think that "care in the community" would be more of an opportunity to set up a retail outlet for druggies if the "patient" was living alone.

    Maybe that's why the prison service is overwhelmed by the mentally ill?



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  • Registered Users Posts: 29,092 ✭✭✭✭AndrewJRenko




  • Registered Users Posts: 620 ✭✭✭scottser


    Involuntary detention for mental illness is outlined under the Mental Health Act. I use the term 'mental health' because someone's situation might vary between prolonged periods of wellness and stability to unwellness and chaos depending on a variety of factors, of which medication might be only one.

    If you believe that medication should be compulsory in certain cases, by all means you are free to do so. Where the line is, who does it benefit, who gets to decide - all these issues are ethically and legally problematic. There is no magic bullet. 'Lock them up if they're off meds' is a very blunt tool to try to work on a complex problem, given the historical approaches to those who are mentally unwell.

    Given the recent scandal over the lack of available services for those who require voluntary admission, there is scant hope that those who require an involuntary response will receive it in a timely fashion or even that it will do much good.



  • Registered Users Posts: 726 ✭✭✭Slightly Kwackers


    What a refreshing change from those who have all the answers.

    You wouldn't be on many peoples Xmas card list in Nottingham today, they prefer the quick vindictive actions that are being clamoured for while blundering on to the next travesty.

    It's easier and cheaper to blame the sufferer than prevent the progress of their troubles.



  • Registered Users Posts: 40,291 ✭✭✭✭Gatling


    Violent offenders should be left in the community and left to there own devices until they take a life or several because they refuse to take the meds to keep them stable,and when it does go wrong blame everyone from the victims to the authorities but absolving the attacker of any blame because of mental health,



  • Registered Users Posts: 3,920 ✭✭✭Grab All Association


    The UK is running the same scam as Ireland where they closed the mental hospitals and say they are providing care in the community.

    I'm from Thurles, and when I lived in Thurles they would bring a lot of people with severe mental health issues in and medicate them, then they'd be let wander the street until 5pm. Previously these people would be accommodated in Clonmel mental hospital before it was shut down.

    A young girl I know was talking on the phone to her boyfriend when a man in his 60s came up and punched her thinking she was laughing at him.

    My dad was talking to a guy about the weather and a couple of minutes later the man came up accusing my dad of saying stuff he never even said.

    These people could be hearing voices and are a danger to themselves and others and need to be sectioned under the mental health acts.



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