The client experience of psychiatric medication: A qualitative study

Abstract

This qualitative study examined the client experience of psychiatric medication among an unusual and under-studied subpopulation, individuals diagnosed with SMI who eventually experienced functional recovery. Four themes emerged from in-depth qualitative interviews with 16 such individuals: (1) primacy of medication, (2) informed consent, (3) self-determination, and (4) clinical engagement. Participants reported that psychiatric medication was the primary, and sometimes the only, intervention offered to them. Some described substantial delays in receiving psychosocial services, or that they were not informed of their availability. Participants also identified deficiencies in the process of informed consent, with some receiving information on adverse effects belatedly, or not at all. Coercive medication practices (e.g., court-ordered medication) were described negatively. Good clinical engagement from prescribers (e.g., good listening and a respectful relationship) was highly appreciated by the participants and seen as an essential component of their recovery process. Poor clinical engagement on the part of prescribers was a source of frustration. In some cases this resulted from poor micro-level skills; in others, it was more reflective of systemic problems (e.g., 15-minute med checks or rotating prescribers). The participants in this study had all attained functional recovery, an unusually positive outcome. Thus, their experiences and insights could have utility. As recovery-oriented mental health services expand, the integration of client voice into the use of psychiatric medications could result in more collaborative, and possibly more effective, mental health treatment.

Keywords:

• Psychiatric medication
• informed consent
• clinical engagement
• microskills
• relationship