Subjectivity as “evidence”: an exploration of medication adherence in the treatment of schizophrenia using in-depth interviews

ABSTRACT

Anti-psychotic medication is considered one of the most efficaciousinterventions for the treatment of severe schizophrenia, yet ratesof adherence are notoriously and consistently low despite volumesof medical research. Scientific knowledge has failed to improvemedication adherence because it systematically rejects subjectiveexperience in conceptualizing mental illness. In this paper, thecontent of interviews with people diagnosed with schizophreniareceiving Assertive Community Treatment are interpreted from aFoucaldian perspective to illuminate how disciplinary assumptionsperpetuate power inequities and may be a barrier to adequateresearch generation and effective treatments. Implications for futureresearch methodology and clinical approaches are discussed.

KEYWORDS:

• Schizophrenia
• Foucault
• evidence-based practice
• medication adherence

Notes

1. I will use the term consumer to refer to individuals receiving services from the ACT team for continuity and because it is the preferred nomenclature in the model, but the term receives mixed support from those with the label.