Thursday, July 15, 2010

Moving Forward - A Balancing Act

Just got off the phone with JSB's social worker.  There is good news.  He is going to spend two nights at the transitional apartment and then go back to the hospital on Friday.  This is a test drive to see how he likes the new digs, and to see if he will be able to handle the conditions of living there.

There is also a plan to switch to an injectable medication -- one that remains in his system for a longer basis -- because of his history with nonadherence to meds.   Like many individuals with schizophrenia, JSB lacks insight into his illness.  He doesn't believe he's sick.  Doesn't believe he needs meds.  I would love for that to be the case, would love for him to be able to manage without them.  The fact is, the idea of him going back to where he was last winter terrifies me.

Wow.  I just realized there is so much I could say about mental illness and medication.  Last night, at the board meeting of the mental health advocacy group upon which I sit, one of our members is a OT working on her dissertation about schizophrenia and med adherence.  She is doing great work trying to understand the attitudes of people who are prescribed anti-psychotics.

It's a difficult, controversial, and not a one-size-fits-all topic.  She indicated that based on her qualitative research, individuals are afraid that the medication will diminish their sense of "self."  Reason to be frightened indeed.  JSB believes the medications are what made him sick in the first place, and believes that he does not suffer from a mental illness.   In his case, and I speak only of his case, I believe that medication is a critical component to his continued recovery.  Medication is a tiny piece; there is so much more.  Medication does not define him - nor does schizophrenia.  But without medication, I have seen schizophrenia devour him.

I blogged about a fantastic program -Minds on the Edge blog a while back.  It really addressed head on the difficult issues of patient rights and involuntary treatment.  I have utmost respect for Pete Earley, Ellyn Saks, and the other panelists on the program.  It is a courageous conversation and it needs to continue.


And here's their website Minds on the Edge
  
At any rate, I didn't mean to digress on meds.

While this isn't what I imagined 22 years ago, when JSB blinked up at me in the delivery room, it's what it is.  I look forward to supporting him as he takes these steps toward independence and self-reliance - and pray that he accepts the assistance available to him and the terms of his occupancy.  Like any mom who dreams of her child taking their fledgling steps towards independence, I am holding my breath, stepping as far back as is necessary in order to give him room to gain independence, and sending many prayers his way.

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