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The least worst option: user experiences of antipsychotic medication and lack of involvement in medication decisions in a UK community sample

Morant, N; Azam, K; Johnson, S; Moncrieff, J; (2018) The least worst option: user experiences of antipsychotic medication and lack of involvement in medication decisions in a UK community sample. Journal of Mental Health , 27 (4) pp. 322-328. 10.1080/09638237.2017.1370637. Green open access

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Abstract

BACKGROUND: Treatment decision-making that fully involves service users is an aim across medicine, including mental health. AIM: To explore service users experiences of taking antipsychotic medication for psychotic disorders and their perceptions of decision-making about this. METHOD: Semi-structured interviews with 20 users of community mental health services, conducted by service user researchers and analysed using thematic analysis. RESULTS: Antipsychotic medication was perceived to have beneficial effects on symptoms and relapse risk, but adverse effects were prominent, including a global state of lethargy and demotivation. Weighing these up, the majority viewed antipsychotics as the least worst option. Participants were split between positions of "willing acceptance", "resigned acceptance" and "non-acceptance" of taking antipsychotics. Many felt their choices about medication were limited, due to the nature of their illness or pressure from other people. They commonly experienced their prescribing psychiatrist as not sufficiently acknowledging the negative impacts of medication on life quality and physical health concerns and described feeling powerless to influence decisions about their medication. CONCLUSION: The study highlights the complexity of agendas surrounding antipsychotic medication, including the pervasive influence of coercive processes and the challenges of implementing collaborative decision-making for people with serious mental health problems.

Type: Article
Title: The least worst option: user experiences of antipsychotic medication and lack of involvement in medication decisions in a UK community sample
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/09638237.2017.1370637
Publisher version: http://doi.org/10.1080/09638237.2017.1370637
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Antipsychotics, decision making, qualitative research, schizophrenia, subjective experience of antipsychotics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/1572279
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