For us, the goal was to remove shame from the pill itself.
Our aim in writing the facts about ‘pill shame’ was to make life easier for those who benefit from drugs. Our desire is for all mental health patients to receive optimal treatment. Not just with drugs, but with it as well.
Our commitment aims to address the serious health challenge of stigma associated with mental illness. We must stand together on this, regardless of our professional viewpoint.
Openness about mental health has increased significantly in recent years. However, people with mental disorders are still highly stigmatized and, in many cases, develop self-stigma. Stigma is associated with both the disorder and treatment – perhaps especially with substance abuse treatment.
Informed choices
Some call the numbers – how many are affected by pill shame? For us, the goal was to elevate the phenomenon itself. But from numerous meta-analyses, we know that patients’ attitudes toward medication are one of the most important reasons they stop taking effective treatment, or don’t start at all.
Many also stop taking medications because they remind them of their illness. Some people find that drugs show weakness. For us, the main message is that everyone should be able to make informed choices about medication use, without excessive negative or positive voices contributing to poor choices.
We expect respect for patients who choose to use a physician-recommended medication, and respect for those who choose not to use it after a thorough evaluation.
Overcoming stigma is a shared task and requires constant vigilance. Negative media reports about psychotropic substances help maintain and sometimes increase stigma.
Side effects occur
Our engagement with this issue is not rooted in a particular ideological understanding of what mental disorders are. We are not calling for an increase or decrease in drug use. Nor whether it should be understood from a medical, psychological or psychosocial framework.
Breath and soma go hand in hand. The truth is that mental disorders can in many cases be treated by the use of medications, usually accompanied by other measures.
What mental disorders are and what treatment should consist of is a separate discussion that we encourage as part of continuing professional development.
We realize that many patients experience side effects and therefore choose not to use the medication. We realize that it is painful to experience forced treatment. All people have a need for belonging and security. Health care workers (including psychiatrists) must act with respect and humility. At the same time, healthcare workers must demonstrate professionalism, take responsibility and be able to convey even unpleasant messages when this is the reality.
Expect respect
We believe that medicine is not always harmful, and that the goal is not to take as few drugs as possible. We believe that not all mental disorders are treated equally without medication. We believe that psychiatrists and other clinicians who recommend and prescribe psychotropic medications do so because they want what is best for the patient and based on their best professional judgment.
We expect respect from our colleagues and members who make a continuous effort every day (and night) to ensure that patients receive optimal screening and treatment in line with the best current knowledge. We expect respect for patients who choose to use a physician-recommended medication, and respect for those who choose not to do so after careful consideration.
The circular was signed by the Board of Directors of the Norwegian Psychiatric Association:
Lars Lin, Director
Solveig Kleibo Reitan, Vice President
Niklas Jørgen Nilsson Halvorsen
Anna Ulrika Larsson
Christina Norheim Lorentzen
Elizabeth Mork
Shahram Shijani
Marian Smithtop
Melissa Ann Ellen Othen Whipple
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