Years ago I worked in a county mental health clinic that treated serious mental health issues utilizing the "medical model". (For more information on this model see my article, "The Medical Model for Treating Mental 'Disorders'".) I worked with a client who was diagnosed with Schizophrenia. I always remember his story when I hear of clients being "noncompliant" and refusing their psychiatric medications.
This client tried many different psychiatric medications over the course of about two years. He was put into public housing and placed on Social Security benefits. He lived in an apartment complex and was checked on by a caseworker weekly. But the medications were a problem.
Though they all greatly reduced his symptoms, they also caused side effects he found to be intolerable. The client was a brilliant artist and this was a significant part of his identity. But the psychiatric medications, in tranquilizing the symptoms in his fevered mind, also tranquilized his creativity. He was unable to create when on meds. He tried and tried again, taking everything which was prescribed for him, as it was prescribed, but his art did not return.
After two years of struggle he made a conscious decision to stop taking his medications. His symptoms returned which made it unbearable for him to live in the apartment complex. He had a great deal of difficulty tolerating crowds of people and noise. But his art returned.
He moved back into the woods and lived in an area surrounded by other artists. He showed me his camp, introduced me to his friends and showed me his work. His art gave his life purpose and meaning. He lived to create and expressing himself artistically made the suffering in his mind bearable. His friends understood his illness and did not stigmatize him because of his somewhat eccentric behavior. They valued his art and understood this was the price he paid to express it. He was treated with respect and dignity in his community. He developed coping skills to deal effectively with his symptoms. He expressed happiness at his decision to stop medications and delight at the return of his art and with it his identity and purpose as an artist.
Back at the clinic he was documented as being "noncompliant". His case was eventually closed and regarded as a treatment failure. But was it? If it was a failure, whose failure was it? If it was a success, whose success was it?