Mental Health Issues: Why some people struggling with mental health don’t take their medications

Nov 2020 | Resources

The 2020 Point-in-Time Count reported that 61% of those experiencing homelessness in Nanaimo are also struggling with mental health issues. People with mental health are more susceptible to factors that can lead to homelessness.

– They may not have the capacity for sustained, full-time employment;
– They may withdraw from family and friends;
– They may struggle with resiliency and resourcefulness;
– They may experience impaired judgement.

A common statement we hear is “I don’t understand why some people struggling with mental health don’t take their medications.” The idea being that, once well, the person would be able to find employment, a home and get off of the streets. Here are some common reasons people suffering from mental ill-health may not take their medications:

Fear and shame Associated with Mental Health Issues
There’s stigma around mental health struggles and taking medication means acknowledging a shaming disorder. Taking medication can seem like an admission of defeat, admitting they couldn’t handle it on their own and they need help.  

mental health infographic

Unawareness
Many people are unaware that they’re experiencing mental health struggles. Life events such as grief, trauma, or feeling stuck can feel very similar to depression, bi-polar, personality disorder or Post-Traumatic Stress Disorder (PTSD). They may not know that their experience is more than just a really hard time.  

As we learn more about mental health and addictions and how it evolves throughout our lives, we’re understanding more about how significant life events can cause changes in the brain. These changes can lead to life-long PTSD, depression or other mental ill-health. Many people still believe the myth that you’re either born with mental ill-health or not.

Lack of access
Many people experiencing homelessness don’t have access to medication and/or health care. For example, they may not have a cell phone to call for help or make an appointment with a doctor. They may not have reliable transportation or aren’t able to pay for bus fare. People experiencing homelessness are fighting to address their most basic needs; staying warm and finding a meal. Making and attending a doctor’s appointment is often a luxury they don’t have.

Side effects
Side effects of some antidepressants, anti-anxiety medicine and psychotropic drugs can include sedation, insomnia, drowsiness, dry mouth, weight gain and sexual issues. If someone is already hesitant about taking medication, these side effects can be a powerful deterrent.

They feel better
Many people take medication until they feel better and the symptoms disappear. However, with many mental health disorders, once patients stop taking the medication the symptoms may return. Life events such as the death of a loved one or stress at work could also cause symptoms to re-appear.  

Misunderstanding
It’s difficult to talk about personal details with a doctor or counsellor, particularly one that a person doesn’t have a relationship with.  Patients also may not understand the potential benefits of the medicine, the nature of the side effects or the time it will take to see results. Physicians and counsellors may may not see their patients regularly enough to make an accurate diagnoses.

More challenges
Not only does homelessness have a direct impact on health, it makes it difficult or impossible to obtain medication and to adhere to medical treatment. The stress of experiencing homelessness may amplify mental illness disorders. People struggling with mental illness while facing homelessness encounter more barriers to employment and tend to be in poorer health than other people experiencing homelessness. [1]

To make it even more difficult, many services have long wait-lists and limited availability. This can be a major barrier to getting the consistent support that recovery from mental ill-health requires.

[1] Homeless Hub

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