Psychiatric Dept Explains Relapses Among Mental Patients
By Azian Othman

Bandar Seri Begawan - Individuals suffering from mental health problems who have been seen wandering around in town have been warded before at the psychiatric unit to undergo medical treatment.

Once they stop taking the medication, relapses would occur.

Reports have been lodged of these people wandering around in the capital, stopping cars in the middle of the road, entering restaurants and consuming other people's drinks, even dressing and acting indecently.

"Relapses are a common occurrence among psychiatric patients because some mental disorders tend to have a chronic relapsing course," said Dr. Ramli Hassan, Head and Specialist of the Psychiatric Department at RIPAS Hospital.

"Many patients tend to stop taking their medications once they have recovered from their illness despite being informed that they need to continue with their medications over a certain length of time:"

Dr. Ramli added that several reasons contribute to this non-compliance, the most important being the patient's lack of insight into his illness. The patient may no longer think he is ill and therefore believes he doesn't need to continue with his medication.

Some patients are given monthly injections to ensure they remain on medication, However, this still requires willingness on the part of the patient to come to the hospital or on the part of his family to bring him to hospital for the injections.

Some patients and their families are unwilling to do that. For the few such patients, the Department's Community Psychiatry team visits them at home to give the necessary injections in addition to counselling them on "the need for good compliance to their medication" to prevent relapses and re-admissions.

Such scheme of visits appears to succeed in reducing the relapse rate among the chronic schizophrenic patients.

Dr. Ramli added that another important cause of noncompliance with the medication is the side effect of these medications that can be very distressing.

"Because of this, proper counselling pertaining to medications and their side-effects are important so as to ensure patients and their families know what to expect and how to deal with them," he said.

"Doctors are also encouraged to use newer medications which are more expensive than the older ones but are associated with much less side effects and less impairment in the patient's quality of life."

Currently, the department has three specialist psychiatrists and four medical officers with 22 staff nurses. The department also has a social worker, an occupational therapist, a clinical psychologist and several mental health assistants and visitors working with the department. -- Courtesy of Borneo Bulletin

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