The Politics of Psychiatric Drug Treatment

Abstract

It is difficult to overstate the central role that drug treatment plays in modern day psychiatry. Psychiatric hospitals and community mental health team activities revolve around the various rituals of drug treatment. In hospital, where virtually every patient is on at least one psychoactive drug and most are on several, there are the regular drug rounds, as well as more dramatic emergency situations where disturbed people are forcibly drugged. Much discussion and energy among staff is devoted to whether patients are on the right sorts of drugs and to whether or not they are actually taking them. Drugs have become the focus of hospital life in a way that ECT and other physical procedures were in the 1940s and 1950s (Braslow, 1997). In the community, staff are also concerned about whether patients are being compliant with medication. Administering depot medications (by injection) is one of the main tasks of community psychiatric nurses, and again, issues about medication are a central feature of meetings between staff and patients and among staff. Medication changes or non-compliance are usually the first explanation invoked when there are changes in someone’s mental state, both in hospital and outside.