Psychologist's responses to medication concerns

Section A: Presented here, is a systematic review of the literature detailing the experiences of taking psychotropic medication in service users from minoritised ethnic backgrounds with psychosis-related diagnoses. Eleven qualitative studies are discussed and critically appraised. The review synthesises findings under six main categories; medication helping versus negative effects; coercion; “They’re quite happy to just hand out pills”; surrender versus disengaging; the need for cultural understandings alongside medication; and family support for versus opposition to medication. The review provides some initial evidence which suggests negative experiences of medication (predominant in the papers), although not specific to ethnicity per se, are more likely to be compounded if service users are a member of a minoritised ethnic group. Future research would benefit focusing on the voices of service users from minoritised ethnicities looking directly at this issue and investigating how clinicians might respond to service users who wish to challenge their current treatment.

Section B: Presented here, is a study exploring psychologists’ experience of responses to concerns about the medication of service users given a psychosis-related diagnoses. Guided by a critical realist grounded theory methodology, the constructed model identified 43 sub-categories organised within six main categories: Observing Coercion; ‘Walking the Tight Rope’; ‘Listen’ or ‘Shut Down’; Service Users ‘Stuck in the Middle’; Teams, People and Relationships; Economic Climate and Societal Discourses. Findings highlight some of the dilemmas participants experienced regarding medication and is important in its acknowledgement of how difficult it can be to negotiate these dilemmas. The results indicate the need to improve shared decision making with service users, to offer increased support in the withdrawal of medication, and to help teams feel able to take more positive risks in relation to prescribing.