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Noncompliance and the Abdication of Responsibility

One of the most difficult challenges to overcome when dealing with a mental illness is the temptation of the excuse.  With a psychiatric diagnosis comes an excuse for everything.  Any bad behavior, lack of motivation, or failure can be passed off as a symptom or the result of an episode.

The excuse is always available.  Don’t take it.

No one’s asking you to take responsibility for having a mental illness.  That’s not your fault.  But you have to take responsibility for your actions.  Sure, unexpected things happen as a result of a serious mental illness, but most of our behavior is within our control, or at least our influence.  And the behavior that most influences our wellness is compliance.

If you have a treatment regimen that works, stick with it.  If you had one and left it, get back on it.  While many of us bemoan the fact that we’ll never be well, treatment success rates for mental illness are very high.

The National Institute of Mental Health has shown success rates for treatment of bipolar disorder of 80%, for schizophrenia 60%, depression, 70 – 80%, and panic disorder, 70 – 90%.  Compare this to treatment success rates for heart disease of only 45 – 50%.

With optimal treatment that the person complies with, a bipolar patient can regain approximately 7 years of life, 10 years of effective major activity, and 9 years of normal health, which otherwise would have been lost due to the illness

Yet treatment noncompliance rates are at least 20% and sometimes as high as 80%

Treatment only works if the patient complies with the doctor’s orders.  So take your medicine as directed, stay away from non-prescribed drugs and alcohol, exercise, sleep, and eat well.  Manage stress.  Chances are you will get better.  But you’ll lose your excuse.  Then you’ll have to start taking responsibility for your actions.

Responsibility brings a sense of control.  This is important because if I feel I have control over key aspects of my life, I am most destined for success and well-being.  If all things that happen to me, or if my very own behavior, is beyond my control, why should I bother?

If prescribed treatment brings me a measure of control over events and my behavior, then I can positively influence what happens to me and those I love.  I’ll have to get out of bed, get off disability insurance if I can work, go to work, and suffer the challenges everyone faces.  Life may even be a bit more boring.

Yet I can contribute, connect with others, and work toward dreams I may have long ago abandoned.  Yes, this can be very hard.  I may have to deal with side effects and limitations.  I may have to say no when I want to say yes.  And compliance can be costly.  But wellness is possible.

Unfortunately, access to treatment is not available to everyone.  Finding a correct diagnosis and a successful treatment regimen can take years.  Some people are truly unresponsive to medicine.  My heart especially goes out to these people and we must maintain services to help them.

But if you have access to treatment and you’re responsive to treatment you have a responsibility to work with doctors, counselors, social workers, and any family and friends available to help you to find a successful treatment regimen.  And then you have a responsibility to stick with it.

Health can be more challenging than illness.  You have to stop identifying with the disease.  But if you’re compliant and you get better, as most do, the life that results is always more satisfying and complete.  With that life you’ll be able to touch others and bring immeasurable good into the world.

Noncompliance and the Abdication of Responsibility

George Hofmann

George is the author of Resilience: Handling Anxiety in a Time of Crisis, from Changemakers Books. Visit George's site or join the Facebook group Practicing Mental Illness

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APA Reference
Hofmann, G. (2019). Noncompliance and the Abdication of Responsibility. Psych Central. Retrieved on May 31, 2020, from


Last updated: 9 Jun 2019
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