In the review of Treatment-Refractory Schizophrenia: A Clinical Conundrum Philip Harvey explores the failure to respond to pharmacological treatments observed through “cycles of treatment, medication discontinuation, and relapse” (para. 1) among patients who are schizophrenic. Despite the dominant focus on pharmacological treatment, with particular attention to clozapine, Harvey reminds readers that “all interventions for schizophrenia are not medical or pharmacological” (last para.). He notes that various psychosocial treatments that are potentially important for patients with poor antipsychotic response are rarely used. Harvey calls for mental health professionals to recognize this fact and address the role that all have in treating patients with schizophrenia who “fail to respond to adequate treatment trials with antipsychotic medications” (last para.).
There are hints that awareness of the importance of psychosocial interventions in the treatment of schizophrenia has lagged among treating professionals in the United States. Have psychologists and other mental health professionals failed to keep abreast of treatment evidence and options for this disorder?
Perhaps we have become intrigued by newer disorders that receive greater media attention; or have we been lulled into an overconfident belief in the effectiveness of pharmacological treatments and abandoned our role in the care of those with serious mental illness?
How likely is it that a population approach to addressing the needs of patients who do not respond to adequate treatment will reengage psychologists in the care of another community of those who may need us?
By Philip D. Harvey
PsycCRITIQUES, 2014 Vol 59(45)