Refusal vs non-compliance in the community Refusal of treatment is not the same as non-compliance. A person can actively refuse treatment- refuse prescribed medications, refuse seeing the treating team and refuse any other psychological interventions. Owiti& Bowers (2010, p. 3) noted refusers as patients that had to indicate overtly by act or statement to the rejection of prescribed antipsychotic medication. However with non- compliance, a person can passively be non-adherent to treatment (Elder, Evans &Nizette 2009, p. 467). A person may agree and be happy with the treatment prescribed but inadvertently not adhere to treatment. For example, a person may take more or less of medication prescribed, forget medical appointments, come to depot appointments late or early. As my experience is in the community, I will address what course of action my team usually takes when a person has a mental illness we are faced with these scenarios: If the person is non-compliant with treatment, the community team will be more assertive in their follow up (ReThink, 2017). The case manager may visit the person more often or remind the person about their appointments via letter/phone call. The case manager may even arrange for the person to be treated in their home (Bond et al, 2001, p. 141). For example given their injection once a month and arrange to see the psychiatrist in their home every few months. The non-compliant patient may or may not be on a community treatment order. A community treatment order (CTO) is a court order mandating treatment on the affected person. It is aimed at increasing engagement with services and preventing relapse (Elder, Evans &Nizette 2009, p. 55) Along with other criteria the applicant treating team must prove the affected person has previously refused to accept appropriate treatment and that the CTO is the least restrictive form to administer treatment (Mental Health Act 2007 (NSW) s. 53). If the person is refusing treatment and needs to adhere to treatment for their wellbeing and the wellbeing of others, the community team will visit the person (if safe) a few times and try to persuade the person to take medication. If they still refuse and the person is safe to stay in the community, they will apply for a community treatment order. If the person is deteriorating and presenting more of a risk to themselves/ others, the community team will schedule the person and assist in the transportation of the person to hospital for further assessment and treatment. Nurses, patients and families should work together to minimise misunderstandings and un-necessary complex medication regimes (Stuart 2009, p. 557). List of References Bond, G, Drake, R, Mueser, K et al. 2001, ‘Assertive Community Treatment for People with Severe Mental Illness’, Disease Management and Health Outcomes, vol. 9, p. 141- 159. Elder, R, Evans, K &Nizette, D 2010, Psychiatric and Mental Health Nursing, 2ndedn, Elsevier, Sydney. Mental Health Act 2007 (NSW). Owiti, J & Bowers, L 2010, 'A Literature Review: Refusal of Psychotropic Medication in Acute Inpatient Psychiatric Care', Institute of Psychiatry Maudsley, November. ReThink Mental Illness 2017, Assertive Outreach Teams, last viewed 8 May 2017 https://www.rethink.org/resources/a/assertive-outreach-factsheet. Stuart, G 2009, Principles and Practice of Psychiartic Nursing, 10thedn, Elsevier, Sydney.