Monday, December 19, 2011

Language Matters: Non-compliant

This post is a part of the Recovery 101 blog series. The series will explore ideas, philosophies, language, tools, and questions about mental health recovery. Submit any ideas for topics in the comments section of any tagged post.

We in social services know the importance of language. We know that words can hurt or empower. We know that labels may stigmatize. And yet so often our work comes from a place, system or history that promotes these very problems. As one part of the Recovery 101 series I want to explore the language and word that hurt the work we do, as well as the people we work with.

One of my greatest pet peeves is the term “non-compliant”. Direct from the medical and clinic model of treatment, it is usually used to refer to someone who stops taking their medication against medical advice. It may also refer to refusal to participate in other forms of treatment.

When I hear non-compliant I hear:
1) that medication is the sole or primary method of improvement
2) that the treating physician knows what is best
3) that the patient or person is doing something WRONG or even deviant
4) that the patient or person does not have the right to determine how they want to recover
5) the reasons the person has for not taking medications are insignificant compared to what professionals or others perceive as the benefits of the medication
6) the patient or person is sick and must be made better

What alternatives exist to these words:
1) person has decided not to take the prescribed medication
2) person does not find the medication effective, or finds the side-effects unpleasant and is seeking alternative methods
3) the person is comfortable/prefers not taking medications at this time
4) the person has difficulty taking their medications consistently and may need help in this area

How do you view or support clients or others in their decisions around taking medications? Do you use the term non-compliant or have an alternative to suggest? Have you as a patient or person dealing with mental illness felt you have agency or decision making power with regards to medical treatment?


  1. This is interesting to think about, because in my line of work (reproductive genetic counseling) "non-compliant" usually confers risk to a fetus, which has implications beyond the patient's own well-being. We genetic counselors do love to think about terminology...

  2. Good point Leah. In fact, I think often when "non-compliant" is raised as an issue in mental health services, the concern is often about risk or perceived risk conferred to others...doctors and family members concerned about whether the person will conduct themselves in a "socially acceptable" way or worries about violence to others. Sometimes these concerns are well founded, and sometimes I think they are more reflective of unhealthy stigma.