Medication Compliance
To the Editor: The article on criminal victimization of persons with severe mental illness by Hiday and associates (1) in the January 1999 issue is an important contribution. Conspicuously absent, however, is any mention of medication compliance among the 331 study subjects with severe mental disorders. Because they all had been involuntarily admitted and subsequently court-ordered to outpatient commitment after hospital discharge, it seems highly probable that they had not been compliant with their psychiatric medications before admission, since noncompliance is the usual cause for outpatient commitment.
In another paper, the authors indicated that 71 percent of the study group were noncompliant with their medication (2). This finding implies that there is a direct relationship between medication noncompliance and criminal victimization, which many of us have observed anecdotally among our patients.
Dr. Torrey is president of the Treatment Advocacy Center in Arlington, Virginia.
1. Hiday VA, Swartz MS, Swanson JW, et al: Criminal victimization of persons with severe mental illness. Psychiatric Services 50:62-68, 1999Link, Google Scholar
2. Swartz MS, Swanson JW, Hiday VA, et al: Violence and severe mental illness: the effects of substance abuse and nonadherence to medication. American Journal of Psychiatry 155:226-231, 1998Abstract, Google Scholar
