Date of Award

January 2016

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Danya E. Keene

Second Advisor

Margarita A. Mooney

Abstract

Background:

Many studies have documented high rates of non-adherence to prescribed psychiatric medications among individuals receiving mental health services. Few studies have sought to understand how young adults with mental health conditions who are not consistently connected to mental health services view psychiatric medications, or what types of self-directed symptom management strategies they might prefer to psychiatric medications.

Methods and Results:

This secondary analysis on 11 pairs of semi-structured interviews with young adults (aged 24-28) used a grounded theory approach to elucidate common themes in self-management of mental health symptoms. Many participants described alcohol or marijuana use as preferred strategies for symptom management, perceiving these substances to be less addictive than psychiatric medications, to have preferable effects, and to be expressions of self-control compared to psychiatric medications signifying a lack of self-control. Other participants expressed similar reasons for psychiatric medication aversion, but also rejected self-medication, and instead relied on spiritual or wellness practices to manage symptoms.

Conclusions:

The findings on self-medication shed light on a need for interventions against self-medication with alcohol or illicit drugs. Given inconclusive knowledge on the effects of marijuana, further research on potential risks and benefits of marijuana as an alternative treatment is needed as legality and social acceptability of marijuana increase. The findings on spiritual or wellness practices shed new light on how “personal medicine” (non-pharmaceutical, self-directed symptom management strategies) might complement or replace psychiatric medications as part of a process of shared decision-making between clients and mental health care providers.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/07/2018

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