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Thanks to all who have posted in this thread. Great job uncovering & addressing the rationale for your client not taking their lithium, Christine.
As a community mental health nurse & case manager, I frequently encounter client’s who lack insight & are not med compliant. As a team, we are big fans & advocates for long acting injectables whenever possible.
In past when I’ve had clients that don’t engage well & appear to lack insight, I’ve tried to get them to describe their experience in hospital. (Many of our clients arrive to us following a stay on a psychiatric unit.) Failing that, I will check in regarding specific symptoms that the client is documented to have experienced. While doing this, I comment that I have looked at some of the charting from when they were in hospital (or when recently seen) & ask them to correct me if I am getting anything wrong. Sometimes I find this opens the client up a bit.