Good afternoon from Massachusetts,

I was wondering if you might lend your expertise for this very challenging situation. We currently have a case in which the person’s mental illness is so profound that the individual will not take any TB medications, disbelieving the diagnosis. Before the recent decompensation, the individual had about 8 weeks of witnessed therapy, mostly inpatient however has had no TB medications since around Christmas. The individual is currently hospitalized requiring restraint for anti-psychotic injectables but there is no comparable means to do the same with TB medications. I would appreciate any guidance you may provide to work towards a solution and experiences you might have had. We have an inpatient treatment unit which allows compulsory hospitalization however not forced medications.

Thank you for reading,

Pat

Patricia A. Iyer, MSN, RN, BC

Division of Global Populations and Infectious Disease Prevention

Bureau of Infectious Diseases and Laboratory Sciences

MA Department of Public Health

305 South Street

Boston, MA 02130

Telephone 617 983 6971

Fax          617 983 6990

Cell         617 756 3050