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It was all the way back in the mid 1980's, thirty years ago, from which I remember a very good counselor talking about "the revolving door." Mental illnesses are serious illnesses, and when people don't come to terms with the need for treatment, you get a number of repeated episodes of the illness, with each round making the mental health consumer more debilitated.  

If a consumer, when on the recovery side of the cycle, can gain the insight that it is necessary to remain in treatment, then they may have a fighting chance at having a lasting and meaningful recovery. Such an insight has occurred in my past.  

However (quite a number of years ago) upon going more than five years in a stabilized condition, the memory was faded concerning how bad it is to go through an episode of psychosis. And the insight that had been gained was trumped with the foolhardy thought that I could "tough it out" through the withdrawal from medication and perhaps cure myself through meditation.  

The above incidence of folly happened to me three times, and then finally, in 1996, I made a lasting commitment to remaining compliant with treatment. I was also in a relationship with my wife (at the time my fiancé) who said that if I tried to go off medication, she would move out.  

This is not to say that relapses are always caused by noncompliance. Many people, particularly those with bipolar, can get into a manic or depressed episode that medication, even when taken according to prescription, fails to mitigate. It is part of the stigma of mental illness when people assume that if someone is ill again with mental illness, it must be due to not taking medication. 

Medication is more effective for some people than it is for others. Also, it is a matter of trial and error for psychiatrists to figure out which medications will work and which won't for an individual. And until the psychiatrist figures out the right meds for someone, that individual may continue to suffer.  

I have also met people who have hidden their pills in their cheek, (a rarity today because of the precaution of administering the medication in liquid form) who ended up hospitalized a few months or even a year later. I knew a man who would have wild manic episodes, ones that included violence and destruction of property. He would stabilize in the hospital, and as soon as he got home, he would flush all of his medications.  

The abovementioned man, in a moment of lucidity, commented on the difference between his illness and mine. He said, that since I normally have insight, my mental illness resembled a "mental cold." This was versus his illness, which he said wiped out his insight--this fact making him truly ill. This observation doesn't alter the fact that without treatment, I would be about as bad off as any person suffering from acute psychosis.  

If possible, a person with mental illness is much better off if they acknowledge that they have a disease that requires treatment. Once in a great while, someone gets misdiagnosed. However, this idea also gets used as an excuse for noncompliance among people who really need treatment. Once a mentally ill person acknowledges the need for treatment, they have a chance to avoid becoming exceedingly debilitated by an untreated or inadequately treated mental health condition.