How to improve patient treatment adherence in mental health?

Treatment adherence is a significant issue both in healthcare and mental health settings in the UK. Non-adherence to treatment plans is a common challenge which can have a considerable effect on the effectiveness of interventions and outcomes for patients with mental health conditions. By improving treatment adherence healthcare providers can reduce the revolving door effect, improve patient outcomes and, ultimately, reduce costs. This is why we wrote this blog.  

Addressing treatment adherence issues in mental health settings requires an integrated and multi-faceted approach as we have explored in What is an integrated approach to care.

Luckily, we have 20+ years of experience in providing long-term solutions in mental health and our mission here at RESET is to help you make an informed decision on the best solution for your service. 

The main goals of this article are to help you confirm if you have an issue with patients’ treatment adherence and, if so, to give you the information you need to resolve that problem. Even if that journey leads you to a different provider, we are happy to simply give you the information you need to ensure you can provide the best treatment for your patients. 

This article will cover:

  • What is treatment adherence in psychology?
  • What causes a lack of adherence to treatment in mental health?
  • How do you encourage adherence?

What is treatment adherence in psychology? 

According to the American Psychological Association, treatment adherence refers to the extent to which the patient follows and engages in the recommended treatment plan (psychological intervention) provided by the mental health professional.  

This involves attending therapy sessions, actively participating in therapeutic activities, completing take-home tasks, and implementing the strategies learned into their daily lives. 

There is already extensive research about treatment adherence to medication, but adherence to psychological interventions is equally important and not as researched.

Causes of lack of adherence to treatment in mental health

Several factors contribute to treatment non-adherence in mental health settings. These factors can include:

  • Stigma: The presence of stigma surrounding mental health problems can impact patients’ willingness to follow through with recommended treatments due to fear of judgment from society. Patients may begin treatment and then feel discouraged to continue due to social consequences.
  • Lack of access to appropriate care: Limited access and long waiting times which is the case across mental health settings at present. Lack of access can hinder patients from receiving timely and consistent care, reducing the likelihood of treatment adherence. 
  • Complex treatment regimens: Mental health treatment can involve multiple components (eg. medication, therapy, nutrition programme) and the involvement of professionals from a variety of disciplines. The complexity of these regimens can challenge patients to adhere consistently to the treatment plan.
  • Poor therapeutic alliance: The therapeutic relationship between the patient and therapist plays a huge role in treatment adherence. If there is a lack of trust, empathy, or collaboration, it can lead to non-adherence. 
  • The patient lacks insight or motivation: Some patients with mental health conditions may experience a reduced sense of insight into their condition or lack motivation to engage in treatment. The mental healthcare professional may contribute to this. 

Treatment adherence in mental health settings is important because psychological interventions involve a collaborative process between the therapist and the patient. It requires the active involvement and commitment of the client to achieve the desired therapeutic outcome. 

Non-adherence to treatment can pose detrimental effects on a patient’s health, psychological and physical well-being. Non-adherence can lead to a worsening of symptoms, reduced quality of life, and increased risk of relapse or recurrence of mental health issues.

Not only does non-adherence to treatment impact the patient but also the economy. Non-adherence to psychological interventions can increase healthcare costs. A lack of adherence can extend the duration of treatment, this means it may take longer to achieve the desired therapeutic outcome. Patients may experience inadequate symptom management which can lead to frequent emergency department visits or hospitalisations – all leading to higher healthcare costs for individuals, healthcare systems and increased waiting times for others in need. 

How do you encourage adherence?

  • Promote mental health literacy: to reduce stigma and increase awareness of mental health difficulties. Providing information about available treatment can also positively impact treatment adherence. 
  • Improve access to services: increase investment in mental health services, and expand the workforce to reduce waiting times to enhance access to timely care. 
  • Simplify treatment regimens: make treatment regimens as simple and manageable as possible. Provide clear instructions and reminders to help patients adhere to their treatment plan. 
  • Psychoeducation: Providing comprehensive information about mental health conditions, treatment options, and available support resources that can improve understanding and engagement in treatment.
  • Psychoeducation about adherence: educating patients about the importance of treatment adherence and the consequences of non-adherence can also be beneficial.
  • Collaborative care: facilitating collaboration between mental health professionals, primary care providers, and other relevant professionals can enhance coordination and support for patients. Involving patients in their treatment plan is also vital in ensuring they adhere to treatment. 
  • Address practical barriers: identify and address practical barriers that may hinder treatment adherence such as financial constraints, transport or conflicting responsible. Professionals should provide support to help patients overcome these barriers. 
  • Motivational Interviewing: an effective, evidence-based technique to help patients resolve any ambivalence towards treatment. 
  • Involve family and social support: Engage with family members if the patient consents to the treatment process. Their encouragement helps to reinforce treatment adherence and provide a support network.
  • Regularly assess and address adherence: monitoring of treatment adherence is essential throughout the therapeutic process. This enables organisations to problem-solve and adjust the treatment plan if needed. 
  • Therapist/Organisational training: Ensure professionals receive up-to-date training in establishing strong therapeutic alliances, and effective communication skills can enhance treatment adherence.

You came to this article to better understand if you have an issue with treatment adherence and, if so, how to solve it. 

We covered elements that contribute to non-adherence such as stigma, limited access to care, complex treatment regimens, poor therapeutic alliances and lack of patient motivation contribute to non-adherence. 

We also discussed how addressing these challenges requires a multi-faceted approach, including promoting mental health literacy, improving access to services, simplifying treatment regimens, providing psychoeducation, fostering collaborative care, addressing practical barriers, utilizing motivational interviewing, involving family and social support, regularly assessing adherence, and providing therapist training. 

We mentioned that by implementing these strategies, you can empower patients, reduce stigma, and ensure timely and consistent care, leading to improved well-being and more efficient resource utilization. 

At RESET, we are committed to supporting you overcome treatment adherence challenges. Our mission is to share our expertise by providing you with all the information you need to provide the best possible care for your patients.

If this blog helped you identify if your service is struggling with treatment adherence, your next step is to think about the 5 best methods to increase patient adherence.

Msc Saiyuri Naidu is a Senior Assistant Psychologist at the RESET Health Group and an MSc Clinical Psychology Graduate with a special interest in trauma and how this can affect an individual’s mind and body. 

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