Perceptions of treatment adherence among people with mental health problems and health care professionals

Aims: To explore patients' and mental healthcare professionals' perceptions of supportive and restrictive indicators of adherence to treatment in patients with mental health problems. Background: People with mental health problems may have difficulties adhering to their treatment, causing relapses and hospitalizations. It is, therefore, important to learn more about how patients' treatment adherence can be supported and what jeopardizes adherence. Design: A descriptive qualitative study. Methods: Nine focus groups and semi-structured interviews were conducted in Finland during 2010-2011. The patients (n = 19) were recruited from patient associations and the healthcare professionals (n = 42) from healthcare organizations. The data were analysed using inductive content analysis. Findings: Participants agreed that treatment adherence can be supported. Suggestions focused on treatment planning mindful of both patient involvement and needs. A structured daily routine helps patients manage their everyday issues and further facilitates adherence. On the other hand, patients found that their adherence was affected by factors related to the mental health system, including arrangements for follow-up care, access to services, the receptiveness of providers to meet patient needs and a disconnect time between hospital and community life. Conclusion: Patient adherence should already be taken into account when treatment is planned. The content of treatment should be individually designed according to the patient's activities of daily life. In addition, stressing the importance of medication and listening to the patient's opinions and experiences of taking medication may improve the patient's willingness to adhere.