Adherence to mental health treatment in a primary care clinic
Open accessAbstract
BACKGROUND: Patient nonadherence is common for the standard mental health treatments in primary care: antidepressants and referrals to specialty mental health treatment. This is one of few studies to prospectively identify predictors of nonadherence. METHODS: We observed 95 veterans attending an internal medicine clinic prescribed antidepressant medication or referred to mental health treatment. We collected information on sociodemographic factors, health beliefs, preferences about treatment, past experiences, and treatment knowledge. RESULTS: At 1 month, medication adherence was greater when patients experienced previous pharmacy trouble and traveled for less than 30 minutes to reach the clinic. Appointment attendance improved when patients were ready for treatment, perceived benefits, and saw their physician as collaborative. At 6 months, medication adherence was greater when patients reported a preference for medicine treatment, traveled for less than 30 minutes, and perceived greater benefits. Fewer negative effects from previous mental health treatment improved adherence to appointments. In multivariate analyses examining adherence to all treatments, greater readiness for treatment predicted 1-month adherence, whereas being unmarried and seeing the physician as more collaborative improved 6-month adherence. CONCLUSIONS: Adherence to antidepressant medications and to mental health referrals should be examined separately. A brief initial assessment for nonadherence risk factors may identify persons for targeted adherence promoting interventions.
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This patient population is often resistant to CBT.
“Allen and Woolfolk (2010) and Gonzalez, Williams, Noel, and Lee (2005) demonstrate that this patient population are often resistant to CBT.”
From Clinical outcomes from The BodyMind Approach™ in the treatment of patients with medically unexplained symptoms in primary health care in England: Practice-based evidence (2016) · cites this paper as Gonzalez et al., 2005
The Abstract describes nonadherence to mental health treatment, and the ‘Adherence to a Mental Health Referral’ section finds that patients with greater readiness for treatment were more likely to attend an initial appointment. The study examines antidepressants and mental health referrals, not resistance to CBT specifically. Page numbers were not available in the indexed passages. (LLM, conf=0.85)
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- Authors
- Gonzalez, J., Williams, J. W., Noel, P. H., & Lee, S.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- The Journal of the American Board of Family Medicine
- Published
- 2005-03-01
- Volume
- 18
- Issue
- 2
- Pages
- 87-96
- ISSN
- 1557-2625 (ISSN-L)
- 1558-7118
- OpenAlex
- W2134747994
- Semantic Scholar
- a514fa90bc2f0308c362323eb698d1aba99965e4
- Cited by
- 110
- References
- 45
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 3 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 9 · 2014: 16 · 2013: 8 · 2012: 8
- FWCI
- 2.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of the American Board of Family Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Health Services Research and Development
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- medication adherence, antidepressants, primary care, veterans, predictors of non-adherence, treatment readiness, physician-patient relationship, health beliefs, travel distance, marital status
- MeSH terms
- Adult, Aged, Attitude to Health, Mental Disorders, Female, Hospitals, Psychiatric, Hospitals, Veterans, Humans, Male, Middle Aged, Patient Compliance, Physician-Patient Relations, Primary Health Care, Prospective Studies, Quality of Health Care, Surveys and Questionnaires, Referral and Consultation, United States, Directive Counseling
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