Four in ten individuals with a serious mental illness do not receive any treatment for their conditions, and many others drop out after only one or two visits. The most common reason that people with serious mental illness do not seek care is that they do not believe that they need treatment. Other reasons for failing to engage to care may include lack of insurance, out-of-pocket payments, transportation challenges, and difficulties scheduling appointments due to job or family responsibilities. Shared decision making, in which a clinician offers options and describes their risks and benefits, and the patient expresses his or her preferences and values, can be a useful approach for engaging patients in their treatment. Providers should also ask about potential financial and logistical factors that could raise impediments to making and keeping appointments.
Barry, M.J., & Edgman-Levitan, S. Shared Decision Making–The PInnacle of Patient-Centered Care. The New England Journal of Medicine. 2012. doi: 10.1056/NEJMp1109283. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp1109283
Olfson M, Mojtabai R, Sampson NA, et al. Dropout from outpatient mental health care in the United States. Psychiatr Serv. 2009;60(7):898-907. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774713/
Walker ER, Cummings JR, Hockenberry JM, Druss BG. Insurance status, use of mental health services, and unmet need for mental health care in the United States. Psychiatr Serv. 2015;66(6):578-84. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461054/