ABSTRACT
A major challenge in medicine is ensuring that patients adhere to their schedules for treatment and clinical appointments. The estimated yearly cost of nonadherence to treatment for all medical disorders in the United States is $100 billion (1). As described in earlier chapters of this volume, mental illness has been identified as a risk factor for poor adherence. In chapter 9, Gonzalez and Williams outline the deleterious effects of clinical depression on adherence to general medical care. In this chapter, we focus on issues surrounding adherence to psychiatric treatment among individuals with severe mental illness (SMI). Improving treatment adherence of patients with SMI is one of the biggest challenges facing psychiatry today. Among patients with SMI, nonadherence with psychiatric treatment is associated with increased social, economic, and clinical costs and is closely related to relapse, rehospitalization, and poor outcomes (2).
