Comparison of Clinical Profile and Current Status of the Treatment Nonadherent Persons with Mental Illness: A Study from a Rural Community Mental Health Center in India

Abstract

Treatment nonadherence comprises a combination of individual, family, social, treatment center, and illness-related factors. In this context, the present study aims to compare the clinical profile and the current status of persons with mental illness who have discontinued their treatment at a rural community mental health center (RCMHC) in India. The persons who discontinued treatment with a diagnosis category of severe mental disorders (SMDs), common mental disorders (CMDs), and substance use disorders (SUDs) who sought treatment at RCMHC are the study population. The present study has followed a comparative research design that compares the clinical profiles of SMDs, CMDs, and SUDs. A survey method of sampling was adopted. A semi-structured interview schedule, clinical global impression (CGI), and errors in drug adherence schedule were used as measures in the study. A home visit approach, telephone contacts, and collateral information were followed to collect the data. Out of the 80 respondents, only 16 (20.0%) reported improvement, and the remaining 16 (20.0%) are receiving treatment from various facilities. The rest of the 48 (60.0%) subjects were not on treatment despite being ill. The number of respondents who did not take their medication even for a day was 10 (12.5%), and another 34 (42.5%) subjects completely stopped their medication within a month. CGI-improvement highlights that nearly 47 (58.7%) respondents had shown much and very much improvement while they were on treatment. The CGI-severity of illness rating scale revealed that 54 (67.5%), i.e., nearly 2/3 of the respondents, were currently in the mild-to-extreme mentally ill category. Comprehensive psychosocial and community-based approaches will enhance treatment adherence in mental illness.