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Home arrow Language & Literature arrow The open door : homelessness and severe mental illness in the era of community treatment
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Self-Declared Reasons for Rejecting Treatment

Reasons given by individuals for not seeking mental health care are instructive. In the National Comorbidity Survey (Kessler et al., 2001), a survey of a nationally representative household sample,[1] fewer than 40 percent of people with a diagnosis of severe mental illness received stable treatment. The majority of those who received no treatment felt that they did not have an emotional problem requiring treatment. Among people who recognized their need for treatment, the most common reason for failing to seek treatment or for dropping out of treatment was the desire to solve the problem on their own (Kessler et al., 2001, p. 987). Situational and financial barriers and the view that treatment would not be effective were also reported as reasons for not seeking treatment.

Other reports of reasons for not seeking or continuing with mental health care include a fear of loss of control from the effects of psychiatric medication that might interfere with a desire to be a capable and independent person (Priebe et al., 2005), dissatisfaction with treatment, and a feeling that treatment would be unlikely to help (Rossi et al., 2008). Some individuals fear the mental health system as a consequence of prior experiences of mistreatment or coercion (O’Brien et al., 2009; Rossi et al., 2008; Watts & Priebe, 2002). Complaints of not being listened to and not being able to actively participate in decision-making have also been reported as reasons for dropping out of treatment (Priebe et al., 2005). Kreyenbuhl et al. (2009) reported a host of practical reasons for disengaging from treatment, such as a move to a new location, the high cost of transportation, or merely forgetting to keep an appointment.

  • [1] Homeless people were not included in this study.
 
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