About this article
Medically reviewed- Written by
- Dr Paul Watson
- Medically reviewed by
- Dr Han Simpson
- Published
- July 24, 2026
- Medical review date
- September 8, 2026
- Evidence searched through
- September 8, 2026
- Next review due
- September 8, 2027
- Intended audience
- General Readers & Patients
- Geographic scope
- Worldwide
- Conflicts of interest
- None declared.
- Funding
- Website Owner
- Report a correction
- Report an error or editorial concern
- Medical disclaimer
- Read the medical disclaimer
Nonadherence to medication remains a challenge in psychiatric treatment. It can directly raise the likelihood of a relapse and possible hospitalization, based on the severity of the condition. Not taking prescribed medication can lead to a deteriorated quality of life.
Over time, if the condition worsens, this situation can lead to financial setbacks.
In people with mood disorders and other psychiatric conditions, such as clinical depression and schizophrenia, medication nonadherence is especially serious.
A BMC Psychiatry study from 2024 found that half of the participants, all of whom were dealing with schizophrenia, were non-adherent. Failing to follow the treatment can impact the prognosis. In some conditions, it can lead to more frequent emergency visits.
Healthcare professionals must identify the predictors of such behavior and support their patients in managing them.
Common Predictors of Medication Nonadherence for Mental Illness
While evidence of nonadherence is perhaps most widely documented for schizophrenia and bipolar disorders, it is also a problem among patients dealing with other mental health concerns. For example, a PubMed study found that the proportion of nonadherence among those with major depressive disorder was 42 percent.
What’s causing this behavior? Here are the common causes:
Weak or Vague Understanding of Illness
Consider an individual who repeatedly gets told to take their medication for memory problems. But they don’t feel a problem exists at all. Why should they take unsettling drugs to address a nonexistent condition?
This lack of awareness of memory decline, or anosognosia, affects some individuals with Alzheimer’s disease. A 2025 paper published in Scientific Reports observes that up to 80 percent of patients with this dementia may experience anosognosia. Unsurprisingly, it is a key predictor of nonadherence.
Note that although dementia is a neurodegenerative disorder, a treatment overlap often occurs due to psychiatric symptoms, such as delusions and anxiety. Anosognosia also impacts some people with schizophrenia.
In general, a poor understanding of (or denial of) their illness can discourage people from taking their prescribed medication.
Medication With Strong Side Effects
Some psychiatric medications, such as antidepressants, have been linked to weight gain. Some others may cause distressing symptoms, including sleepiness and tremors. Patients who have been prescribed drugs with more severe and poorly managed side effects will likely be at a higher risk of nonadherence.
Depression as a Demotivator
What if the patient is hopeless about the treatment’s success? This can be a challenge for people struggling with depression. Feeling demotivated can lead to negative behaviors, such as forgetting doses or intentionally skipping them.
Isolation and Low Social Support
Without caregivers or an engaged therapist checking on them, some psychiatric patients grow isolated. Limited social support may be linked to distance, travel difficulties, or stigma associated with mental illness.
In any case, it can contribute to nonadherence. According to a 2025 BMC Public Health study, this risk is higher in older patients managing chronic conditions. (Besides mental health concerns, these could also be physical conditions, such as hypertension.)
Nursing Best Practices for Promoting Adherence
The demand for nurses who can support patients with mental health concerns is rising. As Felician University notes, these professionals now work not only in hospitals but also in community centers and telehealth environments.
Since nursing professionals build trust-based relationships with their patients, they can significantly promote adherence.
Patient Education and Counseling
At the outset and during the treatment, patient education plays a vital role. Psychiatric mental health nurse practitioners are trained for reassuring and empowering patient interactions. They can explain the condition while focusing on the expected benefits and side effects of the treatment.
For instance, many PMHNP online programs explore psychopharmacology, or how drugs affect mood and behavior. This helps them to interact with patients confidently. It also lets patients feel that they are part of shared decision-making.
Assessing Medication Routine for Complexity
For older patients, psychiatric medications may feel like another burden they must handle. They may already be on a complex routine that requires multiple dosages throughout the day.
Nurses can work on simplifying this routine to reduce the possibility of nonadherence. This can be achieved by combining medicines or shifting from daily to weekly doses when applicable.
Continued Monitoring of Side Effects
Routine follow-ups are an integral part of psychiatric treatment. But as with nonadherence to medication, many patients also miss appointments. This affects the monitoring of side effects. It also worsens the probability of the patient following their medication regimen.
Ensuring that follow-ups happen has become a core responsibility for nurses in this field. They should discuss the importance of these visits from a wellness check perspective.
Telehealth services are making this easier. Supporting patients in accessing these services will allow nurses to perform better care coordination and improve overall health outcomes.
That said, in-person visits remain crucial. They may enable a multi-sensory experience, improving emotional attunement and diagnostic accuracy. Nurses can check nonverbal cues, such as facial expressions and eye contact.
This is indispensable for managing conditions that involve minimization and concealment, such as anorexia nervosa. Telehealth providers, including nurses, must recognize the technological barriers in these systems to maintain accuracy and effectiveness.
“Telepsychiatry and virtual therapy rely on digital fluency, privacy, and adequate technology, assumptions that do not hold true for all populations. These disparities can unintentionally impact care quality, HIPAA regulations, session duration, and therapeutic effectiveness.” – Dr. Jeffrey DeSarbo, Author, Neuropsychiatrist.
Nursing Interventions for Medication Adherence: More Ideas
| Motivational interviewing | Helps patients explore their concerns, beliefs, and readiness for treatment. |
| Assessing health literacy | Helps determine whether patients understand their diagnosis, medication, dosage, and side effects. |
| Involving caregivers with patient consent | Family members and caregivers can provide reminders, emotional support, and assistance with routines. |
| Screening for cognitive challenges | Helps identify memory difficulties or cognitive changes that may interfere with medication use. |
| Using reminders and adherence tools | Assist patients with medication organizers, phone reminders, and automated refill systems. |
Adherence Promotes Recovery and Sustained Wellness
As challenging as adherence can be for patients with mental health conditions, it is paramount for managing the illness in question. It requires a heightened awareness of the problem and collaboration with caregivers. In this sense, nursing efforts in patient education and monitoring should extend to family members and attendants.
Nurses who prioritize identifying risk factors for nonadherence and support their patients in addressing them can make a meaningful improvement in recovery.