James A. Benn

Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)




Nature of the problem: Medication non-adherence is consistently the most frequent cause of mental health decompensation, relapse of mental illness, and hospitalization. The solution to non-adherence remains quite elusive, despite it being relatively easy to identity as the most major obstacle to successful control of mental illness.

Method: Eighteen documents published between years 2002-2012 were rated using the AACN’s evidence leveling system. The 18 studies were examined to better understand what is known and not known about the challenge we face in trying to effect recovery and to prevent relapse of mental illness in the United States.

Results: Various study designs, diverse interventions and treatment strategies demonstrated limited success in effecting sustained adherence. However, to date, the literature does not show there to be a single, simple, intervention that is effective. The evidence strongly suggests an interdisciplinary approach, using various combinations of interventions is the best strategy, but not a guarantee. A Power Point presentation was used to share the findings of this project with 13 PMHNP students and 2 active, expert PhD, PMHNPs.

Nursing implications: Adherence is a complex, multi-determinant, individualized process that is embedded in the core belief of the person. Nursing can use this knowledge to collaboratively work with patients, their families, and other health care team members to devise approaches to facilitate recovery and understanding of the role of medication adherence in recovery maintenance.