Leverage, the Treatment Relationship, and Treatment Participation

Individuals with severe mental disorders who do not adhere to community-based treatments are often subject to pressures to leverage participation, including pressures related to the criminal justice system, housing, and money. In this study, researchers interviewed nearly 200 outpatients in San Francisco, 40% of whom reported experiencing leverage in the past six months. Those who reported greater coercion were more likely to report taking their medications as prescribed. But higher perceived coercion came at a cost in terms of satisfaction with care.