Controversial research suggests offering financial rewards would encourage mental health patients to take medication

A team of London doctors has suggested offering financial incentives to encourage people with severe mental illness to take their medication.

Between 20% and 50% of adults being treated by psychiatric services are estimated not to take their medication. Previous research has shown that financial incentives have helped patients being treated for tuberculosis, dental problems, weight loss and people on cocaine abstinence programmes to stick to their treatment regime.

As part of the research, the team studied five mental health patients in East London with a history of not taking medication.

Each patient was offered between £5 and £15 per injection of medication. Four accepted the offer and their adherence to their medication was seen to improve. Three of the four have had no hospital admissions since entering the scheme.

Dr Dirk Claassen, Consultant Psychiatrist at the East London Community Mental Health Trust who led the study said: “The results in terms of reduced hospital admissions for the patients who accepted the offer seem beneficial.

“Financial incentives might be a treatment option for a high-risk group of non-adherent patients with whom all other interventions to achieve adherence have failed.”

However the mental health community has urged caution. Bill Walden-Jones, Chief Executive of Hafal stated: “We are not convinced that paying patients is the way forward in encouraging people with severe mental illness to take their medication.

“We prefer an approach that puts patients in control of their recovery, so that they are fully informed about their medication and involved in the choice of drug they are prescribed. This, we feel, would make people more inclined to adhere to a treatment programme. The reason many patients do not take medication is because of difficult side-effects – let’s put our effects into improving the drugs”

Marjorie Wallace, Chief Executive of mental health charity SANE said: “This very small study highlights the desperate situation of people with schizophrenia and bipolar disorder who depend on medication to prevent relapse of their condition.

“But SANE believes that offering what amounts to bribes to take medication that can cause serious side-effects is not the answer.”