Motivation for medical treatment among people with schizophrenia in a post-hospitalization rehabilitation center: Self-determination theory perspective

Background: Medication non-adherence rates are substantial among people with severe mental illness. Although many studies have examined factors associated with psychiatric medication adherence, few have focused on motivation. The present study applied the principles of Self-Determination Theory (SDT) to identify the sources of motivation for medication adherence among individuals with schizophrenia. Method: Semi-structured interviews were conducted with 10 participants receiving treatment and support in a post-hospitalization rehabilitation center (RC) in Israel. Results: The findings highlight the significant role of the treatment environment in shaping self-regulation processes for taking medication. In contrast to participants’ previous hospitalization experiences, the RC was experienced as more supportive of their psychological needs for autonomy, relatedness and competence. The participants reported more autonomous regulation such that taking medicine was no longer perceived as forced upon them, but rather as a necessary, valuable action on their part on the way to recovery. Conclusion: Even in difficult conditions, people with schizophrenia can determine whether their environment is supportive or non-supportive of their needs. When working with people with schizophrenia, needs support, as described by SDT, can increase well-being and internalized motivation.