Payeeship, Financial Leverage, and the Client-Provider Relationship

Abstract

Although payeeship provides important support and may enhance functional outcomes for the patient, decisions about using the mechanism for promoting treatment adherence should take into account the potential disruption to the client-provider relationship.

Perception and use of informal coercion in outpatient treatment: a focus group study with mental health professionals of Latin culture

“…The sociodemographic and clinical profile of the subject on whom covert coercion was applied coincides with that described in the literature and corresponded to patients with psychosis and/or substance use disoders (Angell, Martinez, Mahoney & Corrigan, 2007;Appelbaum & Redlich, 2006;Burns, 2011;Monahan et al, 2001), severe and chronic illness (Appelbaum & Redlich, 2006;Burns et al, 2011;Molodynski, Rugkåsa & Burns, 2010;Monahan et al, 2005), poor insight (Gert, Culver & Clouser, 2006;Jaeger & Rossler, 2010), and dangerousness (Conrad et al, 2006;Monahan et al, 2001).…”

“…Our professionals agreed when justifying the use of these strategies in their effectiveness and, in fact, several studies, which used economic incentives, found that they improved adherence Priebe, 2013); global functioning (Appelbaum & Redlich, 2006) and quality of life (Angell, Martinez, Mahoney & Corrigan, 2007). However, there are also authors who consider it negatively because of the possibility of stigma, loss of the therapeutic relationship and pose a barrier in treatment (Angell, Martinez, Mahoney & Corrigan, 2007;Swartz, Swanson & Hannon, 2003). More studies are needed to clarify the efficacy of them.…”

“…In general, the use of informal coercive strategies, for example with financial incentives, has shown effectiveness in improving patients' adherence Priebe et al, 2013); justifying their use because they improve health either with a better balance between health and capacity to decide (Szmuk-ler, 2015) or from a paternalistic view (Gert, Culver & Clouser, 2006). However, there are studies that question their efficacy due to the deterioration that may occur in the therapeutic relationship (Angell, Martinez, Mahoney & Corrigan, 2007).…”

Financial Capability: Clinicians' Assessment of Beneficiaries With Dual Diagnoses

“…The potential benefits include improved housing stability (Luchins, Roberts, & Hanrahan, 2003;Rosenheck, Lam, & Randolph, 1997;Stoner, 1989); decreased inpatient hospitalization (Luchins et al, 1998), increased adherence to mental health treatment (Ries & Anne Comtois, 1997), and empowerment through supported decision making (Serowik, Bellamy, Rowe, & Rosen, 2013). The risks of having a representative payee include financial mismanagement by the payee (National Research Council, 2007), interpersonal conflict (Angell, Martinez, Mahoney, & Corrigan, 2007;Elbogen, Wilder, Swartz, & Swanson, 2008), perceived stigma (Elbogen et al, 2008), and loss of autonomy (Appelbaum & Redlich, 2006;Dixon, Turner, Krauss, Scott, & McNary, 1999;Elbogen, Soriano, Van Dorn, Swartz, & Swanson, 2005). The effects of being assigned a payee on substance use have not been consistent across locales.…”