Self-Determination Theory and Outpatient Follow-Up After Psychiatric Hospitalization
The objective of this study was to assess whether the constructs of self-determination theory—autonomy, competence, and relatedness—are associated with adherence to outpatient follow-up appointments after psychiatric hospitalization. 242 individuals discharged from inpatient psychiatric treatment within the Veterans Health Administration completed surveys assessing self-determination theory constructs as well as measures of depression and barriers to treatment. Medical records were used to count the number of mental health visits and no-shows in the 14 weeks following discharge. Logistic regression models assessed the association between survey items assessing theory constructs and attendance at mental healthcare visits. In multivariate models, none of the self-determination theory factors predicted outpatient follow-up attendance. The constructs of self-determination theory as measured by a single self-report survey may not reliably predict adherence to post-hospital care. Need factors such as depression may be more strongly predictive of treatment adherence.
KeywordsMotivation Services Mental health Discharge Inpatient Aftercare
This work was undertaken as part of the Veterans Administration’s PACT Demonstration Laboratory initiative, supporting and evaluating VA’s transition to a patient-centered medical home. Funding for the PACT Demonstration Laboratory initiative is provided by the VA Office of Patient Care Services. Funding was also provided by the Department of Veterans Affairs Health Services Research and Development Service (HSR&D). Writing of this manuscript was supported by the Department of Veterans Affairs Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC) and the VA Ann Arbor Healthcare System.
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflicts of interest.
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