Somanathan R, Gandhi S, Sivakumar T, Manjunatha N. Nurse-led treatment engagement interventions for persons with severe mental illnesses in community settings. World J Psychiatry 2025; 15(9): 107720 [DOI: 10.5498/wjp.v15.i9.107720]
Corresponding Author of This Article
Revathi Somanathan, PhD, Assistant Professor, Mental Health Nursing, Ramaiah University of Applied Sciences, MSR Nagar, Bangalore 560054, Karnataka, India. revathi.somanathan@gmail.com
Research Domain of This Article
Nursing
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Sep 19, 2025; 15(9): 107720 Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.107720
Nurse-led treatment engagement interventions for persons with severe mental illnesses in community settings
Revathi Somanathan, Sailaxmi Gandhi, T Sivakumar, Narayana Manjunatha
Revathi Somanathan, Mental Health Nursing, Ramaiah University of Applied Sciences, Bangalore 560054, Karnataka, India
Sailaxmi Gandhi, Department of Nursing, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India
T Sivakumar, Narayana Manjunatha, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore 560029, Karnataka, India
Author contributions: Somanathan R designed, conceptualized, reviewed the literature extensively and wrote the report; Gandhi S, Sivakumar T and Manjunatha N were involved in the conceptualization, intellectual contribution and revising of the report.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Revathi Somanathan, PhD, Assistant Professor, Mental Health Nursing, Ramaiah University of Applied Sciences, MSR Nagar, Bangalore 560054, Karnataka, India. revathi.somanathan@gmail.com
Received: April 1, 2025 Revised: May 1, 2025 Accepted: July 21, 2025 Published online: September 19, 2025 Processing time: 151 Days and 2 Hours
Abstract
This review aims to gain a deeper understanding of the current interventions used in high-income and low- and middle-income countries worldwide on treatment engagement among persons with severe mental illnesses. Treatment engagement involves cultivating therapeutic partnerships to address patients’ unique needs and challenges. This multifaceted process requires sensitivity, collaboration, and a tailored approach to promote positive outcomes. Effective treatment engagement reduces the chances of relapse and rehospitalization and helps individuals steer through their daily lives and social relationships. Through literature analysis, it was found that individual, situational, and environmental factors affected treatment engagement. Community nurses are crucial in promoting behavioral changes by engaging patients and applying tailor-made interventions. Applying problem-solving, coping skills, and strategies to address factors influencing adherence, motivational interviewing, and telephone follow-ups yielded significant results. The interventions recommended in community settings are tele-aftercare programs and home visits to address issues of dropped-out persons with severe mental illnesses and ensure continuity of treatment. Accessible, non-stigmatizing, non-coercive, informal, and appropriate services are suggested. These interventions can improve treatment engagement, medication adherence, and therapeutic alliance, thereby reducing symptoms and improving patients’ quality of life.
Core Tip: Treatment engagement is a continuous, collaborative and dynamic process. Due to the multifactorial nature of non-adherence, need-based client-centered care would help reduce the treatment gap and improve their quality of life. Engagement can be improved by having a relationship of trust, empathy and non-judgmentality. Internationally, shared decision-making, peer support, family involvement and other psychosocial strategies have shown to improve engagement. Nurses, in collaboration with the multidisciplinary team, are capable of long-term engagement through psychoeducation, motivational interviewing and home visits. A tailored approach to engaging the clients through a strong therapeutic alliance is important for enhancing treatment outcomes and active participation.
