Compliance and the health belief model: a challenge for the liaison psychiatrist

Noncompliance or nonadherence to prescribed medical regiments is a widespread problem. The behavior of noncompliance is complex, requiring an analysis based upon theoretical constructs. We review the Health Belief Model (HBM) as one such construct that may aid in understanding the problem. The four essential ingredients of the model include (1) a perception of susceptibility to disease, (2) a belief that the impact of this disease will affect him/her biologically and/or psychosocially, (3) a belief that the potential benefits of the regime outweigh the risks of the disease and its treatment, and (4) an ability to surmount barriers to treatment. The HBM has been shown to have construct validity and has provided a means of exploring practical and cost effective methods for reducing noncompliance and perhaps morbidity and mortality associated with failures to follow up on recommended medical procedures. Moreover, the general problem of noncompliance provides a unique opportunity for students of human behavior to interact constructively with their medical and surgical colleagues.