Effects of the financial incentives were large, with findings suggesting multiple ways in which incentives could be used, such as at the start of treatment to improve attendance for initial sessions, for preliminary treatment goals like signing a treatment plan, and for reducing dropout from psychotherapy, case management, or medication management. Findings also indicated that incentives to enhance treatment engagement might have beneficial downstream effects on mental health symptoms, functioning, and quality of life.
However, efforts to put these findings into practice have run into significant barriers. Some people worry that incentives may coerce patients into seeking treatment or undermine their autonomy, reduce their intrinsic motivation to engage in treatment, or cost too much for the health system to maintain. Research demonstrates, however, that providers and patients typically value these interventions once they are put into practice, and patients’ intrinsic motivation shows no sign of decreasing after receiving incentives. These financial interventions generally are cost-effective in the long term, particularly when factoring in patients’ potential work productivity or criminal justice costs.