Fifty Ways to Leave Your Treatment: First-Person Accounts of Factors That Helped Actualize the Choice to Disengage From Mental Health Services

Objective: To investigate which factors and processes facilitated disengagement from mental health services (MHS). Method: The study adapted the narrative approach to the life stories method. We interviewed 13 women and 10 men who were diagnosed with a serious mental illness (SMI) for which they were hospitalized and used medication in the past but disengaged from MHS and were no longer engaged in any mental health treatment for at least a year. Results: Data analysis of the factors and processes that facilitated disengagement revealed three main factors, each overarching several subthemes: (a) Factors Related to Personal Resilience and Motivation; (b) Factors and Processes Related to Interpersonal Relationships; and (c) Using External Resources. Conclusions and Implications for Practice: Disengagement from MHS is not necessarily a problem that needs a solution but rather—in some cases—a legitimate choice that may actually represent healthy reasoning and an important step toward recovery. These findings emphasize the need for a broader and more flexible conceptualization of the potential role of MHS in the recovery process. Such an approach challenges the widespread notion that disengaging from MHS is a negative course of action and suggests that—for some—it is a significant and meaningful life choice that can empower individuals.