Adherence in Mental Healthcare: The Role of Frontline Employee Behaviors

Victoria Kramer et al.

Journal of Service Research2026https://doi.org/10.1177/10946705251410017article
AJG 4ABDC A*
Weight
0.50

Abstract

As mental illnesses surge globally, delivering effective care for mentally disordered and disabled individuals is crucial. While frontline employees play a critical role in service interactions with vulnerable consumers—a central issue in transformative service research—there is limited understanding of how frontline employees’ behaviors can influence adherence, defined as the extent to which individuals follow healthcare providers’ recommendations. Taking an empirics-first approach, we analyze longitudinal field data from 118 individuals with mental illnesses over 12 months, yielding 2,445 observations. Guided by social support theory, we employ a split-hazard model to examine how distinct frontline employee behaviors affect adherence in Communication and Cognitive Tasks, Daily Living Activities, and Social and Community Integration. Our findings highlight the need for tailored behavioral strategies, showing that listening and active conversation consistently enhance adherence, while repetition significantly reduces it. Our study offers novel insights into how frontline employee behaviors can improve the well-being of vulnerable consumers, particularly in mental healthcare. These insights inform both theory and practice by advancing social support as a framework for frontline service delivery and providing actionable strategies to improve care and adherence.

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https://doi.org/https://doi.org/10.1177/10946705251410017

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@article{victoria2026,
  title        = {{Adherence in Mental Healthcare: The Role of Frontline Employee Behaviors}},
  author       = {Victoria Kramer et al.},
  journal      = {Journal of Service Research},
  year         = {2026},
  doi          = {https://doi.org/https://doi.org/10.1177/10946705251410017},
}

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Evidence weight

0.50

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.50 × 0.4 = 0.20
M · momentum0.50 × 0.15 = 0.07
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

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