Some of the VPA-985 inhibitor reasons for not discussing non-adherence connected to issues about the consequences, accessibility of health care pros, or for the service user's own state of mind "in fear he may perhaps take me off the haloperidol" (P7) "frightened of getting sectioned" (P27) "I never see the medical doctor for a further six months" (P3) "I did not would like to interact with anyone" (P18) "too ashamed" (P26) In other cases service customers described a partnership in wh.Cts" (P15) "I had a meeting at operate the following day so skipped my evening dose" (P9) "I had been coping effectively for a significant period of time" (P33)Subthemes `Feeling properly enough'; `Contending with sideeffects and symptoms' Service customers had been asked to choose from a list of alternatives that ideal described the factors for their unintentional non-adherence (Table 1). For some, forgetting appeared to become a function of `Feeling nicely enough', that is, of a remission of symptoms andor getting busy or normally engaged with daily life "Just forgot also busy at work" (P15) "Somehow I forgot to take the medication, perhaps since I was feeling well" (P25) For other individuals `forgetting' was a part of the expertise of "Contending with side-effects and symptoms" "last evening I forgot to take my lithium simply because I was too tired and did not want to feel sick" (P23) "Last week, was awake for 3 days did not take any medicine in the course of this period" (P14) This also incorporated aspects of loss of motivation "too mentally and physically tired to obtain out of bed and fetch medicationwater" (P27) "I did not really feel like carrying out anything and taking medication was among these things" (P37) as well because the experience of symptoms directly impacting on adherence, including delusional thoughts or fears about medication, hopelessness, hallucinations,Gibson et al. BMC Psychiatry 2013, 13153 httpwww.biomedcentral.com1471-244X13Page 6 ofFigure 1 Service user satisfaction with medication.Figure 2 Service user satisfaction with assistance.Gibson et al. BMC Psychiatry 2013, 13153 httpwww.biomedcentral.com1471-244X13Page 7 ofmania or beliefs about the impact of non-adherence on symptoms "I wanted to know what I actually thought and I believed that the medication was controlling my thoughts - so it had to become stopped" (P35) "Too low felt there was no point as was going to kill myself anyway" (P15) "I am hearing poor voices and they often inform me that the medication is poison" (P7) "I was high as a kite" (P4) "Thought I may feel greater if dose missed occasionally" (P16) Additional, exactly where service customers reported sensible issues these may well often be understood as combining with side-effects or symptoms with a resulting elevated influence "I was stuck within a flat with tiny power immediately after being on two a lot of medication sleeping 16 hours or much more with no transport" (P24) One shared element with the two themes presented so far could be the way in which decision-making and behaviour tends to be in response towards the day-to-day challenges and demands of living using a severe and enduring mental illness, instead of on longer term considerations. This can be discussed under.therapy recommendations with their medical professional. A few of the factors for not discussing non-adherence connected to concerns in regards to the consequences, accessibility of wellness care specialists, or to the service user's personal state of thoughts "in worry he may take me off the haloperidol" (P7) "frightened of being sectioned" (P27) "I do not see the medical professional for yet another 6 months" (P3) "I didn't need to interact with anyone" (P18) "too ashamed" (P26) In other circumstances service customers described a partnership in wh.