Regulatory compliance of mental healthcare professionals: determinants of reporting waiting time data

Long waiting times for healthcare are a growing issue, leading to prolonged patient suffering, reduced quality of life in mental healthcare, and inefficiencies in care delivery. Reducing waiting times has become a key policy goal in many OECD countries, with governments relying on accurate waiting time data to inform interventions. Regulatory agencies require healthcare professionals to report this data, but compliance is often lacking. In the Netherlands, self-employed mental healthcare professionals have particularly low compliance rates. This non-compliance undermines the accuracy of waiting time calculations, making policy interventions difficult. This study explores both economic and psychological motivations behind non-compliance in self-employed mental healthcare professionals in the Netherlands. This study examines whether the determinants of the Theory of Planned Behaviour, along with moral obligation, perceived detection risk, and resistance, can predict compliance among self-employed mental healthcare professionals. Survey data were collected from 481 participants, and structural equation modelling was used to analyse the relationships between these factors and compliance behaviour. We found that scepticism about regulation on submitting waiting times negatively influenced attitudes towards compliance, and attitudes positively influenced compliance intention. The perceived detection risk positively influenced, and perceived controllability negatively influenced compliance intentions. In turn, compliance intentions predicted actual compliance. We found that reactance, subjective norms, moral obligation, and inertia had no significant impact on mental healthcare professionals’ intention to comply with waiting time reporting or their actual compliance behaviour. To increase compliance, it is crucial to understand how intention to comply and actual compliance are influenced. This study identifies the psychological and economic factors affecting compliance with waiting time reporting among mental healthcare professionals. These findings offer policymakers valuable insights for designing interventions to improve administrative compliance in mental healthcare.