MISSED PSYCHIATRIC APPOINTMENTS - WHO RETURNS AND WHO STAYS AWAY

Objective: This study investigated reasons for missed psychiatric appo intments, rescheduling of appointments, adverse outcomes, and the asso ciation of specific diagnoses and treatments with missed appointments. Method: A prospective survey covering all individual outpatient visit s to seven mental health clinic psychiatrists was conducted during a 3 -month period in 1991. Of the 1,620 scheduled visits, 142 (8.8%) were missed, representing 130 separate patients. For each missed appointmen t, the psychiatrist involved completed a questionnaire on the type of visit, the patient's DSM-III-R diagnosis, the reason for missing the a ppointment, the date of patient recontact, and adverse outcome, if any . Results: Of the 142 missed appointments, 71.1% were rescheduled spon taneously by the patients, of these, most (73.3%) were rescheduled wit hin 2 weeks. The remaining missed appointments represented various out comes, including dropping out of treatment. The most common stated rea son for missing an appointment was patient error, such as forgetting, oversleeping, or getting the date wrong. Patients with PTSD and/or sub stance abuse were significantly more likely than others to miss appoin tments, and those with major depression were somewhat less likely to d o so. Conclusions: Most patients quickly reschedule missed appointment s, and those in more intensive treatments miss fewer appointments. Mis sed appointments for initial evaluation are not rescheduled most often . Patients in ongoing treatment who do not return may have histories o f noncompliance with treatment. The high rate of rescheduling suggests that follow-up of patients who miss appointments should be a clinical decision rather than a routine policy.