The efficacy of an individualized treatment schedule to maintain treatmentadherence in an urban community mental health center

Objective: We present an observational study on the efficacy of an individu alized treatment schedule, which is meant to support treatment adherence in an urban community mental. health center (CMHC). Methods: The present inve stigation was carried out in the natural setting of a CMHC in Vienna. Durin g a 3-month period we observed the compliance with the appointments and the actions taken by the team in response to missed appointments as well as th e utilization of the CMHC during a follow-up period of 6 months. Results: D uring the observation period 393 (19,2%) of 2049 scheduled visits were miss ed affecting more than half of the patients. Only a minority of patients wi th low-intensity treatment and a high rate of missed appointments had a hig h risk for discontinuing treatment. Conclusions: Missed appointments in out patient psychiatric care are a common phenomenon but they constitute no maj or threat to the continuity of care for the majority of the patients due to the graduated efforts of the team. The time required to make up for missed appointments is considerable but the results of the follow-up confirmed th e beneficial effects on utilization of psychiatric care.