Non-compliance in community psychiatry: failed appointments in the referral system to psychiatric outpatient treatment.

Knowledge about the drop-out pattern of psychiatric patients in the referral phase for outpatient treatment is limited. The aim of the present study was to investigate the importance of selected psychiatric, demographic and administrative parameters in this matter. In a newly opened community psychiatric unit with an open referral system, available relevant data concerning the referred patients were gathered over a 6-month period. Of the 137 patients included in the study, 32% did not show up for their first appointment. On making further attempts to contact the patients, the drop-out frequency dropped to 16%, demonstrating that it is worthwhile offering new appointments to the patients who do not show up. There was no demonstrable relation between the time the patients had waited for the first appointment with a psychiatrist and the drop-out frequency. For patients who had been referred with a diagnosis of psychosis (F 20-29, WHO criteria), or addiction, or had been previously admitted to psychiatric hospital, there was a significant increase in the drop-out rate.