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Non-Attendance at Initial Out-Patient Appointments at a Hospital-Based Child Psychiatric Clinic

Non-attendance at initial Child and Adolescent Mental Health Services out-patient appointments has been a major problem for staff and (indirectly) for families. The findings presented in this article are, to some extent, in line with previous studies of non-attendance, and to some extent go beyond them. The article organizes findings from previous studies and our own results into four categories: demographic, referral related, system (clinic) related and personal or family related. It focuses on demographic and system-related factors, and reports several significant findings in these areas. Making contact with the family prior to the date of the appointment seems to be a very potent factor in avoiding non-attendance, particularly when the family are asked to confirm whether they will be attending. Demographic factors such as the possession of a car, poverty, single parenthood, and having to care for other dependent relatives are significantly related to attendance rates, either positively or negatively. The quality of the referral letter seemed in some circumstances to be highly related to attendance. Suggestions are made on how to reach out to families that find it hard to attend initial appointments.