Reducing missed initial appointments in a community mental health center.

Budget cutbacks and cost accountability are currently key issues for community mental health centers. Consequently, maximizing the available resources is important to the staff and to the community. Clients who fail to attend the initial appointment represent a significant loss of staff time and resources. Many studies have looked at variables related to missed initial appointments. However, the current study looked at means of reducing missed initial appointments. Eighty-eight subjects were assigned to one of four groups. Group A received a letter three days prior to initial appointment; Group B received a telephone call three days prior to initial appointment; Group C received a telephone call one day prior to initial appointment; Group D was a non-intervention control. The results showed a significant reduction in the rate of missed initial appointments in the group receiving a telephone call one day prior to the initial appointment. This group had a 9% nonattendance rate. Groups receiving either a letter or telephone call three days prior to the initial appointment had a 32% nonattendance rate. The nonintervention control group had a 55% nonattendance rate. The effectiveness of these interventions in reducing the nonattendance rate and thereby enhancing the resources of CMHCs was discussed. Unexpected effects of the study upon the homeostasis of the CMHC were looked at as well as other areas of application.