Dropout from outpatient mental health care: results from the Israel National Health Survey.

OBJECTIVES

To examine the dropout rates from outpatient mental health treatment in the general medical and mental health sectors and to identify the predictors of dropout.

METHOD

The study population was extracted from the Israel National Health Survey. The analysis was related to 12-month service utilization for mental health reasons.

RESULTS

The total dropout rate from mental health treatment was 24%, but differed between sectors. The dropout rate from general medical care was 32, and 22% from mental health care. In the general medical care sector, 30% ended treatment within two visits, while only 10% did so in the mental health-care sector. Chronic health condition, but not severity of psychiatric disorder, predicted dropout in the mental health sector.

DISCUSSION

The higher rate of early dropout in general medical care may be related to the brevity of general medical visits and/or the inexperience of primary care physicians, which limits the opportunity to develop patient-physician rapport. Providers of services will have to promote education programs for GPs and allocate proper time to psychiatric patients.

LIMITATION

The sample, although based on a national representative cohort, was small and limited the number of independent variables that could be examined.