'No-show' for initial screening at a community mental health centre: rate, reasons and further help-seeking

The aim of this study was to investigate aspects of the phenomenon of 'no-show' for initial screening in a community mental health centre (CMHC). First, the 'no-show' rate was assessed and possible differences between the 'show' and 'no-show' populations were studied. The 'no-show' individuals were then approached to ask about their reasons for their no-show and about any subsequent help seeking.

Included in this study were all adults referred to the Maastricht CMHC between December 1995 and April 1997. The 'no-show' rate was assessed for the referrals in 1996. In May 1997 a brief questionnaire, concerning the 'no-show' reason and further help-seeking was sent to all 202 individuals who failed to keep the first appointment in the 15-month period.

The 'no-show' rate in 1996 was 9.6% (165 out of 1716 individuals). The most prevalent reasons for 'no-show' were the waiting list, lack of motivation and resolution of the mental health problem. The presenting complaint was still present in 78.7% of the 'no-show' subjects. Most of them had received treatment from their GP, social worker or a private practice. Despite persistence of their problem, 29% didn't seek further treatment. An equal number of subjects solved their problem before the screening interview.

The 'no-show' rate in this population was very low. Measures to reduce this rate (e.g. reducing the waiting list, sending appointment reminders) may be counterproductive as they can discourage successful active problem coping. Additionally, it is doubtful whether if these measures increase the show-rate of less motivated individuals.