Walk-in patients' decisions about follow-up care

This study examined the decisions patients made about obtaining follow-up care after an initial visit to a psychiatric walk-in clinic. Sixty-nine randomly selected patients who received a variety of ambulatory referrals were questioned by means of structured and ured to, and 70 per cent of the patients given medication took it substantially as prescribed. Completion of the referral was associated with being employed, not abusing drugs and alcohol, having a positive view of the walk-in clinic, and adherence to the medication regimen. Referral success was unrelated to sociodemographic characteristics, social integration, the nature of the intended disposition, or prior medical or psychiatric care. Patients who adhered to the disposition did not necessarily adhere to the medication regimen, and vice versa. Referrals were more successful when the patient had preceded the clinical encounter with an active appraisal of his situation. The decision to adhere was a complex and prolonged one in which the patient weighed many factors, of which the physician's suggested disposition was only one.