Case manager follow-up to failed appointments and subsequent service utilization

Area of Science:

• Mental Health Services Research
• Healthcare Management
• Community Psychiatry

Background:

• Missed appointments are a significant challenge in community mental health centers, impacting patient care continuity.
• Effective follow-up strategies are crucial for engaging seriously mentally ill (SMI) individuals in consistent treatment.

Purpose of the Study:

• To evaluate the effectiveness of different case manager follow-up strategies after missed appointments among SMI individuals.
• To determine the relationship between follow-up intensity and subsequent appointment attendance.

Main Methods:

• A study monitored case manager responses to failed appointments for 83 SMI persons in a rural community mental health center.
• Follow-up actions were categorized: home visit, phone call, letter, and no follow-up.
• Subsequent appointment attendance was analyzed based on the type of follow-up received.

Main Results:

• Most missed appointments received no follow-up (56.7%), followed by letters (21.3%), phone calls (18.7%), and home visits (3.3%).
• Home visits were the most intensive, with all clients attending their subsequent appointment.
• Clients receiving phone calls or letters had better attendance than those with no follow-up; those with no follow-up were more likely to require emergency services.

Conclusions:

• Intensive case management follow-up, particularly home visits, is highly effective in ensuring subsequent appointment attendance for SMI patients.
• Less intensive follow-up methods offer some benefit over no follow-up, but are less effective than home visits.
• A lack of follow-up for missed appointments in SMI populations may lead to increased reliance on emergency services.