Correlates of attendance in mental health services for individuals with psychotic disorders: A critical review

Low attendance to mental health care results in loss of time, money, and treatment gains. No prior review in this area has taken into account the quality of studies or varying definitions of attendance. The current review provides a critical evaluation of variables associated with attendance in consumers with psychotic symptoms participating in outpatient mental health services, with a focus on study quality and operationalization of attendance. EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched for empirical articles relevant to attendance to mental health services by individuals diagnosed with a psychotic disorder. Eligible articles were rated for quality by two coauthors; high-quality articles were reviewed in-depth. Twenty-eight articles were eligible; 11 articles qualified for in-depth review. Four attendance outcome types were identified, including the prediction of dropout, time engaged, categorical attendance, and continuous attendance. Ongoing substance use during treatment was consistently associated with lower attendance in high-quality articles. More high-quality research using systematically defined outcome types is needed to identify reliable associations with attendance. Commonly tested variables such as demographics show little utility in predicting attendance. Future research in this area should expand upon current findings focusing on clinically and theoretically relevant variables