Impact of Distance, Diagnosis, and Demographics on Attendance for Rural Outpatient Treatment

Missed psychotherapy appointments inhibit mental health treatment, limit the availability of treatment to those waiting for care, and reduce clinician revenue. Previous research has revealed that the factors that predict missed appointments vary depending on the geographic location in which that research is conducted. There is not a complete understanding of the characteristics of people who miss appointments in a rural context. This study used information from 281 client records to examine the predictive relationships among missed appointments and the distance traveled to the clinic, mental health diagnosis, age, and gender at a rural outpatient mental health clinic. The purpose of this research was to identify the factors that significantly predicted if clients missed 30% or more scheduled psychotherapy appointments. The health belief model was used as the framework. Logistic regression analysis revealed that clients with a diagnosis of depression, bipolar disorder, or anxiety were more likely to miss 30% or more appointments. The distance traveled to the clinic did not predict missed appointments. This finding deviates from results in previous literature which found that long travel distances increase the likelihood of missed appointments. This could be due to the geographic region or how the client records were selected in this study. This study can have a positive impact by informing rural mental health clinics of factors that may predict the likelihood of missed appointments. Clinics could then use the information to develop empirically-supported retention interventions. Retention interventions could promote social change by increasing appointment attendance, which could improve overall patient care and reduce health care waste accrued by missed appointments