Walk-in Clinic Drop-Outs

Abstract

Data were collected among 159 consecutive new patients in a walk-in clinic. Patients were given an appointment for a subsequent visit after the initial clinical diagnostic interview, and 61% completed their referral. A long waiting list and a diagnosis of depressive neurosis were significantly associated with drop-out. Possible forms of follow-up are suggested.

The demand for readily available psychiatric services is increasing, and psychiatric walk- in clinics are a major step in that direction; they are a fairly recent phenomenon in India, however, in contrast to the West. These clinics have encouraged early therapeutic interven tion, by abolishing the waiting list and providing easy accessibility of treatment.

A patient, in our set-up, after immediate consultation and treatment advice, is called back for detailed evaluation on an appointed day. But the acceptance of this subsequent visit varies, and many do not turn up. Previous researchers have made several attempts to look into the problem of drop-out from psychiatric clinics; the percentage has varied between 64%2, 26%4, 58%5, 63%6, 30%7, 30%-45%10, 57%11 and 42%12. Among educated and upper social class patients, the rate was only 6% in one psychotherapeutic clinic.⁸

Patients who drop out probably have different expectations from those of the clinic, and gained little from their first visit. Previous studies have identified some of the factors associated with drop-out, such as long waiting lists,^3,7 elaborate intake procedures,⁹ and par ticular characteristics of the patients themselves. 1,5,8,9,10,12 The present paper reports a prospec tive study which looked into some of these problems.