• Alex J Mitchell and Thomas Selmes.
• Department of Liaison Psychiatry, Leicester General Hospital, UK. alex.mitchell@leicspart.nhs.uk
• Psychiatr Serv. 2007 Jun 1; 58 (6): 868-71.

ObjectiveMissed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom.ResultsThe pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed.ConclusionsThere was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.

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