Compliance with Psychiatric Referrals from a General Hospital Psychiatry Outpatient Clinic

This study examines the referral patterns of 949 patients seen in a general hospital psychiatry outpatient clinic during a 15-month period. One hundred patients referred to outpatient psychotherapists were interviewed by telephone to determine compliance rates with referral recommendations. Forty-five percent reported compliance with the referral, defined as attendance at one or more psychiatric follow-up visits. Factors associated with higher compliance rates were being married, being referred at the initiation of the therapist and not the patient, and, for a subgroup of patients, receiving a list of potential psychotherapists. Neither diagnosis nor severity of illness predicted compliance, and self-referral was not associated with improved compliance. There was also no relationship found between satisfaction with the referral procedure and subsequent compliance with the referral. In 49% of the noncompliant cases, reasons cited were a self-perceived lack of need for continuing treatment due to symptom resolution and insufficient motivation.