Psychiatric out-patient clinics can have a high non-attendance rate. Department of Health figures for England showed 19.1% of appointments in mental health clinics were missed compared with an overall figure of 11.7% for all specialties (Department of Health, 2003). Many strategies have emerged to try to improve attendance and, more recently, trials of short-message-service appointment reminders have been reported in other specialties (Reference Downer, Meara, Da Costa and SethuramanDowner et al, 2006; Reference Geraghty, Glynn, Amin and KinsellaGeraghty et al, 2008; Reference Koshy, Car and MajeedKoshy et al, 2008). These have reduced non-attendance rates and have been inexpensive to run. There do not appear to be any studies involving text-message appointment reminders in mental health services and we decided to carry out a feasibility study in our general adult psychiatry out-patient clinics.
Unfortunately, we identified some unexpected difficulties. In our random sample of 50 patients, 38 (76%) owned a mobile telephone, which is in keeping with the national average. Of these 38 people, however, only 74% could remember their telephone number and only 53% were agreeable to being contacted by text message.
Short-message-service appointment reminders do, on the surface, appear to be a potentially useful and cost-effective method of improving psychiatric out-patient clinic attendance rates. Our study, however, highlights some difficulties in maximising the effectiveness of such a service and it seems unlikely that psychiatric clinics would provide as impressive results as those reported in other settings.
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