Patrón asociado a la inasistencia a la primera consulta de un centro de salud mental

Abstract

Resumen: El objetivo de nuestro estudio fue conocer las características de los pacientes que no acuden a la primera cita en un centro de salud mental para poder mejorar estas derivaciones. Se examinaron diversas características (sexo, edad, origen de la derivación, días en lista de espera y diagnóstico principal) de los pacientes atendidos en el servicio de salud mental durante un año (N = 433) y se compararon con las de los pacientes que no acudieron a la consulta durante el mismo período (N = 95). Los pacientes que acudieron a la primera consulta con el servicio estuvieron menos días en lista de espera que los que faltaron y provenían en mayor medida del servicio de urgencias. Se concluye que los pacientes que no acuden a su primera cita alargan innecesariamente la lista de espera, produciendo paradójicamente una mayor inasistencia. Se discute el empleo de diversas medidas para mejorar las tasas de inasistencia.

Referrals of Patients With Mental Health Problems From Primary Care to Mental Health Services in Spain

“…The percentage of people who did not attend their scheduled appointment with MHS was 21.7%, a slightly higher result than that found by other authors 13 . However, a study conducted by Diaz et al 22 found that the percentage of patients who did not attend their mental health appointment increased from 21% in 2017 to 25% in 2020.…”

“…Regarding gender, in mental health absences, the female sex predominates, while in other studies, there were no signi cant differences in relation to gender [11][12][13]22 . Women may be more likely to have caregiving responsibilities for children, elderly relatives, or other family members, which can make it more di cult for them to attend appointments 26 .…”

“…However, a study conducted by Diaz et al 22 found that the percentage of patients who did not attend their mental health appointment increased from 21% in 2017 to 25% in 2020. People who were more likely to miss their scheduled appointment have a longer waiting time [11][12][13]23 . Possible explanations for this fact could be forgetting the appointment, if patients have to wait for a long time to receive their appointment, they may forget about it or have di culty remembering the details of the appointment; changes in availability, patients with longer waiting times may have changes in their availability or schedule, which could con ict with their scheduled appointment time; lack of motivation, longer waiting times may also lead to a lack of motivation among patients to attend their appointment, as the wait may make them feel like their care is not a priority or that their needs are not being met; frustration and dissatisfaction, patients with long waiting times may become frustrated and dissatis ed with the healthcare system, which may lead them to feel less inclined to attend their scheduled appointments; or patients prefered to seek care from private professionals rather than waiting for their appointment with the mental health team.…”

“…Younger patients tended to miss their mental health appointment more often [11][12][13]24 . It could be due to various reasons 25 , such as busy schedules, younger patients may have busier schedules due to school, work, or social commitments, which can make it more di cult for them to attend appointments; lack of perceived need, they may not perceive the need for mental health treatment or may not understand the potential bene ts of attending appointments; fear or stigma, these patients may be more likely to feel embarrassed or stigmatized about seeking mental health treatment, which can make them hesitant to attend appointments; transportation issues, they may have di culty with transportation to appointments, particularly if they do not have access to a car or if public transportation is limited in their área; or poor communication, there may be a lack of communication or understanding between younger patients and their mental health providers, which can lead to missed appointments or lack of engagement in treatment.…”

“…On the other hand, patients who are more frequently referred to clinical psychology professionals are younger 2 , less medicated, and with less urgent character 4 , while patients diagnosed with depression, adjustment disorders, or anxiety-depressive disorders are more often referred to psychiatry 10 . Patient no-shows for their rst appointment in mental health centers are associated with longer waiting times [11][12][13] . Additionally, other studies indicate that some patients with depressive or anxiety disorders are not appropriately identi ed in PC 14,15 .…”