Dropout from outpatient mental health care: results from the Israel National Health Survey
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To examine the dropout rates from outpatient mental health treatment in the general medical and mental health sectors and to identify the predictors of dropout.
The study population was extracted from the Israel National Health Survey. The analysis was related to 12-month service utilization for mental health reasons.
The total dropout rate from mental health treatment was 24%, but differed between sectors. The dropout rate from general medical care was 32, and 22% from mental health care. In the general medical care sector, 30% ended treatment within two visits, while only 10% did so in the mental health-care sector. Chronic health condition, but not severity of psychiatric disorder, predicted dropout in the mental health sector.
The higher rate of early dropout in general medical care may be related to the brevity of general medical visits and/or the inexperience of primary care physicians, which limits the opportunity to develop patient–physician rapport. Providers of services will have to promote education programs for GPs and allocate proper time to psychiatric patients.
The sample, although based on a national representative cohort, was small and limited the number of independent variables that could be examined.
KeywordsNonpsychotic mental disorders Mental health services General medical care Dropout
The national health survey was funded by the Ministry of Health with additional support from the Israel National Institute for Health Policy and Health Services Research and the National Insurance Institute of Israel. The views and opinions expressed in this chapter are those of the authors and should not be construed to represent the views of any of the sponsoring organizations, or of the Government. The Israel Health Survey was carried out in conjunction with the World Health Organization/World Mental Health (WMH) Survey Initiative. We thank the staff of the WMH Data Collection and Data Analysis Coordination Centers for assistance with instrumentation, fieldwork and consultation on data analysis. These activities were supported by the National Institute of Mental Health (R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the U.S. Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Co., Ortho-McNeil Pharmaceutical, Inc., GlaxoSmithKline, and Bristol-Myers Squibb. A complete list of WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/.
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