Improving Adherence to Mental Health Treatment in a Low-Income Clinic

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers particularly in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic in a Mid-Atlantic state to improve patient adherence to behavioral health treatment using a collaborative, community-based approach. Interventions were delivered in a bundle format and included patient education, warm patient handoffs, and follow-up phone calls by behavioral health counselors. In the 4-month postintervention time frame, the average number of patients who did not come to their appointment decreased by 60%, and the average number of patients who canceled decreased by 15%. These differences were significant (chi(2) = 9.263, df = 2, p < .01). This pilot project showed that patients who became engaged as active participants in a bundle of interventions were more likely to keep their appointments.