Strategies to increase compliance with out-patient aftercare among patients referred to a psychiatric emergency department: a multi-centre controlled intervention study.

Background: Compliance with referral for out-patient aftercare of psychiatric emergency patients is limited. This study investigated the efficacy of a combination of several referral strategies (fixed appointment, involvement of the family, presence of the aftercare person, motivational counselling) in increasing referral and treatment compliance of patients referred to the psychiatric emergency department of three general hospitals.

Methods: A randomized controlled design was used to assess the effect of this experimental condition on referral compliance and on continuation of aftercare treatment.

Results: A significant beneficial effect on compliance with the referral was found in two hospitals and a near-significant effect in the third. After 3 months of aftercare, the influence of the experimental procedure on adherence to therapy was still significant in two hospitals, but not in the third.

Conclusions: Helping the patient to attend an initial appointment can be achieved by a combination of practical and organizational arrangements.