Referral from the Primary Health Centre to Mental Health Clinic (MHC) for mental health counselling services operates predominantly on a self-referral model. Factors that influence attendance have been described in the literature, but local data is lacking, and the effect of a formal referral has not been well described.
We sought to answer: 1) What is the influence of demographic factors on attendance rates to counselling appointments? 2) What are patients’ perspectives on the process of securing and attending a counselling appointment?
Results: Attendance rate to counselling services at the Mental Health Clinic in North Battleford was found to be 32.8%. Age over 30 years, home-to-MHC distance of less than 3km, and presence of a formal referral were associated with increased attendance to MHC. Odds ratios were 5.6 (95% CI: 1.2-26.9), 4.2 (95% CI: 1.4-12.7), and 17.8 (95% CI: 4.9-64.6) respectively.
Three themes emerged through interviews. 1) Facilitators: rapid access to services, intake via phone, ability to self-refer, and feeling listened. 2) Barriers: impact of psychiatric/comorbid illnesses, and personal feelings of weakness. 3) Areas for improvement: lack of knowledge about emergency services.
Conclusion: Formal referral appears to have the most significant effect on attendance rates to MHC. Qualitative factors that assist and hinder attendance must also be addressed in any future interventions, including consideration of the impact of patients’ comorbid illnesses.