Non-attendance at psychological therapy appointments

James Binnie (Psychology Department, London South Bank University, London, UK)
Zoe Boden (London South Bank University, London, UK)

Mental Health Review Journal

ISSN: 1361-9322

Publication date: 12 September 2016



Research demonstrates that non-attendance at healthcare appointments is a waste of scarce resources; leading to reduced productivity, increased costs, disadvantaged patients through increased waiting times and demoralised staff. The purpose of this paper is to investigate non-attendance and implemented interventions to improve practice.


A mixed methods service audit took place in a primary care psychological therapies service. Existing service guidelines and reporting systems were reviewed. A cross-sectional design was used to compare a year’s cohort of completers of cognitive behavioural therapy (CBT) (n=140) and drop-outs (n=61).


Findings suggested contrasting guidelines and clinically inaccurate reporting systems. The overall service did not attend (DNA) rate was 8.9 per cent; well below rates suggested in the literature. The drop-out rate from CBT was 17 per cent. The most influential factor associated with CBT drop-out was the level of depression. The level of anxiety, risk ratings and deprivation scores were also different between completers and drop-outs. The main reasons given for non-attendance were forgetting, being too unwell to attend, having other priorities, or dissatisfaction with the service; again these findings were consistent with prior research.


A range of recommendations for practice are made, many of which were implemented with an associated reduction in the DNA rate.



Binnie, J. and Boden, Z. (2016), "Non-attendance at psychological therapy appointments", Mental Health Review Journal, Vol. 21 No. 3, pp. 231-248.

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