Follow-up attendance and documented reasons for non-attendance in child and adolescent mental health care: a retrospective analysis

Vollständiger Abstract

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Background Failure to continue scheduled follow-up is a common challenge in child and adolescent mental health services and may reduce treatment effectiveness. Objective The present retrospective study aimed to examine demographic, clinical, and treatment-related characteristics associated with attendance at the last scheduled follow-up appointment among children and adolescents receiving outpatient psychiatric care and to identify characteristics associated with the documented reasons for non-attendance among patients who missed their last scheduled follow-up appointment. Methods A retrospective study was conducted using medical records of 841 patients aged 1–18 years who attended a tertiary child and adolescent psychiatry outpatient clinic between 2015 and 2026. Demographic, clinical, and treatment-related characteristics were summarized descriptively. Associations between categorical variables were examined using Pearson’s chi-square test, and effect sizes were reported using Cramér’s V. Results Of the 841 patients, 142 had no scheduled follow-up appointment and were excluded from the attendance analysis. Among the remaining 699 patients, 56.8% attended their last scheduled follow-up appointment. No significant associations were observed between attendance and the demographic, clinical, or treatment-related characteristics examined. Among the 302 non-attendees, unspecified reasons (36.8%) and scheduling conflicts (17.5%) were most frequent. Documented reasons for non-attendance were significantly associated with medication prescription status (χ² = 9.749, p = 0.008, Cramér’s V = 0.181) and drug class (χ² = 10.202, p = 0.037, Cramér’s V = 0.130). Conclusions Last scheduled follow-up attendance was not significantly associated with the demographic, clinical, or treatment-related characteristics examined. Among non-attendees, documented reasons for non-attendance were associated with medication prescription status and drug class. Systematic documentation of non-attendance reasons may help identify barriers to continuity of care and inform targeted follow-up strategies.