Pathways of Low-Income Minority Patients to Outpatient Psychiatric Treatment

OBJECTIVE: Low-income outpatients with scheduled appointments (“scheduled patients”) were compared with those who sought treatment without appointments (“walk-ins”). METHOD: The charts of scheduled patients and walk-ins at an outpatient mental health clinic serving a low-income group were reviewed to determine sociodemographic and clinical characteristics and patients’ pathways to treatment. RESULTS: Walk-ins (N=241) outnumbered scheduled patients (N=141). The two groups differed significantly in type of presenting complaint and source of referral. A higher proportion of walk-ins sought help with social relationships, while more scheduled patients had complaints involving social performance. Self-referrals were more common among the scheduled patients, and family members were more likely to have motivated the walk-ins. CONCLUSIONS: The two groups have more in common than might be expected. Scheduled patients are probably more motivated to seek treatment and therefore more likely to initiate appointments. Walk-ins appear to postpone asking for help until their families urge them to do so.