Outcome of patients dropping out from community-based mental health care: A 6-year multiwave follow-up study

OBJECTIVE: To test three hypotheses: i) is dropping out of community mental health care due to dissatisfaction? ii) Do those who appropriately interrupt mental health care need any more help? iii) Do those who need treatment continue to receive it? METHOD: A cohort from a Community Mental Health Service in Verona, Italy, was followed up for 6 years, interviewing patients at follow-up who are both in contact and not in contact with the service. RESULTS: The main reason for dropping out was service dissatisfaction. Patients still in contact with the service were more often psychotic. Many patients no longer in contact had mild-to-moderate problems, especially anxiety and depression and some social disability. Patients out of contact rarely sought help from other agencies. CONCLUSION: Comprehensive community mental health services seem to offer good continuity of mental health care to patients with psychosis, but dedicate less attention to patients with less severe problems. Some of these patients will go on experiencing a burden of symptoms and disability, over the years.