This study examines the clinic variable of wait-time as a predictor of intake attendance in a rural community mental health center (CMHC) serving child and adolescent consumers. Data from 1,317 contacts seeking services for a child or adolescent (ages 2-17) were examined. In logistic regression analysis, wait-time between initial consumer contact and intake appointment was identified as a significant predictor of appointment attendance, even after accounting for consumer variables. The impact of wait-time on the likelihood of intake appointment attendance was not moderated by the urgency of consumer need. Findings elucidate the odds of intake attendance versus non-attendance associated with each day of wait-time and clarify the impact of this clinic variable on pre-intake attrition above and beyond more often studied consumer variables. These results provide information that can assist rural CMHCs in assessing the costs and benefits of steps to reduce wait-time or its impact.

Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed.

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