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For psychiatric services, wait for the beep
Date:2/25/2009

was able to reach clinic personnel, only 67 percent of privately-insured and 33 percent of Medicaid patients were able to make an appointment.

The Penn researchers used an "audit study" design that has previously been used to measure discrimination in other markets such as housing and employment. In the Penn study, trained research assistants posed as patients calling to obtain an appointment after being diagnosed with depression in a local emergency room the night before and referred for urgent follow-up to the number being called.

Results from calls to a random sample of mental health clinics in nine U.S. cities revealed that callers were able to reach appointment personnel only 31 percent of the time, compared with 78 percent of calls to medical clinics for physical complaints including pneumonia, severe high blood pressure and a suspected ectopic pregnancy. The "depressed" callers also had to make more calls overall in order to get services; fifteen percent of successful mental health callers had to make five or more attempts before reaching clinic personnel, compared to three percent of callers with medical complaints.

When callers who reached appointment personnel could not get an appointment, due either to insurance or capacity constraints, roughly 75 percent received information about alternative providers, but only half of them were given a name and contact information for that provider. About 14 percent were referred back to an emergency department. Among callers who secured appointments, 61 percent had to be scheduled for during regular business hours because clinics did not offer night or weekend hours which the authors say may pose hurdles to employed persons who seek mental health treatment.

While it is relatively inexpensive to combine resources to outsource appointment scheduling, it is likely that mental health clinics are both short staffed and lack the financial incentives required to reduce barriers to time
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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
Source:Eurekalert

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