Barriers to Treatment Participation and Retention in Mental Health Services at the Regional Children’s Centre

Background: The Regional Children’s Centre (RCC) observed an increase in no-shows and same-day cancellations among families seeking mental health services in 2022. Research on treatment retention indicates that these issues are prevalent, suggesting that families receive less than 50% of prescribed interventions. Purpose/Objectives: This study aimed to identify barriers to treatment participation and develop strategies to promote engagement in treatment. Objectives included: 1) understanding treatment barriers from families’ and staff perspectives, 2) designing and implementing strategies to address the identified barriers, and 3) evaluating the effectiveness of the implemented strategies. Methods: A multi-method study was undertaken which included an administrative chart review, a survey with families, and a focus group with staff. The chart review explored factors to low treatment participation within families (N = 31) from April- October 2022. The Barriers to Treatment Participation Scale was distributed to identify the barriers encountered by families receiving services (N = 35, 48% response). The focus group with staff (N = 26) included designing strategies and then prioritizing those strategies using the “PICK” Quality Improvement Method. Chosen strategies were implemented and evaluated using a retrospective and prospective chart review and a Staff Satisfaction Strategy Survey to assess the perceived effectiveness of the strategies. Results/Conclusion: Key strategies implemented included: 1) automated appointment reminders, 2) psychoeducation resources, and 3) new service agreements. Overall, post-implementation data demonstrated a 46% reduction in missed appointments and a 44% decrease in no-shows and same-day cancellations. Efforts are ongoing to spread these practices to other programs within the RCC.