Exploring Predictors of Treatment Dropout in Primary Care Behavioral Health Using Andersen’s Behavioral Model of Health Services

A recent meta-analysis indicated a 19.7% dropout rate from outpatient mental health care. Andersen’s Behavioral Model of Health Services identifies predisposing, enabling, and need factors as potential predictors of treatment dropout. The Primary Care Behavioral Health (PCBH) model aims to improve accessibility of mental health care but research on dropout in this setting is lacking. This study examined bivariate relationships between Andersen's factors and dropout in PCBH, and interviewed participants about their intentions to attend subsequent PCBH visits. No statistically significant bivariate relationships were found, likely due to small sample size (n = 15). Reflexive Thematic Analysis identified two themes (i.e., facilitators and barriers) and four subthemes in participants’ responses about treatment attendance: patient-level facilitators, treatment-level facilitators, patient-level barriers, and external barriers. While quantitative findings were non-significant, qualitative themes highlight areas for improving PCBH treatment attendance and service delivery.