Patients who fail to attend their first psychiatric outpatient appointment: Non-attendance or inappropriate referral?

All new referrals to a psychiatric out-patient clinic at a District General Hospital over one year were analysed. There was a non-attendance rate of 22%. The quality of referral letter for non-attenders was significantly worse than for the attenders. The implications of these results in organising psychiatric out-patient clinics are discussed. It is argued that some of these referrals may have been inappropriate.