ABSTRACT
Introduction: Studies examining mental health treatment dropout have primarily focused on Western populations and less so on Asian samples. The current study explored the prevalence and correlates of mental health treatment dropout across the various healthcare sectors in Singapore.
Materials and Methods: : Data was utilised from the Singapore Mental Health Study (SMHS), a cross-sectional epidemiological survey conducted among an adult population (n = 6616) aged 18 years and above. Statistical analyses were done on a subsample of respondents (n = 55) who had sought treatment from the various treatment providers (i.e. mental health, medical, social services and religious healers) in the past 12 months. The World Mental Health (WMH) Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was used to determine diagnoses of mental disorders, chronic medical disorders and service utilisation. Results: Of those who had received treatment, 37.6% had ended treatment prematurely, 23.2% had completed treatment and 39.2% were still in treatment. The religious and spiritual sector (83.1%) had the highest dropout, followed by the general medical sector (34.6%), mental health services sector (33.9%) and the social services sector (30%). Marital status emerged as the only sociodemographic factor that significantly predicted treatment dropout—with those who were married being significantly less likely to drop out than those who were single. Conclusion: The overall dropout rate across the various healthcare sectors was comparable to past studies. While the small sample size limits the generalisability of findings, the current study provides useful insight into treatment dropout in an Asian population.Outpatient dropout can be defined as the act of “stopping before completing the recommended course of treatment”. In comparison to barriers to treatment access, relatively less is known about the prevalence and predictors of treatment dropout. Nevertheless, the study of treatment dropout is important for several reasons. Firstly, previous studies have found a strong association between treatment retention and clinical improvement. Individuals who leave treatment prematurely are not only less likely to recover independently but are also more likely to be rehospitalised and have a relapse. An understanding of the risk factors associated with treatment dropout enables treatment providers to identify patients who might be at risk of dropout and successively take measures to retain them in treatment. Secondly, prevalence of treatment dropout is to some extent regarded as an indicator of the quality of services offered. Insights gleaned in this area can be used to assess the match between patients’ needs and services offered which in turn provides useful information in improving services to better accommodate the needs of patients.
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