Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Allison Brauch, DNP, APRN, PMHNP-BC, NP-C, CARN-AP


Katee Thornton, MSW, LCSW

Alicia Hutchings, PHD, RN, CNE


Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history of mental health treatment, and perception of referral explanation by primary care.

Results: 133 individuals met inclusion criteria, with 23 choosing to participate in the study. Transportation was the most frequently reported barrier (n=9), followed by the individual’s perception of a poor experience with their PCP at the time of referral (n=6). Other reported barriers included: medical/mental health issues that prevented them from leaving the home, attitudinal reasoning, inability to take off work, forgetting about/being unaware of an appointment, financial problems, an unexpected event, and family obligations.

Implications for Practice: Despite high participation among individuals that were contacted, an excessive number of answered calls indicates that future studies may gain more valuable data if patients were contacted through other means. With transportation and poor perception of primary care as the most frequently reported barriers, organizations should strive to educate patients on available resources and continually work to improve communication between the patient and the provider.