Factors Associated with Dropout from Community Mental Health Clinic in Chandigarh during COVID-19 Pandemic

Abstract

Background: Dropout of patients with mental illness is high. There is inadequate research on dropout of patient with mental illness from community mental health clinics. Aim: The aim of the study was to assess the dropout rate from three community mental health clinics and evaluate factors associated with dropout in relation to the patient, caregivers, community clinics, and COVID-19 pandemic. Methods: Patients aged 18 years and above registered in community outreach clinics (COC) from March 24, 2018, to March 23, 2020, i.e., before the lockdown, for treatment of mental illnesses including substance use disorders (SUDs) were included in the study. Responses on factors associated with dropout were collected on predesigned questionnaire telephonically after resumption of regular clinics. Results: A total of 5450 patients were registered at COCs. Neurotic and anxiety disorders, SUDs, and bipolar affective disorders were the common diagnoses. The dropout rate was 21%. Sixteen percent of patients did not perceive the need to continue treatment against 84% who felt the need for treatment. However, 87% already felt improvement with treatment. Thirty percent of patients were concerned about side effects of medicine and 52% expressed difficulty to purchase medicines from market, in case of nonavailability of free medicines. Forty-nine percent of patients reported fear of contracting COVID-19 infection as the reason for dropout postlockdown. Conclusion: Fear of contracting COVID-19, compulsory testing, and quarantine was the reasons for dropout attributable to the pandemic. Patients-related and medication-related factors were other major reasons for dropout.