RESUMO
Timely access to mental health services is critical to successful treatment of adults with severe and persistent mental illness, and timeliness is a key quality indicator in calls for improvement to the health care system. Waiting weeks for a psychiatric appointment results in increased psychiatric hospitalizations, decompensation, and risk for suicide. However, many community mental health administrators assume that waiting lists for services are inevitable given the high demand for services. The present study evaluates the successful efforts of a large urban community mental health center to eliminate the wait for psychiatric services in an adult outpatient setting. Through systematic changes in the service delivery system, the wait time for a psychiatric appointment was reduced from 13 days to 0 days, and the no-show rate dropped from 52 to 18%. Furthermore, these changes were associated with reduced psychiatric hospitalizations and improved staff morale and teamwork. The change processes implemented can be successfully applied to other systems problems confronting mental health agencies.