Attrition from mental health clinics is afrequent problem and has significant consequences for patients, families andfor the society. It has rarely been researched in Israel. We examined rates of attrition from 5 mentalhealth clinics and its reasons, from the perspective of dropouts and ofdirectors of psychiatric clinics and services.

179 dropouts and 171 patients who continuedtreatment filled questionnaires on socio-demographic and clinical data, attitudes to treatment and barriers, self-stigma and health. We also surveyedattitudes of 51 directors towards attrition.

We found high attrition rates in all clinics. Main reasons for attrition from the perspective of the dropouts were no need oftreatment, bad/unhelpful treatment and problems with medications. Twopredictors were found: patients' report that the treatment approach was notappropriate and past compliance problems. Dropouts reported worse conditiontoday and were less in treatment. Directors estimated the dropout rate as lessthan half of the actual rate and did not speculate correctly its predictors.

Attrition is frequent in psychiatric clinics, but can be predicted. Disengagement fromtreatment predicts getting less treatment in the future. Attention is neededtowards the negative consequences of attrition and to ways to decrease it.