Message Framing and Engagement in Specialty Mental Health Care: A Follow-up Analysis

Objective: Nonengagement rates in specialty mental health care are high. This study examined the extent to which varying the message frame of appointment reminder letters was associated with attendance rates in specialty mental health appointments. Methods: In a randomized, prospective, and experimental design, 360 patients meeting criteria for major depression and referred to specialty mental health care were randomly assigned to receive either a routine reminder letter or a reminder letter that included one of two messages (gain framed or loss framed). Letters were sent prior to patients' scheduled specialty care appointments, and attendance data were extracted for up to six months. Results: Participants who received letters with gain-framed messages attended their scheduled appointments at a significantly higher rate than those who received a routine letter with no additional message (p=.01). Conclusions: Emphasizing the benefits of attending specialty mental health care appointments was associated with increased rates of attendance.