Improving access to psychiatric outpatient care through feedback-informed treatment: a study on waiting times and therapy duration in Sweden.

Abstract

Background: General adult psychiatry in Sweden faces significant challenges with rising patient volumes and limited therapeutic capacity, leading to prolonged waiting times and restricted access to care. Feedback-informed treatment (FIT) has shown promise in improving access to mental health services by enhancing treatment efficiency and patient outcomes.

Aim: This study aimed to evaluate whether the implementation of FIT in an adult psychiatric outpatient clinic in Region Skåne, Sweden, was associated with changes in therapy duration and waiting times compared with a control clinic without FIT.

Methods: A retrospective, observational design was employed to compare therapy length and waiting times between a clinic implementing FIT (n=139) and a control clinic (n=74) from 2022 to 2024. Data were extracted from patient records, including demographics and patient-reported outcomes (Outcome Rating Scale scores). Linear regression analyses were conducted to assess trends over time, and the steady-state assumption was evaluated to ensure the validity of the findings.

Results: The FIT clinic exhibited a significant reduction in therapy duration over time (B=-0.019, p<0.001), while no significant trend was observed in the control clinic. Waiting times remained stable at the FIT clinic but increased non-significantly at the control clinic. The interaction effect for waiting times was significant (B=0.120, p=0.028), indicating a more favourable trajectory at the FIT clinic. Patient-reported outcomes did not differ significantly between the two periods (2021-2022 vs 2023-2024).

Conclusions: The implementation of FIT in adult psychiatric outpatient care was associated with shorter therapy durations and more favourable waiting time trajectories, without deteriorating patient-reported outcomes, although these data were descriptive and not available for the control clinic. Given the observational, non-randomised design and modest effects, the findings should be interpreted as exploratory evidence that feedback-informed practice may be relevant to efforts to improve access and resource use in routine psychiatric care.