Missed a therapy or psychiatrist appointment? What to do

Contact the clinic, even if you feel embarrassed

Use the contact details on your booking confirmation. If you cannot find them, use the clinic's official website. NHS outpatient guidance recommends contacting the service to rearrange an appointment you cannot attend. After the appointment has passed, ask staff what they need you to do now.

You might see “no-show”, “did not attend” or “DNA” in a message. Ask the service what that entry means for your booking. It is not enough on its own to tell you whether your referral has closed, a fee is due or a new appointment is arranged.

Give the date, time and clinician's name if known. If you were waiting online, note when you joined and any error message. If the clinic gave you different information, keep the confirmation so staff can investigate. Describe the facts without guessing whose mistake it was.

A receptionist can help with booking, but a treatment question may need a clinician. Ask for the message to reach the appropriate person and when to expect a response. Record the agreed next step; a message marked “sent” is not a confirmed appointment.

Missed therapy appointment email: a template you can adapt

A short message can be enough to restart contact. Use a patient portal or another contact method the service accepts. Include only the identifying information it requests and avoid sending a detailed medical history through ordinary email.

If you tried to attend but the call failed, replace the second sentence with: “I tried to join the appointment at [time], but [what happened]. Could you check how it was recorded?” There is no need to describe yourself as a no-show when that is what you are asking the clinic to investigate.

If something clinical is time-sensitive, use the clinic's urgent contact route and say so clearly: “This appointment was also for [prescription review, injection or monitoring]. Could a clinician advise me on the delay?” A routine email may not be read in time.

If making contact feels difficult, you could ask someone you trust to sit with you while you write or call. If you want them to speak on your behalf, ask the clinic what permission it needs. You can explain the practical barrier without sharing every detail of your life.

Will I have to pay a no-show or cancellation fee?

Check the policy for your service and funding arrangement. A missed-session fee and the cost of an attended consultation are different charges. Rules vary, and there is no single worldwide notice period or fee amount. The country section below explains some specific limits.

Before deciding how to respond to a bill, ask for:

• The reason for the charge: the appointment date and whether it was recorded as missed, cancelled late or affected by a technical problem.
• The policy: the notice required, how cancellation should be made and when that information was provided to you.
• A review route: whom to contact if the record is wrong, you had an exceptional circumstance or you cannot afford the charge.
• The effect on care: whether the fee issue affects rebooking, and who can address any immediate clinical need.

A request does not guarantee a waiver. Keep any written answer, and ask your insurer or local patient advice service if you are unsure whether the charge is permitted. If the record says you attended a consultation that did not happen, ask the provider to investigate the record and billing.

If the wider cost of care is the barrier, our guide to affordable mental health care covers other routes to explore.

Missed a psychiatrist appointment? Check prescriptions and monitoring

When you contact the clinic, say what the visit was meant to cover. A missed therapy session, a medication review and an appointment for an injection or blood test may need different follow-up. Ask a clinician what needs to happen and how soon; the next available calendar slot is not a clinical assessment.

If medication is running low, contact your prescriber and pharmacist promptly with the medicine name, prescribed instructions and amount left. Our psychiatric medication refill guide helps you prepare that conversation. Rebooking does not automatically renew a prescription.

NIMH advises working with a health care provider and not stopping prescribed medication on your own. Do not change doses or improvise a replacement schedule because you missed a review. If you have already missed doses, tell the clinician or pharmacist and ask for instructions for that medicine.

If the missed contact was soon after leaving hospital, tell the discharging team as well as the receiving service. Use our guide to follow-up after psychiatric hospital discharge to identify the care contact named in your discharge plan. Seek urgent advice if your condition is worsening.

Missed mental health appointments: guidance by country

These are starting points for adults in routine outpatient care. Your service's policy, funding and circumstances matter. Compulsory treatment or court-ordered appointments can involve separate requirements: contact the responsible team and an appropriate local advocate promptly if that applies.

Go to: United States · United Kingdom · Australia · Canada · New Zealand.

United States: check the clinic policy and your health plan

Ask the clinic to rebook and explain any charge. If you have insurance, ask the plan about the rules that apply to your provider and coverage; do not assume the fee is a covered consultation or an ordinary copayment.

For Medicare, CMS's billing manual, section 30.3.13, allows physicians and suppliers to charge for missed appointments when the policy and amount apply equally to Medicare and non-Medicare patients. Medicare does not pay these missed-appointment charges. This does not establish the rules for every other plan, state or service. For Medicaid, Medicare Advantage or private insurance, ask the relevant plan to check your situation before assuming a charge is valid.

United Kingdom: contact your service; check NHS App requests in England

Call the number on your appointment letter and ask whether you can rebook or need another referral. In England, NHS App guidance says a rescheduling request may remain pending until the provider accepts it. If it is not accepted, the original booking remains. Some appointments are not shown in the app at all.

If you still want care, make that clear before cancelling a future appointment: the same NHS guidance warns that cancellation can result in removal from a waiting list and a new referral being needed. Further appointments on an existing referral should be managed with the provider.

Local mental health services have their own procedures. For example, RDaSH's policy includes attempts to re-establish contact and clinical consideration of the person's situation. It is one trust's policy, not a rule for every NHS service. For Scotland, Wales and Northern Ireland, check directly with your local service.

Australia: separate the missed-appointment fee from a Medicare rebate

Services Australia states that Medicare does not cover the cost of a cancelled or missed doctor's appointment. Ask the practice for its cancellation policy and whether your circumstances can be reviewed. A rebate for an attended psychiatrist consultation does not mean a no-show fee will be reimbursed.

Confirm the cost and referral requirements for the replacement appointment. If attending in person is the problem, ask whether a suitable telephone or video appointment is available and what its cost and rebate eligibility would be. Services Australia describes telehealth options, but the practice needs to confirm what it can arrange for you. For a public mental health team, use the contact on your care plan and ask about its rebooking process.

Canada: check provincial rules; Ontario has specific fee guidance

Ask your clinic about rebooking and its attendance policy. Provincial or territorial rules and the professional involved matter; a physician, psychologist and counsellor may be subject to different requirements.

In Ontario, CPSO's patient guidance says physicians charging for missed appointments must have informed patients of the policy, provided a cancellation system and been available for the appointment. It also describes consideration of exceptions and financial hardship. Explain an isolated incident, technical problem or difficulty paying and ask for a review. This guidance concerns Ontario physicians, not every therapist in Canada.

If an Ontario physician says the care relationship has ended, CPSO's separate policy sets expectations for written notice and continuity arrangements, with safety-related exceptions. Ask for the notice, the reason and who will cover necessary care while you arrange the next step. Elsewhere in Canada, check with the relevant provincial or territorial regulator.

New Zealand: ask for a clear explanation and continuity plan

Contact the clinic or community mental health team named in your appointment information. Ask whether care remains open, how to rebook and what any fee is for. If you cannot get a clear answer, ask who handles patient concerns or can connect you with independent advocacy.

The HDC Code includes rights to effective communication, information about options and costs, and cooperation between providers for continuity of services. You can ask for a written summary of information provided. Use that conversation to clarify your next appointment and care contact. These rights do not mean every missed-session fee must be waived or that a particular appointment is guaranteed.

Elsewhere: start with the service that booked the appointment. Ask a local patient organisation, regulator or insurer about the rules in your location if the answer remains unclear.

What if the clinic closed your referral or discharged you?

Read the message for a response deadline and contact the service promptly. Ask what “discharged” means here: a closed referral before assessment, the end of a therapy course, or the end of an ongoing clinical relationship. Those situations may have different routes back.

• “Can this decision be reviewed in light of [what happened]?”
• “Do you need a new referral, or can I arrange a return directly?”
• “Who has been informed, and what care is in place while this is resolved?”
• “Who can help me understand or challenge the decision?”

If you disagree with the reason, give a factual account and any relevant booking messages. Ask the service to record the barrier and explain its decision. A referral being closed does not answer whether you still need help; take that clinical question to your current care team or primary care clinician.

If you need another provider, our guide to finding care when psychiatrist appointments are unavailable can help. If a transfer is arranged, our guide to changing psychiatrists covers the handover. Rebooking, reviewing a discharge decision and changing clinicians are separate requests.

Make the next appointment easier to attend

Choose the obstacle that mattered most. RDaSH's mental health policy recognises barriers such as transport, caring responsibilities, digital access and communication difficulties. You can ask your service which adjustments it can offer.

If depression, anxiety or experiences related to bipolarity made it hard to attend, describe what happened in everyday terms: “I saw the reminder but could not manage the journey” or “I felt too overwhelmed to make the call.” You do not have to diagnose the reason yourself. That information can help your clinician understand what support to discuss.

• Timing: ask about a time you can realistically manage and confirm the time zone for online care.
• Reminders: check your contact details and ask which reminder method is available and safe for you.
• Getting there: ask about transport help, accessibility, an interpreter or a support person where needed.
• Online access: ask how to check the link, whom to call if it fails and whether another format is suitable.
• Cancellation: save the accepted contact route, required notice and what to do outside office hours.

Before ending the conversation, repeat the date, time, location or video link and any action you need to take first. If no appointment has been offered yet, agree when and how to follow up. Aim for one change that addresses the actual difficulty.