The objective of this study was to identify the factors associated with missed initial psychiatric assessments among new patients in an outpatient setting.A 12-month analysis of no-show rates for initial assessments during an entire academic year of residency (July 2017 to June 2018) was conducted based on sex, age, status of insurance coverage, and length of waiting time for an appointment.The average no-show rate was 22.3%, with no significant difference on the basis of sex (male 21.4% vs. female 22.9%). A 2-fold higher no-show rate (43.5%) was seen in the youngest age group (18 to 30 y of age), whereas an age-dependent higher show rate was noted in patients older than 30 years of age. A higher percentage of no-shows was found in patients without insurance (35.9%) compared with those who had commercial insurance (18.8%) or Medicare/Medicaid (20.9%). A seasonal pattern of no-shows was found around the December holiday period. A lower (November 17.8%) and the lowest (January 11.9%) no-show rates were followed by the peak no-show rate (February 29.3%). There was a 9.0% no-show rate when there was a 1-week waiting period before the appointment; however, the no-show rate was 3 times higher when there was a 1-month waiting period (28.6%), and ∼4 times higher with a 3-month waiting period (36%).Younger age, lack of insurance, major holidays, and longer waiting periods before the appointment were associated with nonattendance for the initial assessment in this outpatient resident clinic. This information can be helpful in developing interventions to improve attendance for the first step in engaging in psychiatric care.