Analysis of the flow of patients from an inner city hospital psychiatric emergency service to three separate outpatient clinics disclosed the effects of structural barriers on the rate of completion of referral. Generally, giving the patient, at the time of emergency room contact, an appointment for follow-up within one week produced a threefold increase in completion over more traditional modes of referral. Variations in this general result between diagnostic groups and, to some extent, by sex and age suggest interaction between intrapersonal motivation for treatment and administrative barriers erected by treatment facilities.