BACKGROUND. The impact that communication has on adherence, considering outcomes such as patient satisfaction and recall of the content of encounters with health care providers, has been extensively reported on in the literature. The South African Depression and Anxiety Group (SADAG) developed a specific communication intervention program, which was implemented in a local public sector setting. OBJECTIVE. To investigate the attendance and medication adherence of patients at the specialist psychiatric outpatient clinic of the Helen Joseph Hospital in Johannesburg, before and after the pilot implementation of this program. METHODS. Included quantitative and qualitative methodologies. The retrospective component included a review of participants' demographic and clinical profile and medication adherence. The prospective, qualitative component included structured pre- and post-questionnaires. RESULTS. The typical participant was female (76%), older than 40 years (58.2%) and unemployed (74.2%). Comparing the study and control groups, the communication program resulted in a higher post-intervention booking ratio for the Study group, while the diagnostic category of participants were associated with their understanding of their medication. DISCUSSION. Being mindful of the noted limitations of this pilot project, the SADAG program or similar communication intervention strategy, should be a standard operational procedure in local South African state sector clinics.