Original Research
Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the Mental Healthcare Act?
Submitted: 18 October 2018 | Published: 04 December 2019
About the author(s)
Feroza Arbee, AKESO Clinic, Parktown, Johannesburg, South AfricaUgasvaree Subramaney, Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Abstract
Background: Absconding from psychiatric facilities, the aetiology and impact of which have major socio-economic implications, has a multifactorial aetiological basis. Absconding patients are at higher risk of self-harm, violence, non-adherence, relapses, substance use and negative media attention. Most health professionals associate absconding with the escape of potentially dangerous psychiatric patients. Absconding causes fear and uncertainty, and portrays psychiatric services negatively. Identification of potential absconders would assist with risk assessment and prevention.
Aim: The aim of this study was to formulate an absconding rate as well as a descriptive profile of absconders since the inception of democracy and deinstitutionalisation.
Setting: The study was conducted at Sterkfontein Hospital, a specialised psychiatric hospital outside Johannesburg.
Methods: A retrospective record review of absconders from Sterkfontein Hospital in Johannesburg over 1 year was conducted.
Results: The absconding rate was 7.83%. The characteristics of the typical absconder included single, unemployed male, early 30s, known to psychiatric services, diagnosed with schizophrenia and co-morbid substance use. An absconder is more likely to be a forensic patient not returning from official leave of absence.
Conclusion: The absconding rate has decreased to less than half that of a previous study, and is within international norms. While the descriptive profile is of limited value, it does appear that psychiatric patients are being treated in a less restrictive manner resulting in fewer absconders and a change in the method of absconding. The implications for clinical practice are firstly that a clearer definition of the term absconding is needed as this will impact risk assessment and management. It is recommended that future studies separate forensic and general populations. Lastly, the formulation and use of a risk assessment tool may be of value.
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Crossref Citations
1. Investigating the Prevalence and Causes of Escape in Mental Patients
Veronica Ciocan, Manuela Dora Gyorgy, Daniela Margareta Varga, Felicia Marc, Florica Voiță-Mekeres
International Journal of Pharmaceutical Research and Allied Sciences vol: 12 issue: 2 first page: 145 year: 2023
doi: 10.51847/fwleMDZTQ7