Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the Mental Healthcare Act?
Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the Mental Healthcare Act?
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DOI：
10.4102/sajpsychiatry.v25i0.1338
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发表时间：
2019-01-01
影响因子：
1
通讯作者：
Subramaney, Ugasvaree
中科院分区：
文献类型：
--
作者：
Arbee, Feroza;Subramaney, Ugasvaree
背景资料：从精神病院潜逃，其病因和影响具有重大的社会经济影响，具有多因素的病因学基础。潜逃的病人有更高的风险自残，暴力，不遵守，复发，物质使用和负面媒体的关注。大多数卫生专业人员将潜逃与潜在危险的精神病患者的逃跑联系在一起。潜逃造成恐惧和不确定性，并对精神病服务产生负面影响。识别潜在的潜逃者将有助于风险评估和prevention.Aim：本研究的目的是制定一个潜逃率以及描述性的档案潜逃者自成立以来的民主和deinstitutionalisation.Setting：本研究是在Sterkfontein医院，一个专门的精神病医院约翰内斯堡以外进行。对约翰内斯堡Sterkfontein医院1年以上的潜逃者进行回顾性记录分析。典型的潜逃者的特征包括单身，失业男性，30岁出头，精神病服务已知，诊断为精神分裂症和共病药物使用。潜逃者更有可能是一个法医病人不返回官方leave of absence.Conclusion：潜逃率已下降到不到一半，以前的研究，是在国际规范。虽然描述性简介的价值有限，但似乎正在以限制较少的方式治疗精神病患者，从而减少了潜逃者，并改变了潜逃方法。对临床实践的影响是，首先需要对潜逃一词进行更明确的定义，因为这将影响风险评估和管理。建议今后的研究将法医和普通人群分开。最后，制定和使用风险评估工具可能是有价值的。
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.