Absconding: why patients leave

Area of Science:

• Psychiatry
• Mental Health Care
• Patient Behavior Studies

Background:

• Absconding from acute psychiatric care presents significant challenges for staff and risks for patients.
• Understanding the multifaceted reasons behind patient departures is crucial for effective mental health service delivery.

Purpose of the Study:

• To investigate the primary reasons why patients abscond from acute psychiatric facilities.
• To identify contributing factors beyond psychiatric symptoms that influence patient decisions to leave.

Main Methods:

• A prospective study involving interviews with 52 patients who had previously absconded and returned to their wards.
• Qualitative data collection focusing on patient-reported reasons for leaving the hospital environment.

Main Results:

• Patients frequently cited boredom, fear of other patients, feelings of confinement, and external life responsibilities (household, social, property security) as reasons for absconding.
• While psychiatric symptoms play a role, rational, non-symptomatic reasons were often primary drivers for departure.
• Impulsive decisions, often linked to news about leave or discharge delays, and planned departures for specific external activities were also observed.

Conclusions:

• Reducing patient absconding requires addressing not only psychiatric symptoms but also the practical and emotional impacts of hospitalization on patients' lives.
• Healthcare professionals, particularly nurses, should consider the personal meaning of admission and its disruption to patients' everyday lives to mitigate departures.
• A holistic approach that acknowledges patients' external concerns and provides meaningful engagement within the hospital setting may help reduce absconding and improve treatment adherence.