Early outcomes of supervised discharge.

Area of Science:

• Psychiatry
• Mental Health Services Research

Background:

• Previous studies indicated positive initial outcomes for Supervised Discharge (SD).
• A need exists to evaluate the long-term effectiveness of SD in community mental health care.

Purpose of the Study:

• To conduct a longitudinal cohort study examining hospitalization rates before and after Supervised Discharge.
• To assess the long-term impact of SD on patient community tenure and readmission rates.

Main Methods:

• A cohort of 22 patients commenced on SD orders between April 1996 and October 1997 was analyzed.
• Hospitalization data and SD renewal status were tracked until April 1, 1999.
• Key outcome measures included time out of hospital and survival to readmission.

Main Results:

• 12 of 22 patients remained under SD by April 1999.
• 15 patients had no hospital readmissions.
• Mean survival out of hospital was significantly longer (717 days) post-SD compared to pre-SD (607 days) (p=0.037).
• Survival to readmission was also significantly longer post-SD (p=0.023).

Conclusions:

• Contrary to initial professional expectations, patients on SD demonstrate longer community survival.
• SD appears to be an effective component of care for detained patients at risk of relapse.
• Wider consideration of SD as a care package element for non-compliant patients is warranted.