Early outcomes of supervised discharge

We have previously described the generally positive initial experiences of Supervised Discharge (SD) in a large Mental Health Trust serving a mixed inner city, suburban and rural population. This paper seeks to extend our earlier findings by reporting a longitudinal cohort study examining hospitalization before and after SD for the original sample. The main outcome measures were: renewal of SD; time spent out of hospital; survival to readmission or the end of the study period (1 April 1999). Of the 22 patients commenced on SD orders between April 1996 and October 1997, by 1 April 1999: 12 patients were still subject to supervised discharge; 15 had not been readmitted to hospital; survival out of hospital was longer--717 days, compared with 607 days in the same period before SD (p = 0.037); survival to readmission was also longer than before SD (p = 0.023). Contrary to early professional expectations patients subject to SD seem to survive for longer periods in the community. Although not always effective, its wider use should at least be considered as part of the care package for detained patients with a history of non-compliance with care packages leading to relapse and readmission.