Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-18T08:27:27.617Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical predictors and patterns of absconding in a low secure challenging behaviour mental health unit

Published online by Cambridge University Press:  01 December 2009

M Dominic Beer ,
Anandamurugan Muthukumaraswamy ,
Al Aditya Khan  and
Mohammad Arif Musabbir
M Dominic Beer*
Affiliation:
Consultant Psychiatrist in Challenging Behaviour and Intensive Care Psychiatry, Oxleas NHS Foundation Trust and Honorary Senior Lecturer, Division of Psychological Medicine, Institute of Psychiatry, London, UK
Anandamurugan Muthukumaraswamy
Affiliation:
Specialist Registrar, St Thomas’ Hospital, South London and Maudsley NHS Foundation Trust, London, UK
Al Aditya Khan
Affiliation:
Locum Speciality Registrar, Oxleas NHS Foundation Trust, Kent, UK
Mohammad Arif Musabbir
Affiliation:
Speciality Trainee, Oxleas NHS Foundation Trust, Kent, UK
*
Correspondence to: Dr M.D. Beer, Consultant in Challenging Behaviour and Intensive Care Psychiatry, Bracton Centre, Oxleas NHS Foundation Trust, Bracton Lane, Dartford, Kent DA2 7AF, UK, E-mail: Dominic.Beer@oxleas.nhs.uk
Get access

Abstract

Aims: To compare the clinical characteristics of patients who absconded and those who did not abscond; and to show the types of absconding behaviour in a low secure challenging behaviour mental health unit.

Method: A retrospective case control study was conducted. Details of the absconding incidents were collected from an electronic incident database. Clinical predictors of patients who absconded (cases) and those who did not (controls) were compared. Statistical analysis was performed to determine statistical significance of the observed differences.

Results: 80 admissions resulted from 78 patients during a period of 6½ years. 22% of the inpatients absconded from the unit. 84% of the incidents occurred while patients were utilising their unescorted leave. Only one patient escaped from the building. No serious incidents resulted from any of the abscondings. On univariate analysis, the following predictors were more likely to be statistically associated with patients who absconded from the unit: a history of absconding behaviour and a history of substance misuse or dependence. A history of non-compliance with treatment, a history of sexually inappropriate behaviour and a history of childhood conduct problems showed a trend towards statistical significance.

Conclusion: The clinical characteristics of patients who abscond from low secure units show similarities with those who abscond from other psychiatric inpatient settings.

Declaration of interests: None.

Keywords

Abscondinginpatient abscondingescapelow secure unitchallenging behaviourmental health
Type
Original Paper
Information
Journal of Psychiatric Intensive Care , Volume 5 , Issue 2 , December 2009 , pp. 81 - 87
Copyright
Copyright © NAPICU 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Antebi, R. (1967) Some characteristics of mental hospital absconders. British Journal of Psychiatry. 113: 1087–1090.CrossRefGoogle ScholarPubMed
Beer, M.D., Khan, A.A. and Ratnajothy, K. (2006) The effect of clozapine on adverse incidents in a low secure challenging behaviour unit. Journal of Psychiatric Intensive Care. 2(2): 65–70.CrossRefGoogle Scholar
Bowers, L., Allan, T., Simpson, A., Nijman, H. and Warren, J. (2007) Adverse incidents, patient flow and nursing workforce variables on acute psychiatric wards: The Tompkins Acute Ward Study. International Journal of Social Psychiatry. 53(1): 75–84.CrossRefGoogle ScholarPubMed
Bowers, L., Jarrett, M. and Clark, N. (1998) Absconding: A literature review. Journal of Psychiatric and Mental Health Nursing. 5(5): 343–353.CrossRefGoogle ScholarPubMed
Bowers, L., Jarrett, M., Clark., N., Kiyimba, F. and McFarlane, L. (2000) Determinants of absconding by patients on acute psychiatric wards. Journal of Advanced Nursing. 32(3): 644–649.CrossRefGoogle ScholarPubMed
Bowers, L., Simpson, A., Eyres, S., Nijman, H., Hall, C., Grange, A. and Phillips, L. (2006) Serious untoward incidents and their aftermath in acute inpatient psychiatry: The Tompkins Acute Ward study. International Journal of Mental Health Nursing. 15(4): 226–234.CrossRefGoogle ScholarPubMed
Carr, V.J., Lewin, T.J., Sly, K.A., Conrad, A.M., Tirupati, S., Cohen, M., Ward, P.B. and Coombs, T. (2008) Adverse incidents in acute psychiatric inpatient units: Rates, correlates and pressures. Australian and New Zealand Journal of Psychiatry. 42(4): 267–283.CrossRefGoogle ScholarPubMed
Cheng, S.T., Chung, C.H., Leung, Y.H. and Lai, K.K. (2002) Patient absconding behaviour in a public general hospital: retrospective study. Hong Kong Medical Journal. 8(2): 87–91.Google Scholar
Dickens, G.L. and Campbell, J. (2001) Absconding of patients from an independent UK psychiatric hospital: A 3-year retrospective analysis of events and characteristics of absconders. Journal of Psychiatric and Mental Health Nursing. 8(6): 543–550.CrossRefGoogle ScholarPubMed
Meehan, T., Morrison, P. and McDougall, S. (1999) Absconding behaviour: An exploratory investigation in an acute inpatient unit. Australian and New Zealand Journal of Psychiatry. 33(4): 533–537.CrossRefGoogle Scholar
Ogunlesi, A.O. and Adamson, T.A. (1992) Absconders from the Nigerian National Neuropsychiatric Hospital: A case control study. West African Journal of Medicine. 11(4): 297–303.Google ScholarPubMed
Tomison, A.R. (1989) Characteristics of psychiatric hospital absconders. British Journal of Psychiatry. 154: 368–371.CrossRefGoogle ScholarPubMed