Arbee Feroza, Subramaney Ugasvaree
AKESO Clinic, Parktown, Johannesburg, South Africa.
Department of Psychiatry, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Psychiatr. 2019 Dec 4;25:1338. doi: 10.4102/sajpsychiatry.v25i0.1338. eCollection 2019.
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.
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.
The study was conducted at Sterkfontein Hospital, a specialised psychiatric hospital outside Johannesburg.
A retrospective record review of absconders from Sterkfontein Hospital in Johannesburg over 1 year was conducted.
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.
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.
从精神科机构潜逃这一现象具有多因素病因基础，其病因和影响具有重大社会经济意义。潜逃患者有更高的自残、暴力、不依从、复发、物质使用风险以及受到负面媒体关注的风险。大多数卫生专业人员将潜逃与潜在危险的精神科患者逃脱联系在一起。潜逃会引发恐惧和不确定性，并对精神科服务产生负面影响。识别潜在潜逃者将有助于风险评估和预防。
本研究的目的是制定自民主制度建立和非机构化以来的潜逃率以及潜逃者的描述性概况。
该研究在约翰内斯堡郊外的一家专门精神科医院斯特克方丹医院进行。
对约翰内斯堡斯特克方丹医院一年多来潜逃者的记录进行回顾性审查。
潜逃率为7.83%。典型潜逃者的特征包括单身、失业男性、30岁出头、为精神科服务机构所知、被诊断患有精神分裂症且伴有物质使用共病。潜逃者更有可能是一名未从正式请假返回的法医患者。
潜逃率已降至低于先前研究的一半，且在国际规范范围内。虽然描述性概况的价值有限，但精神科患者的治疗方式似乎限制较少，导致潜逃者减少以及潜逃方式发生变化。对临床实践的启示首先是需要对潜逃一词有更明确的定义，因为这将影响风险评估和管理。建议未来的研究将法医人群和普通人群分开。最后，制定和使用风险评估工具可能会有价值。
