Prevalence and clinical and coercion characteristics of patients who abscond during inpatient care from psychiatric hospital

Abstract

Background: Patients absconding from psychiatric hospitals pose a serious concern for the safety of patients and public alike. Absconding is associated with an increased risk of suicide, self-harm, homicide, and becoming “missing” from society. There are only scarce data on profile and outcome of the absconding patients in India. Aims: To study the prevalence and describe the clinical and coercion characteristics of patients who abscond during inpatient care from an open ward. Methodology: “Absconding” was defined as patients being absent from the hospital for a period of more than 24 h. This is an analysis of absconding patients out of the 200 admitted patients at a tertiary psychiatric hospital. Descriptive statistic was used to analyze the demographic, clinical, and perceived coercion profile and outcome. Results: The absconding rate was 4.5 incidents per 100 admissions. Most of these patients were males, from a nuclear family, admitted involuntarily, belonging to lower socio-economic status, diagnosed with schizophrenia or mood disorder with comorbid substance use disorder and had absent insight. The MacArthur Perceived Coercion Scale score was 4.58 (±1.44), and 80% of the absconded patients felt subjective coercive experiences in most domains at admission. Out of the 9 absconded patients, 2 patients had completed suicides and one continued to remain untraceable. Conclusion: The absconded patients were males; admitted involuntarily; diagnosed with schizophrenia, mood disorder, and comorbid substance use disorder; and had absent insight and high perceived coercion. Absconding patients had the tendency to harm themselves and wander away from home.

Keywords

• Absconding
• guidelines
• India
• inpatients
• psychiatry Key message: a) Patients absconding from psychiatric hospitals pose a serious mental health concern. b) Absconding patients with mental illness had the tendency to harm themselves and wander away from home. c) There is a need to adopt a uniform guideline and legal provision across the country to deal with the absconding persons with mental illness.