Abstract
Research related to absconding and its associated risks is limited in relation to inpatients from private psychiatric units. This study aimed to compare patients who abscond from public and private psychiatric inpatient settings. Demographic data was collated on the subjects (n = 214) who all had a history of absconding. Public absconders (n = 159) were more likely to have a psychotic illness, increased number of psychiatric diagnoses, history of aggression, substance use and homelessness, when compared to private absconders. Predictors identified for private absconders (n = 55) were female gender and fewer drugs used. This study has implications for the different profiles of absconders between the public and private settings.
Similar content being viewed by others
References
Mezey G, Durkin C, Dodge L, White S. Never ever? Characteristics, outcomes and motivations of patients who abscond or escape: a 5-year review of escapes and absconds from two medium and low secure forensic units. Criminal behaviour and mental health : CBMH. 2015;25(5):440–50.
Cullen AE, Bowers L, Khondoker M, Pettit S, Achilla E, Koeser L, et al. Factors associated with use of psychiatric intensive care and seclusion in adult inpatient mental health services. Epidemiol Psychiatr Sci. 2018;27(1):51–61.
Tunde-Ayinmode M, Little J. Use of seclusion in a psychiatric acute inpatient unit. Australas Psychiatry. 2004;12(4):347–51.
Muir-Cochrane E, Mosel KA. Absconding: a review of the literature 1996–2008. Int J Ment Health Nurs. 2008;17(5):370–8.
Hunt IM, Windfuhr K, Swinson N, Shaw J, Appleby L, Kapur N, et al. Suicide amongst psychiatric in-patients who abscond from the ward: a national clinical survey. BMC Psychiatry. 2010;10(1):14.
Dolan M, Snowden P. Escapes from a medium secure unit. The Journal of Forensic Psychiatry. 1994;5(2):275–86.
Huws R, Shubsachs A. A study of absconding by special hospital patients: 1976 to 1988. The Journal of Forensic Psychiatry. 1993;4(1):45–58.
Cullen AE, Jewell A, Tully J, Coghlan S, Dean K, Fahy T. A prospective cohort study of absconsion incidents in forensic psychiatric settings: Can we identify those at high-risk? PloS one. 2015;10(9):e0138819-e.
Moore E, Hammond S. When statistical models fail: problems in the prediction of escape and absconding behaviour from high-security hospitals. The Journal of Forensic Psychiatry. 2000;11(2):359–71.
Wilkie T, Penney SR, Fernane S, Simpson AI. Characteristics and motivations of absconders from forensic mental health services: a case-control study. BMC Psychiatry. 2014;14:91.
Morrow WR. Escapes of psychiatric offenders. J Crim L Criminology & Police Sci. 1969;60:464.
Meehan T, Morrison P, McDougall S. Absconding behaviour: an exploratory investigation in an acute inpatient unit. Aust N Z J Psychiatry. 1999;33(4):533–7.
Gacono CB, Meloy JR, Speth E, Roske A. Above the law: escapes from a maximum security forensic hospital and psychopathy. Journal-American Academy of Psychiatry and The Law. 1997;25:547–50.
Moore E. A descriptive analysis of incidents of absconding and escape from the English high-security hospitals, 1989–94. The Journal of Forensic Psychiatry. 2000;11(2):344–58.
Hunt IM, Bickley H, Windfuhr K, Shaw J, Appleby L, Kapur N. Suicide in recently admitted psychiatric in-patients: a case-control study. J Affect Disord. 2013;144(1):123–8.
Appleby L, Shaw J, Amos T, McDonnell R, Harris C, McCann K, et al. Suicide within 12 months of contact with mental health services: national clinical survey. Bmj. 1999;318(7193):1235–9.
Bowers L, Jarrett M, Clark N. Absconding: a literature review. J Psychiatr Ment Health Nurs. 1998;5(5):343–53.
Buchanan A, Grounds A. Forensic psychiatry and public protection. Br J Psychiatry. 2011;198(6):420–3.
Mental Health Act 2014 handbook. Victoria, Australia: Department of Health; 2014.
Fisher WH, Dorwart RA, Schlesinger M, Epstein S, Davidson H. The role of general hospitals in the privatization of inpatient treatment for serious mental illness. Hosp Community Psychiatry. 1992;43(11):1114–9.
Dorwart RA, Schlesinger M, Davidson H, Epstein S, Hoover C. A national study of psychiatric hospital care. Am J Psychiatry. 1991;148(2):204–10.
Goldney RD, Costain WF, Jackson DE, Spence ND. A comparison of patients in private and public psychiatric facilities. Aust Clin Rev. 1988;8(30):117–23.
Kuhn WF, Bell RA, Frierson RL, Lippmann SB. Consultative psychiatry in both private and public general hospitals. Gen Hosp Psychiatry. 1986;8(4):236–40.
Lang UE, Hartmann S, Schulz-Hartmann S, Gudlowski Y, Ricken R, Munk I, et al. Do locked doors in psychiatric hospitals prevent patients from absconding? The European Journal of Psychiatry. 2010;24(4):199–204.
Huber CG, Schneeberger AR, Kowalinski E, Fröhlich D, von Felten S, Walter M, et al. Suicide risk and absconding in psychiatric hospitals with and without open door policies: a 15 year, observational study. Lancet Psychiatry. 2016;3(9):842–9.
Muir-Cochrane E, Mosel K, Gerace A, Esterman A, Bowers L. The profile of absconding psychiatric inpatients in Australia. J Clin Nurs. 2011;20(5–6):706–13.
Dickens GL, Campbell J. Absconding of patients from an independent UK psychiatric hospital: a 3-year retrospective analysis of events and characteristics of absconders. J Psychiatr Ment Health Nurs. 2001;8(6):543–50.
Molnar G, Keitner L, Swindall L. Medicolegal problems of elopement from psychiatric units. J Forensic Sci. 1985;30(1):44–9.
Andoh B. Selected characteristics of absconders and non-absconders from mental hospitals: a comparison. Int J Soc Psychiatry. 1999;45(2):117–24.
Tomison AR. Characteristics of psychiatric hospital absconders. Br J Psychiatry. 1989;154(3):368–71.
Boot B, Hall W, Andrews G. Disability, outcome and case-mix in acute psychiatric in-patient units. Br J Psychiatry. 2018;171(3):242–6.
Bowers L, Jarrett M, Clark N, Kiyimba F, McFarlane L. Determinants of absconding by patients on acute psychiatric wards. J Adv Nurs. 2000;32(3):644–9.
Acknowledgements
Zoe Jenkins, statistician, St Vincent’s Hospital Melbourne.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Declaration of Interest Statement
All authors whose names are listed on this paper certify that they have NO affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
Research Involving Human Participants and Informed Consent
Ethics approval was granted from both the public and private facilities (2018–004 by Mercy Health HREC, and 316 by The Melbourne Clinic HREC respectively). The patient data was de-identified and gathered retrospectively, therefore, informed consent was not required.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Cabarkapa, S., Sadhu, R., King, J. et al. Profiling Absconders from Public and Private Inpatient Psychiatric Units: a Comparative Analysis. Psychiatr Q 91, 299–307 (2020). https://doi.org/10.1007/s11126-019-09703-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11126-019-09703-7