Predictors of unplanned discharge from community-based residential mental health rehabilitation for people affected by severe and persistent mental illness
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McKeon, Gemma
Dark, Frances
Siskind, Dan
Harris, Meredith
Parker, Stephen
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Abstract
Background: Little is known about what predicts disengagement from rehabilitation treatment for people affected by severe and persistent mental illness (SPMI). Aims: To identify predictors of unplanned discharge among consumers admitted to community-based residential rehabilitation units in Australia. Method: Secondary analysis of data from a prospective cohort study of consumers admitted to three Community Care Units (CCUs) between 2014 and 2017 (n = 139). CCUs provide transitional residential rehabilitation support to people affected by SPMI. Demographic, treatment-related and clinical predictors of unplanned discharge were identified using binomial regression models controlling for site-level variability. Factors associated with self- vs staff-initiated unplanned discharge were also examined. Results: 38.8% of consumers experienced unplanned discharge. Significant predictors of unplanned discharge were younger age, higher alcohol consumption and disability associated with mental illness, as well as recovery stage indicating a sense of growth and higher competence in daily task performance. 63.0% of unplanned discharges were initiated by staff, mostly for substance-related reasons (55.9%). History of trauma was more likely among consumers with self-initiated discharge than those with staff-initiated unplanned and planned discharge. Conclusions: Assertive intervention to address alcohol-use, and ensuring care is trauma-informed, may assist in reducing rates of unplanned discharge from rehabilitation care.
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Journal of Mental Health
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30
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4
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Clinical sciences
Social Sciences
Psychology, Clinical
Psychology
Patient discharge
psychiatric rehabilitation
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Arnautovska, U; McKeon, G; Dark, F; Siskind, D; Harris, M; Parker, S, Predictors of unplanned discharge from community-based residential mental health rehabilitation for people affected by severe and persistent mental illness, Journal of Mental Health, 2020, 30 (4), pp. 500-508