Factors Affecting the Follow-Up Arrangements after Discharge from Acute Inpatient Psychiatric Unit

Journal:
April-June 2015 Volume 12(2)

Original Article

Author(s):
Imran S. Khawaja1, Silviu M. Burcescu2, Imtiaz Ahmad Dogar3, Muhammad Waqar Azeem4
Page No:
26

Factors Affecting the Follow-Up Arrangements after Discharge from Acute Inpatient Psychiatric Unit

 

Imran S. Khawaja1, Silviu M. Burcescu2, Imtiaz Ahmad Dogar3, Muhammad Waqar Azeem4,

1MD, Associate Professor of Neurology

University of Minnesota School of Medicine

Minneapolis, Minnesota, USA

 

2MD, Mensana Center

Cortlandt Manor, New York, USA

 

3 MBBS, FCPS, Prof & Head

Department Psychiatry and Behavioral Sciences

DHQ /Allied Hospitals & Punjab Medical College

Faisalabad, Pakistan

 

4MD, DFAACAP, DFAPA, Chief of Psychiatry

Albert J. Solnit Children’s Center

Associate Clinical Professor, Yale Child Study Center

Yale University School of Medicine

Connecticut, USA

 

 

Corresponding Author: Dr. Muhammad Waqar Azeem, mwazeem@yahoo.com

 

 

Abstract

 

Objective: To look at factors contributing to successful transition from inpatient psychiatric unit to outpatient psychiatric treatment.

Subjects and Methods: Information regarding the effectiveness of the discharge plan was collected by phone in the cases of 33 patients randomly chosen from those discharged from an inpatient psychiatric unit in a period of one month. The study was performed at Westchester Medical Center, New York Medical College. Either the patient or significant others were contacted within 3 months of discharge. Compliance with the follow-up appointment and medication, general condition, effectiveness of living arrangements were assessed either by self report or from collateral sources of information like parents, treating clinicians.

Results: Most of the patients used the follow-up arrangements and did go to the first outpatient visit yet only a little more than a half were still in any form of treatment at the moment of the interview. Patients gave two main reasons for non compliance: either lack of geographical accessibility (lack of transportation to and from the clinic) or ineffectiveness of treatment. Discharge to places other than non therapeutic home placements appeared in this group of patients to be the least associated with compliance after discharge, placement in a residence the most.

Conclusion: Discharge planning is a crucial phase of inpatient treatment. Patients do use the discharge arrangements but fail to persist in their relation with the outpatient facilities. The type of housing has a major impact on further compliance after discharge even more so than diagnosis, age or gender.

 

Key words: Compliance, Inpatient Psychiatric Admission