Community follow-up of mental health consumers discharged from forensic services

Abstract

Objective

Consumers discharged from forensic mental health services (FMHS) are highly vulnerable and require careful follow-up. This paper aimed to investigate the duration of engagement and patient outcomes after discharge from FMHS to community mental health team/s (CMHT), in addition to factors associated with follow-up.

Methods

This descriptive analytical study was undertaken in a metropolitan mental health service in Melbourne, Australia. Adults aged over 18 discharged from FMHS were included. Quantitative data analysis utilised multiple methods. Hazard ratios from univariate Cox Proportional Hazards regression models were reported with 95% confidence intervals to identify factors associated with CMHT discharge.

Results

Of n = 37 cases identified, n = 29 (83%) remained engaged with CMHT following discharge from FMHS at 12 months. Of discharges, n = 3 (15%) were unplanned. Variables associated with CMHT follow-up reaching statistical significance included diagnosis of schizophrenia or schizoaffective disorder, clozapine use, and psychosocial recovery service engagement. Conversely, long-acting injectable antipsychotic (LAI) use was associated with earlier CMHT discharge.

Conclusion

Factors associated with CMHT follow-up after discharge from FMHS include diagnosis, clozapine and LAI use, and psychosocial recovery service engagement. The findings indicate subsets of consumers who require varied support when discharged from the FMHS to the community setting.