Factors contributing to absconding of mental health care users in Mopani District Limpopo Province, South Africa

Abstract

Introduction: Prohibited malingering of patients from psychiatric wards is a critical concern among professionals responsible for their care. This is because patients who abscond from psychiatric hospitals pose a risk of potential injury and harm to themselves, other patients, and the community. The consequences of absconding include physical harm, delayed treatment time and financial expenses to families and the government. Aim: The purpose of this study was to explore and describe the factors contributing to the absconding of mental health care users at Evuxakeni Hospital. Methods: The study was conducted among 11 psychiatric nurses and 7 mental health care users. The data was collected through in-depth structured interviews which were recorded using a voice recorder and field notes were also recorded. All the ethical issues were adhered to throughout the study. The coded data were analysed using thematic analysis following Tesch’s steps of qualitative data analysis and the findings were present in themes and subthemes. Results: The study findings revealed that the patients’ social and behavioural factors and hospital related economic factors contribute to the absconding of MHCUs from psychiatric institutions. Furthermore, factors such as stigma, lack of family support, addiction, unsatisfactory budget, poor security setup, and low knowledge of patients regarding psychiatric health trigger absconding among MHCUs. These issues have resulted in patients being victims of violence, suicide, and consequently poor adherence to treatment, which is now a burden to the health system. Recommendations: The study recommended that security personnel and security apparatus such as CCTV cameras be installed to deter absconding. The patients also suggested that they should be provided with better facilities where they can feel comfortable in the process of rehabilitation. All stakeholders (policymakers, healthcare providers, caregivers, and patients) should be involved in rethinking how psychiatric facilities should be operated to make the journey of patient recovery more positive.