Abstract:
BACKGROUND : Designated psychiatric facilities are responsible for the care, treatment and
reintegration of State patients. The necessary long-term care places a considerable strain on
health-care resources. Resource use should be optimised while managing the risks that patients
pose to themselves and the community. Identifying unique factors associated with earlier
discharge may decrease the length of stay. Factors associated with protracted inpatient care
without discharge could identify patients who require early and urgent intervention.
AIM : We identify socio-economic, demographic, psychiatric and charge-related factors
associated with the discharge of male State patients.
METHODS : We reviewed the files of discharged and admitted forensic State patients at
Weskoppies Psychiatric Hospital. Data were captured in an electronic recording sheet. The
association between factors and the outcome measure (discharged vs. admitted) was
determined using chi-squared tests and Fischer’s exact tests.
RESULTS : Discharged State patients were associated with being a primary caregiver (p = 0.031)
having good insight into illness (p = 0.025) or offence (p = 0.005) and having had multiple
successful leaves of absences. A lack of substance abuse during admission (p = 0.027), an
absence of a diagnosis of substance use disorder (p = 0.013) and the absence of verbal and
physical aggression (p = 0.002 and p = 0.016) were associated with being discharged. Prolonged
total length of stay (9–12 years, p = 0.031) and prolonged length of stay in open wards (6–9
years, p = 0.000) were associated with being discharged. A history of previous offences (p =
0.022), a diagnosis of substance use disorder (p = 0.023), recent substance abuse (p = 0.018) and
a history of physical aggression since admission (p = 0.017) were associated with continued
admission.
CONCLUSION : Discharge of State patients is associated with an absence of substance abuse, lack
of aggression, multiple successful leave of absences and length of stay in hospital.
