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Post-inpatient Attrition from Care “As Usual” in Veterans with Multiple Psychiatric Admissions

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Abstract

Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed.

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Authors and Affiliations

  1. Serious Mental Illness Treatment Research and Evaluation Center, North Campus Research Complex, 2800 Plymouth Rd, Building 10 6016, Ann Arbor, MI, 48109-2800, USA

    Nicholas W. Bowersox

  2. Marquette University, Milwaukee, WI, USA

    Stephen M. Saunders

  3. Clement J. Zablocki VA Hospital, Milwaukee, WI, USA

    Bertrand Berger

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  1. Nicholas W. Bowersox
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  2. Stephen M. Saunders
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  3. Bertrand Berger
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Correspondence to Nicholas W. Bowersox.

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Bowersox, N.W., Saunders, S.M. & Berger, B. Post-inpatient Attrition from Care “As Usual” in Veterans with Multiple Psychiatric Admissions. Community Ment Health J 49, 694–703 (2013). https://doi.org/10.1007/s10597-012-9544-8

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  • DOI: https://doi.org/10.1007/s10597-012-9544-8

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