Investigating factors associated with absconding behaviours amongst hospitalised mental health care users within Harry Gwala District Kwazulu-Natal Province.

Abstract

Introduction: Absconding of hospitalized mental health care users is a significant concern, compromising treatment adherence and safety. Further investigation is needed to identify potential absconders and also gain insights from nurses' perspectives on the reasons behind this problem absconding. The aim of the study was to investigate factors associated with absconding behaviours amongst Hospitalized Mental Health Care Users in Harry Gwala District KwaZulu-Natal Province. Methods: As such the study used a positivist paradigm and a non-experimental descriptive exploratory survey to investigate factors leading to inpatient mental health care absconding. Data was collected from 51 participants and analyzed using Predictive Analysis Software, focusing on the impact and characteristics of absconding. Theoretical framework Research objective Questionnaire item was applied in this section to prove the validity of the instrument. To explore and describe the factors associated with absconding and impact of absconding on treatment as well as the characteristics of absconding and the motive or reasoning being the absconding behavior. The reliability of the instrument was tested by administering the questionnaire to five (10) mental health professionals of the population, and then administering the same questionnaire to the same respondents after two weeks later. The two rounds of the questionnaire from these respondents were then checked to see if the results remained consistent, which would indicate the reliability and trustworthiness of the questionnaire to elicit the necessary information. The University of KwaZulu-Natal's Research and Ethics Committee approved the study proposal, ensuring human subjects' rights and adhering to ethics principles such as respect, beneficence, justice, and autonomy. Results: The results indicated that hospital environment, particularly seclusion rooms, can be distressing and dehumanizing, contributing to a desire to escape to regain a sense of freedom and dignity. Additionally, the study showed that severity and type of mental health symptoms played a significant role. Individuals with psychotic disorders, especially those experiencing exacerbations of symptoms, were more likely to abscond. The desire to escape, distressing symptoms or delusional thoughts were identified as supporting the prevalence of absconding behaviours. In terms of experiences with Caregivers study results showed that mixed emotions regarding caregivers influenced absconding. While some patients felt overly controlled and infantilized, leading to a desire for independence, others felt burdened by the emotional and financial strain their care imposed on their families. This complex dynamic thus motivated patients to abscond in order to relieve perceived burdens on their caregivers. Also, study findings showed that in terms of hospital resources and services, poor hospital conditions, including inadequate facilities and lack of engaging activities led to feelings of boredom and frustration among patients and this prompted them to abscond. Conclusion: This study realized that by enhancing hospital resources and providing more therapeutic activities these feelings could be mitigated. The study concluded that in order to reduce absconding behaviours, a comprehensive approach involving hospital environment improvements, caregiver-patient dynamics enhancement, resource allocation, and structured leave processes can be implemented.