Thesis (M.Med.(Psychiatry))--University of the Witwatersrand, Faculty of Health Sciences, 2014. / Introduction Absconding from psychiatric facilities has socioeconomic implications. The aetiology is multifactorial. Absconding patients are at higher risk of self-harm, violence, non-adherence, relapses, substance use and negative media attention. Identification of potential absconders would assist with risk assessment and prevention. Methods A retrospective record review was conducted of all absconds from a tertiary psychiatric hospital over one year. An abscond rate and a profile were formulated. In addition, trends were identified since the inception of democracy and deinstitutionalization. Results 97 patients absconded 108 times during the study period, 7 having absconded more than once. The absconding rate was 7.83%. The typical absconder is: single, unemployed male, in his early 30’s, known to psychiatric services, diagnosed with schizophrenia and co-morbid substance use. The typical absconder is more likely to be a forensic patient not returning from an official leave of absence. Conclusion The study defines the profile of the typical absconder. The abscond rate has decreased to half that of a previous study by Siwinska (1993). Mental health care users are being treated in a less restrictive manner and this results in less absconds and a change in the method of absconds. This has implications for clinical practice.

Forensic psychiatry in South Africa came to be in the 1970’s following the introduction of the Mental Health Act of 1973 and the Criminal Procedures Act of 1977. Forensic psychiatric units offer psychiatric observation for defendants referred from the courts, as well as providing indefinite detention, for the purpose of treatment and rehabilitation, of those who have been declared unfit to stand trial and/or not criminally responsible due to a mental illness or defect. State patients are mentally ill offenders whose charges involved serious violence. Ultimately these state patients are released back into the community. There is a paucity of South African literature regarding the outcome of state patients.