Magister Curationis - MCur / Unlawful absence of patients from the acute psychiatric ward increases concern on the part of the professionals responsible for their care. Patients who abscond from psychiatric hospitals represent a risk of potential harm to patients or the general public. Consequences of absconding may include physical harm and prolonged treatment time, as well as considerable economic cost to the family and government. The aim of the study was to explore and describe the nurse's experiences of assessment and management for patients at risk of absconding from an acute psychiatric ward in the Western Cape. A qualitative approach using an exploratory descriptive design was applied to conduct this study. The target population was mental health nurses working in acute psychiatric wards where patients were at risk of absconding. A sample of ten (n=10) mental health nurses was purposively selected to participate in the study. Semistructured interviews were used to collect the data from participants. Data collection continued until data saturation was reached (until no further new information emerged). Data was analysed manually by coding, categorizing and identifying similar patterns. Trustworthiness of the study was ensured through addressing the confirmability, transferability; credibility and dependability. Ethics approval was obtained from the University Research Ethics Committee and Ethics Committee of the Department of Health and the selected psychiatric hospital. The ethical principles of the right to self-determination, withdrawal from the research study, privacy, autonomy and confidentiality, fair treatment, protection from discomfort and harm, and obtaining informed written consent were adhered to. Three themes emerged from the data: risk assessment, risk management, and increased observations. The results of the study was discussed with relevant recent literature evidence. The qualitative research is limited to few study sample size, and the results cannot be generalized to other similar population.

The researcher wanted to explore the experiences of children who removal by a social worker either to an institution or to foster homes. The researcher wanted to find out if the behaviour of absconding could be explained by using systems theory, contructivism, cybernetics and person- centered theory. The researcher hypothesized that children abscond from alternative care as a means of communicating with the social worker involved as well as any other person significant in their lives. The study wanted to explore how these children perceived their involvement in the decision making process of their removal. The researcher only interviewed children who had absconded from the alternative care placements. The study found that all the children interviewed perceived that they were not involved in any way in the process of removal. They all saw their removal as a form of punishment for something they did wrong, but they did not get an opportunity to discuss with their parents or significant others. They also perceived their absconding as an effort to rectify the situation. A lot of anger and suspicion towards social workers was encountered during the study. In terms of the theories mentioned above, these perceptions are the children’s own reality, which might differ from the realities as created or perceived by social workers. It is hypothesized that social workers who use the Child Care Act 74/83 and its regulations in the removal of children, do it to protect the children from risky situations as their job responsibility requires. This study indicates that the children did not experience removal as protection. Instead of children feeling protected in the alternative care, they felt blamed, judged and unhappy about their removal and excluded from the process. The researcher made a few suggestions that could be considered when social workers removing children to alternative care. It is recommended that social workers involve the children and their parents or significant others in the entire process of deciding the future of any children in their (parents’) care. However, if removal is deemed necessary, just telling or informing children that they will be removed for their own safety is not enough. Children might not perceive the situation as dangerous. Instead, they might see the social worker as posing a danger to them and their families and thus try to shut the social worker and what s/he says out of their minds. Findings safe ways to involve children and families in the decisions about their future may require of social workers to revive their academically acquired knowledge in this respect. / Social Work / M.A. (Social Sciences (Mental Health))

The researcher wanted to explore the experiences of children who removal by a social worker either to an institution or to foster homes. The researcher wanted to find out if the behaviour of absconding could be explained by using systems theory, contructivism, cybernetics and person- centered theory. The researcher hypothesized that children abscond from alternative care as a means of communicating with the social worker involved as well as any other person significant in their lives. The study wanted to explore how these children perceived their involvement in the decision making process of their removal. The researcher only interviewed children who had absconded from the alternative care placements. The study found that all the children interviewed perceived that they were not involved in any way in the process of removal. They all saw their removal as a form of punishment for something they did wrong, but they did not get an opportunity to discuss with their parents or significant others. They also perceived their absconding as an effort to rectify the situation. A lot of anger and suspicion towards social workers was encountered during the study. In terms of the theories mentioned above, these perceptions are the children’s own reality, which might differ from the realities as created or perceived by social workers. It is hypothesized that social workers who use the Child Care Act 74/83 and its regulations in the removal of children, do it to protect the children from risky situations as their job responsibility requires. This study indicates that the children did not experience removal as protection. Instead of children feeling protected in the alternative care, they felt blamed, judged and unhappy about their removal and excluded from the process. The researcher made a few suggestions that could be considered when social workers removing children to alternative care. It is recommended that social workers involve the children and their parents or significant others in the entire process of deciding the future of any children in their (parents’) care. However, if removal is deemed necessary, just telling or informing children that they will be removed for their own safety is not enough. Children might not perceive the situation as dangerous. Instead, they might see the social worker as posing a danger to them and their families and thus try to shut the social worker and what s/he says out of their minds. Findings safe ways to involve children and families in the decisions about their future may require of social workers to revive their academically acquired knowledge in this respect. / Social Work / M.A. (Social Sciences (Mental Health))