Retrospective evaluation of extended leave of absence in Scotland 1988-94
Title:
Retrospective evaluation of extended leave of absence in Scotland 1988-94
Author:
Atkinson, Jacqueline Gilmour, Harper Dyer, James Hutcheson, Fiona Patterson, Lesley
Appeared in:
The journal of forensic psychiatry & psychology
Paging:
Volume 10 (1999) nr. 1 pages 131-147
Year:
1999-04-01
Contents:
Extended leave of absence (ELOA) is defined as leave of absence over 6 months and could be unlimited in Scotland until 1996. Patients have previously been detained under s.18 of the Mental Health (Scotland) Act 1984. A retrospective evaluation of use of ELOA was carried out using data held by the Mental Welfare Commission for Scotland. Records were used to describe reasons for using ELOA, support and service use. Over the period 1988-94 there were 534 people who had at least one episode of ELOA over 6 months and, of these, 250 had at least one episode of ELOA over 12 months. A diagnosis of schizophrenia occurs in 73% of patients. Lack of insight and threat of stopping medication are the most common reasons for using ELOA. Although threat to others is recorded more often than threat to self, self-neglect is recorded more often than either. The outcome of ELOA by year results in 30% of patients being discharged and 23% recalled to hospital. Of the total, 75% receive good support from at least one relative, most commonly the mother. Good or some support from friends is recorded for 35% of patients. Although 93% are in contact with a consultant psychiatrist and 60% with a CPN, 24% of patients report no contact with either a CPN or a SW. Having good support from relatives made contact with consultants and GPs significantly more likely and no informal support meant contact with residential staff was significantly more likely. Two thirds of patients on ELOA have no contact with any form of day service. A person remains on ELOA because he or she is perceived as a management risk. This risk is more likely to be to self than to others. Three quarters of patients have good support from their family. Over 90% are in touch with their consultants but other formal support is patchy.