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Tijdschrift voor Psychiatrie 51 (2009) 11, 801 - 812

New research

Drop-out from after-care following compulsory hospitalisation- how serious is the problem?

J. Stobbe, A.I. Wierdsma, R.H.P. van Beest, C.L. Mulder

summary 
background Little is known about the amount and quality of after-care provided for patients hospitalised as a result of a court authorisation.
aim To obtain insight into the rate of drop-out from after-care and the quality of after-care.
method In our study we included all patients in Rotterdam Rijnmond who, in the last 3 months of 2004, had been compulsorily hospitalised for at least one day by reason of a court authorisation. A retrospective study of patients' records let us ascertain whether drop-out from after-care occurred and let us check on the quality of the after-care provided.
results 214 patients were included. Of these, 33 (15.4%) dropped out of after-care. Prior to discharge, the drop-out group received an outpatient appointment at a local clinic less often and waited longer for their first appointment at that clinic than did the 'non-drop-out' group. The medical records of the drop-out group were less accurate and there was less cooperation between community care and clinical mental health care professionals.
conclusion The quality of after-care can be improved if community care and clinical health care professionals cooperate more intensively in drawing up conditions for discharge and in arranging the transfer of patients from clinical care to community care. Further investigations are needed to find out whether these steps will have a beneficial effect on the drop-out percentage.

keywords court authorisation, continuity of care, drop-out, psychiatric after-care