Psychiatric Discharges Against Medical Advice

Abstract

Emotional illness does not end dramatically with discharge from a psychiatric hospital. Many discharged patients are subsequently rehospitalized for treatment of psychiatric problems. Not all patients leave the hospital initially with the consent of their attending physicians. Sometimes the decision to sign out of the hospital against medical advice is simply a function of the patient's illness, but this decision may be dictated by a variety of other circumstances: financial problems, family pressure on the patient to return home, dissatisfaction with hospital routine and treatment, etc. Angrist, Dinitz, Lefton, and Pasamanick¹discuss some social and psychological factors in the posthospital situation which appear related to subsequent rehospitalization. The finding that returnees tend to include the more severe diagnoses is not remarkable but does raise a question as to the circumstances surrounding their initial discharge from the hospital. How many of these rehospitalized