Purpose: The goal of this project was to find out why psychiatric patients get hospitalised repeatedly. Studies have found that repeated hospitalization leads to economic drain, disability, poor outcome, stigma and discrimination. Hospitalization consumes more than 90% of mental health budgets. Identifying the potential risk factors for repeated hospitalization, interrelationships between risk factors, and vulnerability will help us take the appropriate measures to prevent hospitalization and promote care in the community. Logistically, there are three possible factors which may lead to repeated hospitalization: (1) Characteristics of the patient; (2) Nature of the illness; and (3) The management of the illness including health care system. This prospective, cross-sectional cohort study done at RMHC St Thomas had the objective to delineate some of these risk factors, their psychosocial correlates and their clinical profiles. Methods: This was a prospective, cross-sectional cohort study. We recruited consenting patients with repeated hospitalizations from an acute inpatient facility. These patients were assessed on the following parameters: clinical factors, psychopathology, life events, current psychosocial stressors, resilience, nature of treatment and community care. We used structured psychometric tools, namely: Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HDRS), Life Events Questionnaire (LEQ), The Holmes and Rahe stress scale (HRSS), Connor-Davidson Resilience Scale (CD-RISC) and level of suicidality was measured using the Scale for Impact of Suicidality – Management, Assessment and Planning of Care (SIS-MAP). Results: Findings from the pilot study show that there are significant patient-related factors e.g. experience of trauma, chronic suicidality and unremitted symptoms, which were the primary causes of re-hospitalization. The nature of illness, nature of treatment and systemic issues were not significantly involved in re-hospitalization. Conclusions: A preventive strategy needs to address specific areas of vulnerabilities in a given patient. Completion of the study is expected to provide broad range of information to prevent repeated hospitalization.
- Mental health,
Available at: http://works.bepress.com/amreshsrivastava/124/