Reflections on facilitated discharge from a mental health service.
OBJECTIVE
The aim of this paper is to review research evidence and describe our experience of facilitated discharge from mental health services to primary care.


METHODS
A literature review of facilitated discharge was conducted. In addition, the clinical characteristics of 21 discharged and 21 non-discharged patients from one shared care service were compared in a retrospective file review. Thirty-one patients in another facilitated discharge program were surveyed.


RESULTS
Discharged patients had a higher level of function. There was a trend towards discharged patients being female and employed with less chronic illness, involuntary treatment, behavioural symptoms, depot medication, triage contact, service contact with family, and more mood disorder. Of the 10 survey respondents, 60% reported feeling better compared with their last service contact, 70% felt not having contact was a good thing and most saw their doctors regularly and reported a good relationship.


CONCLUSIONS
There was a trend towards more stable patients being discharged and it appeared that they responded positively to this, without a clear indication of which factors best determine suitability for discharge. Consequently, we elected to incorporate discharge planning processes as a core function of case management and increase shared care with the primary care sector.
Jespersen
Sean
S
Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia. sean.jespersen@easternhealth.org.au
Chong
Terence
T
Donegan
Tony
T
Gray
Kelly
K
Kudinoff
Teresa
T
McGain
Leanne
L
Gant
Deborah
D
D000328:Adult; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000592:standards*; D017060:Patient Satisfaction; D011570:Psychiatry; D012017:Referral and Consultation; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016896:Treatment Outcome