English Polski
Vol 20, No 4 (2023)
Research paper
Published online: 2023-12-28
Page views 177
Article views/downloads 5
Get Citation

Connect on Social Media

Connect on Social Media

Prevalence and factors related to patients’ abscond from a psychiatric hospital in Iran from 2011 to 2020

Elnaz Takzare1, Reza Zeighami2, Seyed Alireza Haji Seyed Javadi3, Ahad Alizadeh4
Psychiatria 2023;20(4):152-158.


Introduction: In addition to the unfortunate consequences for the patient and family, abscond increases the responsibility and workload of hospital staffs. The aim of the study was to identify the prevalence and factors related to patients’ abscond from a psychiatric hospital 2011 to 2020.

Material and methods: In this descriptive epidemiological study, patients’ files were reviewed over a ten-year period. Data collection tools included a questionnaire of demographic information such as patient’s characteristics.

Results: The research sample consisted of 14,446 files reviewed, and 204 files related to patient escape were extracted. The escape rate was 1.61%, an average upward rate. According to the results, the incidence of patients’ escape had decreased from 3.91% in 2011 to 0.86% in 2020. The highest escape rate was observed in men (83.82%), single (41.67%) and with undergraduate education (50.98%). Also, people with a history of drug use and more extended hospital stays had higher escape rates (72.55%). The highest escape rate is in summer with an incidence of 19.87%, and the lowest rate is in winter with a prevalence of 10.18%.

Conclusions: The possibility of patient escape is considered a nursing diagnosis for all patients with mental disorders, and appropriate preventive measures should be implemented. The necessary interventions by the healthcare team can reduce patients’ motivation to escape by reducing their psychological, social, and communication problems. Therefore, it is necessary to pay more particular attention to patients by identifying those at risk of escape and reducing the rate of escape by providing a high-security environment.

Article available in PDF format

Add to basket: 49.00 PLN

Aready have access?


  1. Oskouie F, Zeighami R, Joolaee S, et al. Outcomes of parental mental illness on children: a qualitative study from Iran. Journal of Psychosocial Nursing and Mental Health Services. 2011; 49(9): 32–40.
  2. Zeighami R, Oskouie F, Joolaee S, et al. The positive effects of parents' mental illness on their children: a qualitative study. Bangladesh Journal of Medical Science. 2014; 13(4): 449–453.
  3. Bailey J, Page B, Ndimande N, et al. Absconding: reducing failure to return in adult mental health wards. BMJ Qual Improv Rep. 2016; 5(1).
  4. Zeighami R, Raeisolhagh A, Ranjbaran M, et al. Effect of home nursing care on the severity of symptoms in patients with bipolar i disorder: a randomized clinical trial. Home Health Care Management & Practice. 2020; 33(2): 81–87.
  5. Ahmadi M, Zeighami R, Ahmadi M, et al. Phenomenological explanation of women's lived experience with spouses with mental disorders. Journal of Nursing and Midwifery Sciences. 2021; 8(1): 34.
  6. Cabarkapa S, Sadhu R, King J, et al. Absconding from public mental health inpatient units — who does it, and why? Psychiatr Q. 2021; 92(1): 229–237.
  7. Arbee F, Subramaney U, Arbee F, et al. Absconding from a psychiatric hospital in Johannesburg, South Africa: Are we seeing a decrease since the implementation of the ? S Afr J Psychiatr. 2019; 25: 1338.
  8. Cabarkapa S, Sadhu R, King J, et al. Profiling absconders from public and private inpatient psychiatric units: a comparative analysis. Psychiatr Q. 2020; 91(2): 299–307.
  9. Raji SO, Ikeji OC, Omoaregba JO. actors associated with absconding behaviours amidst inpatients of a regional psychiatric hospital in Nigeria. The Nigerian Health Journal. 2020; 19(1): 25–36.
  10. Zeighami R, Takzare E. Prevalence and Causes of Escape in Mental Patient: A Review Study. Iranian Journal of Systematic Review. 2022; 2(3): 22–35.
  11. Andoh B, Andoh B. The Mental Health Acts 1983 and 2007 and the offender-patient who absconds from hospital. Med Sci Law. 2017; 57(4): 205–210.
  12. Muir-Cochrane E, Mosel KA, Muir-Cochrane E, et al. Absconding: A review of the literature 1996-2008. Int J Ment Health Nurs. 2008; 17(5): 370–378.
  13. Zarei E, Marzban S, Rajaee R. Patient absconding from emergency department and its financial burden: a study in a large public hospital, Tehran. Journal of Health in the Field. 2015.
  14. Gowda GS, Thamby A, Basavaraju V, et al. Prevalence and clinical and coercion characteristics of patients who abscond during inpatient care from psychiatric hospital. Indian J Psychol Med. 2019; 41(2): 144–149.
  15. Cheng S, Chung C, Leung Y, et al. Patient absconding behaviour in a public general hospital: retrospective study. Hong Kong Med J. 2002; 8(2): 87–91.
  16. Sheikhmoonesi F, Kabirzadeh A, Yahyavi ST, et al. 464 – A prospective study of patients absconding from a psychiatric hospital in Iran. European Psychiatry. 2013; 28: 1.
  17. Memarian A, Yazdinezhad S, Mehrpisheh S, et al. Characteristics of absconders from a general health service, Rasoul Akram Hospital in 2013. Polish Annals of Medicine. 2015; 22(2): 82–85.
  18. Khammarnia M, Kassani A, Eslahi M, et al. Study of patients absconding behavior in a general hospital at southern region of Iran. Int J Health Policy Manag. 2015; 4(3): 137–141.
  19. Powers RA, Kaukinen C, Khachatryan N, et al. Risk factors for absconding among adult parolees in Colorado. Int J Offender Ther Comp Criminol. 2018; 62(14): 4622–4641.
  20. Khammarnia M, Kavosi Z, Karimi Ja, et al. Investigation of the rate of patients’ escape from a general hospital in Shiraz, Iran. Sadra Medical Sciences Journal. 2014; 2(1): 65–74.
  21. Voss I, Voss I. Containment is not the cure: Least restrictive approaches to the management of absconding. J Psychiatr Ment Health Nurs. 2019; 26(9-10): 287–288.
  22. Emirali A, O'Rourke R, Friendship C, et al. Desistance from absconding: “You’ve got to have hope”. The Journal of Forensic Practice. 2020; 22(4): 223–234.
  23. Sheikhmoonesi F, Kabirzadeh A, Yahyavi ST, et al. A prospective study of patients absconding from a psychiatric hospital in Iran. Med Glas (Zenica). 2012; 9(2): 345–349.
  24. Abaatyo J, Favina A, Kaggwa MM, et al. Absconding among admitted patients with bipolar affective disorder diagnosis in Uganda. BMC Psychiatry. 2023; 23(1): 318.
  25. Grotto J, Gerace A, O'Kane D, et al. Risk assessment and absconding: perceptions, understandings and responses of mental health nurses. J Clin Nurs. 2015; 24(5-6): 855–865.
  26. Martin K, McGeown M, Whitehouse M, et al. Who’s going to leave? An examination of absconding events by forensic inpatients in a psychiatric hospital. The Journal of Forensic Psychiatry & Psychology. 2018; 29(5): 810–823.
  27. Ajalli A, Khodaee M, Goodarzi M, et al. Assessment of relationship between characteristics of psychiatric patients escaping from Razi Psychiatric Hospital. Iranian Journal of Psychiatric Nursing. 2015; 2(4): 59–67.
  28. Kaggwa MM, Acai A, Rukundo GZ, et al. Patients' perspectives on the experience of absconding from a psychiatric hospital: a qualitative study. BMC Psychiatry. 2021; 21(1): 371.
  29. Verma DK, Khanra S, Goyal N, et al. Absconding during inpatient care from a tertiary psychiatric hospital: a comparative study. Indian J Psychol Med. 2020; 42(5): 456–463.
  30. Ghani A, Talbot D, Ma C, et al. A retrospective matched case–control comparison of non-fatal hanging to non-fatal self-poisoning in a sample of Australian men and women. Australas Psychiatry. 2023; 31(3): 363–368.
  31. Beer M, Muthukumaraswamy A, Khan A, et al. Clinical predictors and patterns of absconding in a low secure challenging behaviour mental health unit. Journal of Psychiatric Intensive Care. 2009; 5(02): 81.
  32. Kirchebner J, Lau S, Sonnweber M. Escape and absconding among offenders with schizophrenia spectrum disorder - an explorative analysis of characteristics. BMC Psychiatry. 2021; 21(1): 122.
  33. Meehan T, Mansfield Y, Stedman T. Development of a checklist to aid in the assessment of 'failure to return' from approved leave by acute inpatients. Int J Ment Health Nurs. 2019; 28(4): 989–996.
  34. Ferguson L. Profiling persons reported missing from hospitals versus mental health facilities. International Journal of Police Science & Management. 2021; 23(4): 372–384.
  35. Muir-Cochrane E, Muller A, Oster C. Absconding: A qualitative perspective of patients leaving inpatient psychiatric care. Int J Ment Health Nurs. 2021; 30(5): 1127–1135.