ABSTRACT

Receiving passes and privileges to leave secure hospital settings has important therapeutic value for forensic patients. However, events involving patient unauthorized leave of absence (ULOA) prompt public safety concerns. To better understand how to address ULOA, we reviewed literature on patient leave and ULOA from forensic mental health settings, and technological monitoring of forensic patients. We systematically searched the following databases: MEDLINE, PsycINFO, and CINAHL. Searches were not restricted by language, study type, or time period. While the literature lacks a consistent convention to calculate ULOA rates, it suggests that forensic ULOA events are generally infrequent and benign. Common motivations for absconding include boredom and frustration. Structured professional guidelines may enhance transparency and confidence in decision-making about patient leave, but there is a need for validation of tools specific to ULOA risk. More research on interventions designed to reduce forensic ULOA, including use of electronic monitoring, is also needed. The therapeutic risk of forensic patient absconding will never be fully eliminated. Literature to date suggests promising avenues for future research and efforts to address ULOA, such as increasing opportunities for therapeutic and recreational activities, and evaluation of existing and development of new interventions.

摘要

取得通行证和离开安全医院的特权对法医患者具有重要的治疗价值。但是，涉及患者未经许可的请假（ULOA）的事件提示了公共安全问题。为了更好地了解如何解决ULOA，我们回顾了法医精神卫生环境中的病假和ULOA文献，以及法医患者的技术监测。我们系统地搜索了以下数据库：MEDLINE，PsycINFO和CINAHL。搜索不受语言，研究类型或时间段的限制。尽管文献缺乏一致的计算ULOA率的惯例，但它表明法医性的ULOA事件通常不常见且无害。潜逃的常见动机包括无聊和沮丧。有条理的专业指南可能会提高有关病假决策的透明度和信心，但需要验证针对ULOA风险的工具。还需要对旨在减少法医ULOA的干预措施进行更多研究，包括使用电子监控。法医患者潜逃的治疗风险将永远不会完全消除。迄今为止的文献表明，未来的研究和解决ULOA的努力有望带来希望的途径，例如增加治疗和娱乐活动的机会，以及评估现有和开发的新干预措施。法医患者潜逃的治疗风险将永远不会完全消除。迄今为止的文献表明，未来的研究和解决ULOA的努力有望带来希望的途径，例如增加治疗和娱乐活动的机会，以及评估现有和开发的新干预措施。法医患者潜逃的治疗风险将永远不会完全消除。迄今为止的文献表明，未来的研究和解决ULOA的努力有望带来希望的途径，例如增加治疗和娱乐活动的机会，以及评估现有和开发的新干预措施。