A systematic review of the use of ‘leave’ within Inpatient Mental Health

    Research output: Contribution to conferenceAbstractpeer-review


    Background 'Leave' is a term used within inpatient mental health services to describe occasions when a patient, who is either detained formally or voluntarily agreeing to their admission, leaves the hospital ward for a period of time with the agreement of their clinical team. A wealth of literature is available on unauthorised leave, i.e. when a patient absconds from hospital, yet the practice of ‘leave’ is relatively uncharted despite evidence of this practice existing from the 1800’s. Landor (1876) presents 114 patient’s ‘demographics’, ‘diagnoses’ and ‘outcomes of ‘probation’ (aka leave) from the Superintendent London Asylum; in his medical experience of granting ‘probation’, he recognised improvements in the patient’s recovery and recommended his American colleagues adopt this practice. One could reasonably perceive the well-established testimony of ‘leave’ to be a juxtaposition to the dearth of evidence available. Aim The authors aim to establish whether leave-related clinical practice is based on a substantial valid body of evidence, or instead based on custom and clinician-instinct. Methods In December 2016, a systematic review of international literature was conducted: CINAHL; Proquest; Criminal Justice database; Nursing & Allied Health Database; PsycARTICLES; Sage; ScienceDirect; Taylor and Francis Online; Web of Science; Scopus; OpenGrey; Cochrane; OVID and EThoS. Results We will include results on: the incidence of leave; what factors precede being granted leave; patient demographics; risk; circumstances around using leave; who initiates and terminates leave; the consequences of going absent from leave; outcomes of leave; how leave is recorded; the views of staff patients, carers and the public; interventions involving leave. Analysis on the results is currently underway, and we aim to have a concluded presentation by May 2017. Discussion We will discuss the quality of the research from this review, and acknowledge the validity in generalising the results presented to a wide range of mental health in-patient settings. We will evaluate the evidence base, discussing how the current practice of leave has been established. With this, we will discuss any deficiencies in the research, and thus hypothesise how some customs around leave may have came to be. We will discuss the clinical decision making process and accountability for mental health nurses around leave, and any implication for practice. Conclusion We will recommend areas of further research, based on the results of the systematic review, and any subsequent research ideas we have been able to implement. We will offer a ‘question and answer’ session to the floor.
    Original languageEnglish
    Publication statusPublished - 15 Sept 2017
    Event23rd International Mental Health Nursing Research Conference 2017 - Cardiff City Hall, Cardiff, United Kingdom
    Duration: 14 Sept 201715 Sept 2017
    Conference number: 23rd


    Conference23rd International Mental Health Nursing Research Conference 2017
    Abbreviated titleMHNR
    Country/TerritoryUnited Kingdom


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