When statistical models fail: problems in the prediction of escape and absconding behaviour from high-security hospitals

Moore, Estelle; Hammond, Seán

doi:10.1080/09585180050142570

Cited by 17 publications

(35 citation statements)

References 12 publications

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“…The comparatively low absconding rates for the two clinical divisions outlined above appears to support Moore & Hammond’s (2000) assertion regarding statistical tools for risk assessment of absconding. If risk prediction for AWOL were based on an assumption that no one will abscond then a high success rate for these clinical areas would result (97.2% success in General Acute Psychiatry, 98.8% for Continuing Care).…”

Section: Discussionmentioning

confidence: 64%

“…(1998) identify that more sophisticated statistical techniques might allow examination not just of single variables, but also of interaction effects. In contrast, Moore & Hammond (2000) assert that, in a high‐security population where incidence of AWOL is low (0.84%), the use of a sophisticated statistical analysis as a predictor of absconding cannot be supported. Specifically, they argue, the assumption that no patient will abscond will lead to accurate prediction for 99.16% of cases.…”

Section: Introductionmentioning

confidence: 96%

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Absconding of patients from an independent UK psychiatric hospital: a 3‐year retrospective analysis of events and characteristics of absconders

Dickens

Campbell²

2001

Psychiatric Ment Health Nurs

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The need for accurate local information on the scale, nature and outcome of absconding or Absence Without Leave (AWOL) from an independent UK psychiatric hospital led to this 3-year (1997-1999) retrospective analysis of of AWOL data. One hundred and forty-eight AWOL incidents involving 88 patients were identified. Absconders were found to be significantly younger, more likely to be detained upon admission and more likely to be unmarried than a control group (n = 1378) of non-absconders. There were no significant differences for sex, length of admission or ethnicity. Descriptive data on the circumstances surrounding AWOL events are given, with at least 24 (16.2%) incidents having serious adverse outcomes. Baseline absconding rates are presented for the specialist clinical divisions within the hospital. There is a need for more detailed studies of absconding by patients within the Adolescent Mental Health Service subgroup where the absconding rate was relatively high and engagement in risk activity whilst AWOL relatively frequent.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 96%

Absconding of patients from an independent UK psychiatric hospital: a 3‐year retrospective analysis of events and characteristics of absconders

Dickens

Campbell²

2001

Psychiatric Ment Health Nurs

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“…There was only minor evidence supporting absconding patients having a history of self-harm (Bowers et al 1999c;Carr 2006;The Joanna Briggs Institute 2007a). Two papers suggest that the prediction of absconding risk is possible (Brook et al 2006;Moore & Hammond 2000). Carr (2006) and Lockwood (2007) compiled evidence summaries on behalf of The Joanna Briggs Institute regarding the phenomenon of absconding; however, only nine studies were reviewed.…”

Section: Absconding Profilesmentioning

confidence: 99%

Absconding: A review of the literature 1996–2008

Muir‐Cochrane

Mosel

2008

Int J Mental Health Nurs

105

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“…To date, nine studies (summarised in Table 1 ) have attempted to identify patient characteristics associated with absconsion from forensic psychiatric services. These studies have observed that several demographic factors, such as younger age, male sex, ethnicity, length of stay, and legal section are associated with absconsion [ 5 , 6 , 7 , 8 , 9 , 10 ]; however, findings are inconsistent across studies. With regards to diagnosis, perhaps unsurprisingly, psychopathy and personality disorder appear to be more common among those who abscond from forensic settings [ 7 , 11 ], a finding which is consistent with that of an early study which showed that absconders are characterised by higher scores on the Minnesota Multiphasic Personality Inventory than non-absconders [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

A Prospective Cohort Study of Absconsion Incidents in Forensic Psychiatric Settings: Can We Identify Those at High-Risk?

et al. 2015

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BackgroundIncidents of absconsion in forensic psychiatric units can have potentially serious consequences, yet surprisingly little is known about the characteristics of patients who abscond from these settings. The few previous studies conducted to date have employed retrospective designs, and no attempt has been made to develop an empirically-derived risk assessment scale. In this prospective study, we aimed to identify predictors of absconsion over a two-year period and investigate the feasibility of developing a brief risk assessment scale.MethodsThe study examined a representative sample of 135 patients treated in forensic medium- and low-secure wards. At baseline, demographic, clinical, treatment-related, and offending/behavioural factors were ascertained from electronic medical records and the treating teams. Incidents of absconsion (i.e., failure to return from leave, incidents of escape, and absconding whilst on escorted leave) were assessed at a two-year follow-up. Logistic regression analyses were used to determine the strongest predictors of absconsion which were then weighted according to their ability to discriminate absconders and non-absconders. The predictive utility of a brief risk assessment scale based on these weighted items was evaluated using receiver operator characteristics (ROC).ResultsDuring the two-year follow-up period, 27 patients (20%) absconded, accounting for 56 separate incidents. In multivariate analyses, four factors relating to offending and behaviour emerged as the strongest predictors of absconsion: history of sexual offending, previous absconsion, recent inpatient verbal aggression, and recent inpatient substance use. The weighted risk scale derived from these factors had moderate-to-good predictive accuracy (ROC area under the curve: 0.80; sensitivity: 067; specificity: 0.71), a high negative predictive value (0.91), but a low positive predictive value (0.34).ConclusionPotentially-targetable recent behaviours, such as inpatient verbal aggression and substance use, are strong predictors of absconsion in forensic settings; the absence of these factors may enable clinical teams to identify unnecessarily restricted low-risk individuals.

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When statistical models fail: problems in the prediction of escape and absconding behaviour from high-security hospitals

Cited by 17 publications

References 12 publications

Absconding of patients from an independent UK psychiatric hospital: a 3‐year retrospective analysis of events and characteristics of absconders

Absconding of patients from an independent UK psychiatric hospital: a 3‐year retrospective analysis of events and characteristics of absconders

Absconding: A review of the literature 1996–2008

A Prospective Cohort Study of Absconsion Incidents in Forensic Psychiatric Settings: Can We Identify Those at High-Risk?

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