Table 1 Overview of patient characteristicsa
From: Consultations for refractory cases in mental health services: a descriptive study
Characteristic | Total | Self-harm | Aggression | Self-neglect | Socially unacceptable behavior | Other |
|---|---|---|---|---|---|---|
n (%) | 472 (100) | 114 (24.2) | 103 (21.8) | 115 (24.4) | 59 (12.5) | 81 (17.2) |
Sex [n (%)] | ||||||
Male | 262 (55.5) | 18 (15.8) | 78 (75.7) | 92 (80) | 32 (54.2) | 42 (51.9) |
Female | 207 (43.9) | 95 (83.3) | 24 (23.3) | 22 (19.1) | 27 (45.8) | 39 (48.1) |
Missing | 3 (0.6) | |||||
Age [years; mean ± SD (range)] | 35.8 ± 12.93 (19–64) | 30.7 ± 11.1 (19–58) | 37.1 ± 12.4 (19–64) | 38.8 ± 12.7 (19–64) | 37.9 ± 13.4 (19–64) | 35.4 ± 13.4 (19–63) |
Duration of consultation process (months; mean ± SD) | 10.2 ± 6.6 | 10.0 ± 6.7 | 9.4 ± 6.4 | 10.9 ± 6.7 | 11.2 ± 7.2 | 9.1 ± 5.6 |
Applicant [n (%)] | ||||||
Patient | 36 (7.6) | 16 (14.0) | 0 (0.0) | 9 (7.8) | 1 (1.7) | 10 (12.3) |
Patient representative | 62 (13.1) | 14 (12.3) | 6 (5.8) | 24 (20.9) | 1 (1.7) | 17 (21.0) |
Healthcare provider | 338 (71.6) | 76 (66.7) | 93 (90.3) | 77 (67.0) | 51 (86.4) | 41 (50.6) |
Other | 42 (7.9) | 6 (5.3) | 4 (3.9) | 5 (4.3) | 5 (8.5) | 12 (14.8) |
Missing | 4 (0.8) | |||||
Reason for request [n (%)] | ||||||
Inability to provide adequate care | 323 (68.4) | 87 (76.3) | 76 (73.8) | 85 (73.9) | 39 (66.1) | 36 (44.4) |
Lack of proper care provision | 120 (25.4) | 18 (15.8) | 23 (22.3) | 26 (22.6) | 19 (32.2) | 34 (42.0) |
Stagnating dialogue | 22 (4.7) | 5 (4.4) | 3 (2.9) | 4 (3.5) | 1 (1.7) | 9 (11.1) |
Missing | 7 (1.5) | |||||
Reason for closure [n (%)] | ||||||
Issue resolved | 285 (60.4) | 60 (52.6) | 58 (56.3) | 85 (73.9) | 41 (69.5) | 41 (50.6) |
Discontinued by healthcare provider | 51 (10.8) | 14 (12.3) | 13 (12.6) | 6 (5.2) | 5 (8.5) | 13 (16.0) |
Discontinued by CCE | 31 (6.6) | 7 (6.1) | 6 (5.8) | 5 (4.3) | 2 (3.4) | 11 (13.6) |
Relocation | 48 (10.2) | 10 (8.8) | 15 (14.6) | 11 (9.6) | 6 (10.2) | 6 (7.4) |
Patient death | 12 (2.5) | 9 (7.9) | 0 (0.0) | 1 (0.9) | 1 (1,7) | 1 (1,2) |
Waiting for follow-up | 45 (9.5) | 14 (12.3) | 11 (10.7) | 7 (6.1) | 4 (6.8) | 9 (11.1) |
Legal status [n (%)] | ||||||
Voluntary | 153 (32.4) | 46 (40.4) | 18 (17.5) | 42 (36.5) | 15 (25.4) | 32 (39.5) |
Taken into custodyb | 18 (3.8) | 6 (5.3) | 6 (5.8) | 3 (2.6) | 2 (3.4) | 1 (1.2) |
Judicial authorizationb | 121 (25.6) | 26 (22.8) | 37 (35.9) | 30 (26.1) | 21 (35.6) | 7 (8.6) |
Placed under legal restraintc | 2 (0.4) | 0 (0.0) | 2 (1.9) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Other | 35 (7.4) | 5 (4.3) | 11 (10.6) | 9 (7.8) | 6 (10.2) | 4 (4.9) |
Missing | 143 (30.3) | |||||
Restrictive measures [n (%)] | 79 (16.7) | 16 (14.0) | 41 (39.8) | 8 (7.0) | 5 (8.5) | 9 (11.1) |
Setting [n (%)] | ||||||
Inpatient | 149 (31.6) | 37 (32.4) | 53 (51.5) | 32 (27.8) | 17 (28.8) | 10 (12.3) |
Forensic inpatient | 41 (8.7) | 7 (6.1) | 20 (19.4) | 7 (6.1) | 6 (10.2) | 1 (1.2) |
Outpatient | 179 (38.0) | 41 (35.9) | 15 (14.6) | 61 (53.0) | 24 (40.7) | 38 (46.9) |
Other | 33 (7.0) | 11 (9.6) | 6 (5.8) | 7 (6.1) | 3 (5.1) | 6 (7.4) |
Unknown | 70 (14.8) | |||||
Cognitive level [n (%)] | ||||||
Normal (> 85) | 235 (49.8) | 72 (63.2) | 46 (44.7) | 71 (61.7) | 11 (18.6) | 35 (43.2) |
Borderline intellectual functioning (70–84) | 69 (14.6) | 10 (8.8) | 16 (15.5) | 11 (9.6) | 22 (37.2) | 10 (12.3) |
Mild intellectual disability (50–69) | 40 (8.5) | 6 (5.3) | 12 (11.7) | 8 (7.0) | 11 (18.6) | 3 (3.7) |
Severe intellectual disability (< 34–49) | 8 (1.7) | 0 (0.0) | 2 (1.9) | 2 (1.8) | 1 (1.7) | 3 (3.7) |
Missing | 140 (29.7) | |||||
Problem behavior [n (%)] | ||||||
Aggressive behavior | 160 (33.9) | 21 (18.4) | 69 (67.0) | 37 (32.2) | 23 (39.0) | 10 (12.3) |
Problematic verbal behavior | 101 (21.4) | 15 (13.2) | 38 (36.9) | 27 (23.5) | 11 (18.6) | 11 (18.6) |
Self-harm | 75 (15.9) | 52 (46.5) | 6 (5.8) | 5 (4.3) | 5 (8.5) | 6 (7.4) |
Sexually transgressive behavior | 38 (8.0) | 5 (4.4) | 14 (3.6) | 4 (3.5) | 10 (16.9) | 5 (6.2) |
Oppositional behavior | 86 (18.2) | 17 (14.9) | 30 (29.1) | 18 (15.7) | 12 (20.3) | 9 (11.1) |
Extremely passive behavior | 69 (14.6) | 13 (11.4) | 7 (6.8) | 32 (27.8) | 7 (11.9) | 10 (12.3) |
Extremely active behavior | 10 (2.1) | 0 (0.0) | 4 (3.9) | 1 (0.9) | 4 (6.8) | 1 (1.2) |
Destructive behavior | 84 (17.8) | 19 (16.7) | 28 (27.2) | 14 (12.2) | 14 (23.7) | 9 (11.1) |
Suicidal behavior | 49 (10.4) | 15 (13.2) | 13 (12.3) | 9 (7.8) | 8 (13.6) | 4 (4.9) |
Other | 58 (12.3) | 11 (9.6) | 5 (4.9) | 20 (17.4) | 12 (20.3) | 10 (12.3) |
Psychiatric problems at start of consultation [n (%)] | ||||||
Addiction | 81 (17.2) | 9 (7.9) | 25 (24.3) | 24 (20.9) | 19 (32.2) | 4 (4.9) |
Psychotic spectrum disorder | 165 (35.0) | 9 (7.9) | 64 (62.1) | 53 (46.1) | 23 (39.0) | 16 (19.6) |
Personality disorder | 119 (25.2) | 55 (48.2) | 18 (17.5) | 14 (12.2) | 18 (30.5) | 14 (17.3) |
Autism Spectrum Disorder | 167 (35.4) | 35 (30.7) | 36 (35.0) | 58 (50.4) | 10 (16.9) | 28 (34.6) |
Mood disorder | 93 (19.7) | 43 (37.7) | 9 (8.7) | 19 (16.5) | 12 (20.3) | 10 (12.3) |
Attachment problems | 35 (7.4) | 15 (13.2) | 6 (5,8) | 4 (3,5) | 5 (8.5) | 5 (6.2) |
Eating disorder | 46 (9.7) | 32 (28.1) | 1 (1.0) | 5 (4,3) | 3 (5.1) | 5 (6.2) |
Anxiety disorder | 60 (12.7) | 21 (18.4) | 4 (3,9) | 17 (14.8) | 6 (10.2) | 12 (14.8) |
ADHDd | 22 (4.7) | 6 (5.3) | 5 (4.9) | 5 (4.3) | 2 (3.4) | 4 (4.9) |
Other | 19 (4.0) | |||||