ABSTRACT
Box 4.1 Assessing and managing risk of escape and absconding This is a task for the entire multidisciplinary team; there should be particular attention paid to the patient’s history and any previous attempts. It is important to be aware of factors that may make the risk higher: • immediately following admission • remand prisoners • around the time of tribunals or court appearances • around significant dates (bereavements, date of index offence, etc.) • when there has been a reduction in level of supervision/escort level during leave • psychosocial stress/family issues • when mental state has deteriorated • high level of impulsivity • poor collaboration in care and treatment. The clinical team are all responsible for taking part in discussions about risk of escape or absconding. In order to reduce the risk, the following measures are usually taken: • Decisions made regarding changing leave or escort levels should be made by experienced staff who
know the patient well. • Clinical teams should be aware of any dates significant to the patient. • Each patient should have an established care plan to cover any need to leave the unit in an emergency,
such as for physical health treatment. • Before any patient goes on agreed leave there is an assessment of mental state documented by nursing
staff. • If patient going on unescorted leave, there is a record made of the clothing worn on leaving the unit. Each unit will have its own procedures to follow in the event of a patient escaping or absconding. When working in secure settings it is important to be familiar with these. General points will be: • contacting the local police and providing appropriate information (see section on confidentiality) • if the patient is restricted or a transferred prisoner contact the Ministry of Justice (there is a 24-hour
telephone number) • informing the Care Quality Commission • all on-call staff (including the community team) should be informed • each patient should have a specific care plan addressing risks in the event of absconding, including
known likely risk behaviours, likely sanctuaries or destinations, specific potential victims, people who should be informed.
