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Community Ment Health J. 2013 Dec;49(6):694-703. doi: 10.1007/s10597-012-9544-8. Epub 2012 Oct 21.

Post-inpatient attrition from care "as usual" in veterans with multiple psychiatric admissions.

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  • 1Serious Mental Illness Treatment Research and Evaluation Center, North Campus Research Complex, 2800 Plymouth Rd, Building 10 6016, Ann Arbor, MI, 48109-2800, USA,


Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed.

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