Discharging yourself from hospital

indsty

Unless he is detained under the Mental Health Act then he can leave when he wants. However, hospitals do not keep people in unless there are medical requirements. No, the police will not show up but you might find yourself needing to phone an ambulance and they will be none too happy if they find out he has self-discharged and made his condition worse.

TBagpuss

The polic eowuldn't show up unless he is detaind under the mental health act, or they are looking for himfor issues unrelated to his hospital trip, or if he simply walks out without discharging him and the police are asked to look for him due to fears for his safety, in which case I imagine they would check whether he had simply gone home.

Why does he want to discharge himself, and why do his doctors not want him to? In some cases, it can be that they have to advise against it but will support you if they are sure that he understands any risks

Guest101

juliethemuse wrote: »

If my OH discharges himself from hospital, doers anyone know if they will call the police? I know that you are allowed to leave at any time but someone said they might inform the police, I don't want the police hammering on the door in the night.
Every time he tells them he wants to leave they argue and then disappear for ages. reappearing to do his obs then as soon as he mentions leaving they argue again. we seem to be going round in circles.

Assuming he has mental capacity, he can officially discharge himself whenever he chooses.


The police do not 'hammer down the door', they can be asked to intervene as both the doctors and the police have a duty of care. Typically this is used when children are being abused (or suspected of being), medics can intervene.


Simply leaving will get the police involved as he will be a missing person, but they are not going to arrest him, simply conduct a welfare check.

MonkeyDr

(DOI: Hospital Dr. I am only writing wrt to admissions for physical illnesses, not psychiatric ones / people sectioned under the mental health act)

First, I agree with the posters above that no-one wants to keep any patient in hospital for any reason other than they think it is in their best interests. Equally, it is certainly true that 'medical' best interests are not always the same as 'the patient's life' best interests.

You will not get in trouble for just walking out without telling people, but, honestly, it's a massive pain.

So long as you have capacity (roughly = retain and understand salient information, weigh it in the balance and communicate your decision) you can self-discharge against medical advice whenever you want. Anyone self-discharging is likely to be asked to sign a form to show that they have been told the risks. Fine. Your choice.

You are assumed to have capacity as the default position, and your decision doesn't have to be one that the dr agrees with. Note that some illnesses / anaesthetic agents / sedatives / pain meds can make you woozy enough to temporarily lack capacity, so this may well have to be assessed at the time you want to go rather than on a previous day etc.

Out of hours (after approx 5) coming to see someone who wants to self-discharge will be a low priority thing for the on-call dr and you may have to wait longer. You would do best to go through it with a member of your team so do speak up earlier in the day if you can. That is also better as your team will know the specific risks for you and your condition.

Some practical advice: if this is what you want to do, just walk to the nurses' station, look like you're leaving, and tell them that you are going to leave and want to sign the bit of paper. There might be some delay while they find someone free to go through the risks with you, but maybe they think that if you're just staying in your bed then you are just blowing off steam (as an awful lot of people do).

Hospitals have a duty of care to their patients. If someone leaves the hospital staff need to be sure that the patient is safe to leave or fully understands the potential consequences. No-one can keep you there against your will (assuming you have capacity), but if you disappear without specific risks being explained to you the staff may think it necessary to track you down to check on your safety. I have been involved in cases where people have wandered off but they have had life-threatening potential issues and we have had to get out-of-hours GPs or even the police out in the middle of the night to find them and check they are ok.

Every now and again people do have funny reactions to medication such that they aren't thinking straight - imagine the uproar if one of those patients came to harm after disappearing from the ward and medics denying all responsibility. Or maybe a patient has a condition which is perfectly curable with treatment but has a high mortality rate without - the medical team might think it so obvious that you would want the treatment that they haven't bothered telling you that there's a 50/50 chance of dying without it, but they would definitely want you to know that before you made the decision to refuse treatment and walk out.

Tl,dr: you are free to leave when you want, but doing so without discussion with medical team can waste time and resources and so affect other patients.

MonkeyDr

A few more thoughts, sorry.

OP - it would have to be your OH doing all of the above (signing the paperwork etc) as he is the patient. I expect you realised that.

Absolutely if you self-discharge against medical advice you medications etc are unlikely to be ready. It can create a lot of work trying to hurry things through out of the usual system, and if investigations etc are incomplete then arranging all the follow-ups etc can also be more time consuming. Having said that, I work in a specialty of largely chronic disease and I have never seen a patient denied the treatment or follow-up they need on the grounds that they self-discharged, and we often bend over backwards to accommodate our more trying clientele.

ripplyuk

I've done it twice.

The first time, I told the nurses, and asked for some of my property back which they had in safe keeping. They got me to sign something but didn't say much.

Second time, I just walked out without telling anyone.
No one reported me as a missing person, or ever checked up to see if I was ok. Recently I got a copy of my medical records and they just say 'Went missing from hospital'.

I should add that I have mental health problems and was very unwell on both these occasions, which is the reason why I left. It was from general hospitals though, not psychiatric ones (they're harder to get out of!).

OP, it's not hard to self-discharge, but your husband needs to know that the aftercare or follow up might be more challenging.

ifstar

If he just ups and leaves without telling anyone then there is a fair chance he will be reported missing by hospital and police will come to the door, especially if he has something that he really still needs to be in hospital for.

Ripplyuk above has mentioned doing it twice, once with signing paperwork and once without. I'd say there was quite a failing by the hospital in not reporting the occassion when he did not sign out as he himself has admitted he was mentally unwell at that time.

Person_one

The nurses might call the police to do a 'welfare check' if he absconds and they are genuinely worried for his safety.

Why does he want to leave against clinical advice? Does he have capacity? He can't be kept prisoner but the staff are under no obligation to facilitate him leaving if he isn't able to just get up and go independently.

(Just to point out, the mental health act can be used to detain in hospital but so can the mental capacity act, under something called a Deprivation of Liberty Safeguard, usually used when the patient does not have a mental illness, but has lost the capacity to consent to stay in hospital due to the effects of their physical illness.)

jackyann

Would just add that if the hospital are concerned that he is vulnerable for any reason, they will inform Social Services.
The reason people think that the police may be involved is a scenario like this:vulnerable person leaves hospital, social services are informed, they want to ensure that the person is not in need of something / collapsed etc.and they call round.
If at that point, they are unable to get a reply, but have a reason to think that the person may be in the house but unable to access help /be collapsed or similar, then they may call the police to gain entry.

As a community nurse, I called the police on a handful of occasions if I had reason to be concerned about not gaining access. If the patient or someone close to them came to the door and said they didn't want treatment then I would go away, and only seek further help if I thought there was a danger to the patient or others.
Worth remembering that a number of physical illnesses can cause conditions in which judgement is seriously impaired.

Person_one

jackyann wrote: »

Would just add that if the hospital are concerned that he is vulnerable for any reason, they will inform Social Services.
The reason people think that the police may be involved is a scenario like this:vulnerable person leaves hospital, social services are informed, they want to ensure that the person is not in need of something / collapsed etc.and they call round.
If at that point, they are unable to get a reply, but have a reason to think that the person may be in the house but unable to access help /be collapsed or similar, then they may call the police to gain entry.

As a community nurse, I called the police on a handful of occasions if I had reason to be concerned about not gaining access. If the patient or someone close to them came to the door and said they didn't want treatment then I would go away, and only seek further help if I thought there was a danger to the patient or others.
Worth remembering that a number of physical illnesses can cause conditions in which judgement is seriously impaired.

These days there are no spare social workers waiting around to check on people, the police are the first call if there is a safety concern.