Psychosocial Factors Associated with Psychiatric Readmission Following Inpatient Discharge: A Systematic Review

Psychiatric readmission following inpatient discharge is common and is frequently used as an indicator of continuity and quality of care in mental health services. Although readmission is often interpreted as a marker of clinical relapse, increasing evidence suggests that psychosocial factors may contribute to post-discharge outcomes. However, evidence on these factors remains fragmented across settings, populations, and healthcare systems. This systematic review synthesised quantitative observational evidence on psychosocial factors associated with psychiatric readmission following discharge from acute inpatient mental health care. A systematic search of PubMed, Scopus, Web of Science, and APA PsycINFO was conducted from database inception in accordance with PRISMA 2020 guidelines. Eligible studies included adult psychiatric inpatients and examined at least one psychosocial factor assessed during admission or prior to discharge in relation to subsequent psychiatric readmission. Due to substantial clinical and methodological heterogeneity, findings were synthesised narratively. Fifteen studies conducted across diverse international healthcare systems were included. The most consistent findings were observed for housing instability, homelessness, and unstable residential context, which were repeatedly associated with psychiatric readmission across population-based, hospital-based, and clinical registry studies. Evidence for socioeconomic disadvantage, employment status, social integration, and social support was more heterogeneous, limited, or dependent on how these constructs were measured and adjusted for. These findings suggest that psychiatric readmission reflects not only clinical trajectories but also broader social vulnerability during the transition from inpatient to community-based care. Integrating systematic assessment of psychosocial circumstances, particularly housing instability and barriers to outpatient follow-up, into discharge planning may be important for improving continuity of care and reducing avoidable psychiatric readmissions.