1407 – Psychiatric reform in crete and increasing trend of involuntary admissions

Abstract

Introduction Deinstitutionalization in Crete, as part of the psychiatric reform, resulted in the closure of the only psychiatric hospital of the island in 2006. Objectives To explore the trends of yearly involuntary admissions in the Psychiatric Department of the University Hospital of Crete (PD/UHC) (2008-2011), the only inpatient public unit to receive involuntary admissions in a region of 400,000 residents, and the profile of the patients admitted. Aims To find possible associations between the closure of the Psychiatric Hospital in Crete and the number of involuntary admissions. Methods We examined the records of total and involuntary admissions in PD/UHC between 2008–2011. In a subset of 400 inpatients admitted between Nov/2011 and Aug/2012, sociodemographic/psychopathology parameters were also examined. Statistical analysis was conducted with chi-square and regression analysis models. Results Yearly involuntary admissions have increased by 245% during a period of 4 years, with the number of total admissions having increased by 22%. Within the subset of patients admitted during the last year, involuntary admissions account for the 47% of total admissions. Mean age of patients was 41.3 ± 1.38 years. Chi-square tests showed that male gender, aggression and positive psychotic symptoms at admission, absence of spouse/children are associated with involuntary admissions. Multivariate analysis revealed significant correlations for male gender and aggression. Conclusion Deinstitutionalization, i.e. closure of the only psychiatric hospital in Crete, has resulted in a significant and marked increase of involuntary admissions, a fact that also reflects the lack of community services and infrastructure.