Abstract
To assess the frequency of involuntary psychiatric hospitalizations from 2001 to 2008 and to determine associated clinical and socio-demographic characteristics, a retrospective cohort study was conducted. Adult admission data were collected from a university hospital in Brazil. Hospitalizations were classified as voluntary (VH) or involuntary (IH). Groups were compared using chi-square test for categorical variables and Mann-Whitney test for continuous non-parametric variables. The relative risk of certain events was estimated by the odds ratio statistic. Of 2,289 admissions, 13.3% were IH. The proportion of IH increased from 2.5% to 21.2% during the eight year period. IH were more frequently associated with female gender, unmarried status, unemployment, and more than 9 years of schooling. Psychotic symptoms were more common among IH. There were no differences in age, duration of hospitalization, or rate of attendance at first appointment after hospital discharge. Understanding of the characteristics associated with IH is necessary to improve the treatment of psychiatric disorders.
Highlights
Rates of involuntary hospitalizations (IH) are considered an indicator of mental health care legislation 1
The proportion of IH was 13.3% which is consistent with the mean rate of 15-20% reported in literature 5,7,8
It is important to contextualize these findings within the Psychiatric Reform, characterized by (a) the structuring of Community Mental Health Services set up to care for people with severe psychiatric disorders, (b) the Return Home Program, which provided financial support for families
Summary
Rates of involuntary hospitalizations (IH) are considered an indicator of mental health care legislation 1. An inpatient care model based on psychiatric hospitals was replaced by outpatient assistance for the management of critically ill patients, called CAPS (Psychosocial Care Center) 2. In this context, legislation supporting the new concept of public psychiatry anchored in human rights, freedom, and modern methods of treatment within the organization of services needed to be implemented. Patients with psychiatric disorders had their rights protected with regard to access to community mental health treatment, the regulation of hospitalizations, and the reduction of long stay beds in psychiatric hospitals 2
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