Abstract
INTRODUCTION: The objective of this study, carried out in France, was to analyse important psychiatric sector disparities in the rate of compulsory hospitalizations as a function of the severity of disorders among the people hospitalized, and of certain variables linked to the territorial landscape (socio-demographic context, and primary and psychiatric care offer).METHODS: The 125 sectors that took part in this study were divided into three groups on the basis of their compulsory hospitalization rates.RESULTS: The results did not reveal any link between compulsory hospitalization rate and severity of disorders.The hospitalization rate was correlated with variables specific to urban areas: it was higher in more densely populated areas with a larger proportion of people living alone and a greater number of shelters and social rehabilitation centres. It was also higher in the sectors with larger hospitalization capacity, with longer mean hospitalization durations, but with a lower rate of resort to psychiatry and larger human resources.CONCLUSIONS: The frequency of resort to involuntary hospitalization in France does not seem to be linked to the severity of patients’ disorders, but it is higher in sectors with a profile specific to urban areas, larger hospitalization capacities and human resources.
Highlights
The objective of this study, carried out in France, was to analyse important psychiatric sector disparities in the rate of compulsory hospitalizations as a function of the severity of disorders among the people hospitalized, and of certain variables linked to the territorial landscape
The hospitalization rate was correlated with variables specific to urban areas: it was higher in more densely populated areas with a larger proportion of people living alone and a greater number of shelters and social rehabilitation centres
It was higher in the sectors with larger hospitalization capacity, with longer mean hospitalization durations, but with a lower rate of resort to psychiatry and larger human resources
Summary
The objective of this study, carried out in France, was to analyse important psychiatric sector disparities in the rate of compulsory hospitalizations as a function of the severity of disorders among the people hospitalized, and of certain variables linked to the territorial landscape (socio-demographic context, and primary and psychiatric care offer). This proposal was only enforced by law in 2011, when a citizen appealed to the Constitutional Council, which issued a decision in favour of judiciary rulings. Between these two periods, in 2004, a tragic event took place in Pau. A patient suffering from addiction and psychotic disorder left the hospital, later came back in the middle of the night and killed a nurse and an auxiliary nurse after breaking into one of the wings. The WHO gives a broad definition of violence, as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, mal-development or deprivation” (Krug, Dahlberg, Mercy, Zwi, & Lozano-Ascencio, 2002)
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