How involuntary admission might have been avoided: An interview study of referring general practitioners

Abstract

IntroductionThe legal criteria for involuntary admission in Norway are that the patient has a serious psychiatric disorder (i.e. psychosis) and is in need of admission to secure needed treatment or that there is a risk of danger. While there have been some studies focusing on coercion in hospitals, less is known about the processes leading up to involuntary admission and the reasoning of referring doctors. In Norway, it is primarily general practitioners (GPs) that refer patients.AimsTo study which factors that GPs who had recently referred patients to involuntary admission thought might have made their latest referral unnecessary.MethodsSeventy-four GPs were interviewed by phone. They had all recently referred patients involuntarily to a major Norwegian university psychiatric hospital. One central question concerned how their latest involuntary referral might have been avoided.ResultsThese are the main factors that the GPs thought could have been of importance in avoiding involuntary referral of their patients:– that the patient took the prescribed medication (28%);– that they personally had the opportunity to closely follow up the patient in the following days (22%);– that other health care staff could follow up the patient closely in the patient's own home (i.e. home care nursing, etc.) (19%);– that a family member of the patient could help the patient (8%).ConclusionsThe GPs suggested that an increased availability of resources and more assistance from other parts of the health service were some of the factors that could be of importance in reducing involuntary admissions.