Mental health professionals’ attitudes towards mental competency and involuntary commitment in anorexia nervosa: Construction, validation and results of the ACINOVAN questionnaire

Abstract

IntroductionAnorexia nervosa is a serious disorder that causes high rates of morbidity and mortality. Involuntary treatments are only legally admissible if the patient is not competent. However, assessing their capacity can be really complex. This implies that the final decision can be influenced by the individual attitudes of the physician. ObjectiveTo create and empirically validate a questionnaire in Spanish that makes it possible to measure the attitude towards capacity and involuntary commitment and compare between categorical groups. MethodsThe sample consisted of 338 mental health professionals. The items were validated by groups of experts. An exploratory factor analysis and group comparisons were carried out. ResultsFavourable evidence was obtained of a 13-item model consisting of three factors: pro-intervention, lack of competence and chronicity. Professionals tend to believe in the lack of capacity and the need for involuntary interventions, as well as differential suitability due to chronicity. Support prior to involuntary interventions was significantly related to the pro-intervention and absence of capacity factors, and training in bioethics to chronicity. ConclusionsThe resulting instrument is valid and reliable. Its use can be useful to professionals, patients and society.