Abstract
BackgroundThe goal was to investigate the quality in terms of formal and content-based comprehensiveness of the forms for involuntary admission before and after the introduction of the new law (KESR, “Kindes- und Erwachsenenschutzrecht”) for the regulation of involuntary admission. Moreover, the study aimed at assessing if the quality of the admission forms was associated with the professional qualifications of the professionals ordering them. Finally, the patients were characterized.MethodsRetrospective evaluation of all commitment reports at the University Hospital of Psychiatry within a six month period before and after the introduction the KESR (N(2012) = 489; N(2013) = 651). Formal and content-related criteria for the commitment certificates were recorded as well as the socio-demographic and clinical data of the cases admitted. There were no exclusion criteria. The data was descriptively evaluated, formal and content-based criteria were compared between groups of admitting professionals. The Chi-Square-Test following Pearson and T-Test were used to test for group differences.ResultsFormal and content-related quality criteria deficiencies were noted. The best-documented forms came from psychiatrists and emergency physicians, followed by general practitioners and hospital doctors. There have been improvements in the quality of the documents since the new KESR within all professional subsamples.ConclusionsPsychiatrists and those who regularly deal with emergency commitments were likely to issue forms of high quality. Due to the considerable consequences associated with involuntary admission for affected individuals, their relatives and also professionals, the considerable deficits in the quality of the documentation must be intensively addressed in training, advanced training, continuing education and in daily routines.
Highlights
Introduction of obligatory review ofFU after six weeks by local public authority As we found in the present study that in general the duration of stay among involuntarily admitted subjects increased from 21 to 27 days on average in contrast to the intention of the law, we examined the percentage of cases that stayed longer than six weeks
In 2013, a revised federal legislation was introduced that regulates the prerequisites for involuntary commitment as well as further details that are associated with involuntary hospitalization and coercive practices [7]
The percentage of individuals with an involuntary hospitalization longer than 6 weeks was much higher among individuals with schizophrenia main diagnosis compared to other diagnoses
Summary
Introduction of obligatory review ofFU after six weeks by local public authority As we found in the present study that in general the duration of stay among involuntarily admitted subjects increased from 21 to 27 days on average in contrast to the intention of the law, we examined the percentage of cases that stayed longer than six weeks. The goal was to investigate the quality in terms of formal and content-based comprehensiveness of the forms for involuntary admission before and after the introduction of the new law (KESR, “Kindes- und Erwachsenenschutzrecht”) for the regulation of involuntary admission. Until 2012, in Switzerland, the formal and content-based prerequisites for the involuntary admission of a person to an in-patient medical facility were regulated in Art. 397 of the Swiss Civil Code (ZGB). The new KESR attempts to deal with current international health policy concerns, namely the reduction of involuntary commitment and treatment against the patient’s will as well as strengthening human rights in psychiatric treatment, e.g. by introducing the possibility for all patients to issue advanced directives and the involvement of a personal representative for individuals who were involuntarily admitted [9, 10]
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