Compulsory Admission Research Articles

Substance Use in Forensic Assertive Community Treatment: Development and Implementation of a Pilot Project for Internees in Belgium

Substance use is a significant factor associated with new arrests, detentions and compulsory admissions for patients in forensic assertive community teams (FACT). To enhance community tenure for forensic patients and facilitate their sustainable integration into society, a treatment that offers a community-based alternative to admission following substance use was developed. In this paper, the development of the project, FENIX + is described along with the reporting of a pilot study of all included patients during 12 months (N = 24). Recidivism risk and community integration were assessed utilizing the Short-Term Risk Assessment and Treatability (START) as well as the Measurements in Addiction for Triage and Evaluation (MATE) scales. The included patients avoided 60% of admissions, exhibited positive changes in their desire for assistance, and successfully reduced their risk of recidivism. By accessing the community-based alternative, they were able to delay admissions effectively. These promising results suggest that a community-based treatment could benefit patients at risk of reoffending following substance use.

Influence of prior contact with community mental health services on first inpatient psychiatric admission for ethnic minorities: Findings from the NOMIAC study.

Research has extensively documented inequalities in inpatient psychiatric care provided to people of minoritized ethnic groups. Nonetheless, the role of their previous engagement with community mental health care has been little studied. We aimed at exploring whether previous clinical care can influence key domains of subsequent psychiatric inpatient care for people of ethnic minorities. We identified patients with a first hospital admission between 2016 and 2022, from a representative, highly diverse, catchment area of Northern Italy, using electronic health data of the NOMIAC study. We aimed at testing the impact of clinical care prior to admission on indicators of poor inpatient care, as identified by a participatory expert panel, that is, compulsory admission, insufficient length of stay, administration of Long-Acting Antipsychotics (LAI) during the last 7 days before discharge. Multiple regression models, predicted and counterfactual proportions and path analyses from generalized structural equations modeling were used to explore the association between belonging to ethnic minorities and these indicators. Among 1,524 participants, 18% were from minoritized ethnic groups. While these were more likely to experience an involuntary admission, regardless of previous care received, they were offered appropriate length of stay if had previous engagement with community mental health care. Both belonging to ethnic minorities and mental health care prior-to-admission were independently associated with early LAI administration. Several ethnic inequalities in inpatient care continue despite previous community mental health care provided. Future research should examine how these disparities translate into clinical outcomes. Nonetheless, there is the need to actively promote equity, improving the quality of inpatient care of minoritized ethnic groups.

Examining the impact of substance use on hospital length of stay in schizophrenia spectrum disorder: a retrospective analysis

BackgroundAmong patients diagnosed with schizophrenia, the presence of substance use poses an aggravating comorbidity, exerting a negative impact on the course of the disease, adherence to therapeutic regimens, treatment outcomes, duration of hospital stays, and the frequency of hospitalizations. The primary objective of the present study is to investigate the relationship between comorbid substance use disorders, antipsychotic treatment, and the length of stay in individuals hospitalized for treatment of schizophrenia.MethodsWe conducted a retrospective analysis of electronic health records spanning a 12-month period, specifically focusing on adult patients diagnosed with schizophrenia who were discharged from the University Hospital of Psychiatry Zurich between January and December 2019. We documented the number and types of diagnosed substance use disorder, the antipsychotic treatment, the length of stay, and the number of previous hospitalizations for each patient.ResultsOver a third (n = 328; 37.1%) of patients with schizophrenia had comorbid substance use with cannabis being the most frequent consumed substance. Patients with substance use (either single or multiple) were more frequently hospitalized; those with multiple substance use more frequently than those with a single substance use (F(2, 882) = 69.06; p < 0.001). There were no differences regarding the rate of compulsory admission. Patients with no substance use had a lower HoNOS score at discharge (F(2, 882) = 4.06). Patients with multiple substance use had a shorter length of stay (F(2, 882) = 9.22; p < 0.001), even after adjusting for duration of illness, previous hospitalizations, diagnosis, and antipsychotic treatment.ConclusionsIn patients with schizophrenia, comorbid single or multiple substance use has a relevant negative impact on treatment and thus on the course of disease. Substance use in patients with schizophrenia should therefore receive special attention in order to reduce re-hospitalization rates and improve the clinical outcome.

Effectiveness of a peer-supported crisis intervention to reduce the proportion of compulsory admissions in acute psychiatric crisis interventions in an outreach and outpatient setting: study protocol for an exploratory cluster randomised trial combined with qualitative methods

IntroductionCompulsory admissions are associated with feelings of fear, humiliation and powerlessness. The number of compulsory admissions in Germany and other high-income countries has increased in recent years. Peer support has...

Suicide-preventive compulsory admission is not a proportionate measure - time for clinicians to recognise the associated risks.

Suicide is considered a global public health issue and compulsory admission is a commonly used measure to prevent suicide. However, the practice has been criticised since several studies indicate that the measure lacks empirical support and may even increase suicide risk. This paper investigates whether the practice has enough empirical support to be considered proportionate. To that end, arguments supporting compulsory admission as a suicide-preventive measure for most suicidal patients are scrutinized. The ethical point of departure is that the expected benefits of compulsory admission should outweigh the potential harms of the measure to be proportionate and defensible. It is concluded that, for most suicidal patients, suicide-preventive compulsory admission cannot be presumed to be a proportionate measure. To be so, the expected medical benefits of the measure should be greater than the potential increase in suicide risk and other harms that compulsory admission could entail. Instead of using compulsory admission as a suicide-preventive measure, extra safety measures may be needed during and after compulsory admission to prevent the risk of hospitalisation-induced suicide.

‘I was going into it blind’: Nearest Relatives, legal literacy, and the Mental Health Act 1983

Eligible relatives are given rights and powers in the compulsory treatment of people with mental health problems in several international jurisdictions, including within England and Wales. However, little attention has been given to whether relatives feel legally literate or competent to fulfil such roles. This article examines this issue through focussing on the experiences of Nearest Relatives, who are given rights and powers during Mental Health Act 1983 (MHA) assessments for compulsory admission in England and Wales. Interviews with nineteen Nearest Relatives in England were conducted and were thematically analysed. Three themes were identified. First, NRs spoke about their awareness and knowledge of the role. They predominantly reported negative experiences in which they received no or little information. They also reported that professionals assumed they possessed legal knowledge, and their legal knowledge was largely self-taught. Secondly, NRs reported uncertainty about their own rights and powers, noting the role lacked status or informational or emotional support. Third, NRs highlighted areas for legal reform, stating that the NR role was important, but required specialist support systems for NRs. The findings of this study indicate greater attention needs to be given by law and policy makers to support relatives' understanding of their rights and powers under the MHA, if the NR role is to be effective in helping to safeguard patient rights under the European Convention on Human Rights. These include the right in Article 5 not to be arbitrarily deprived of one's liberty and the right to a private and family life in Article 8. Legislators also need to take account of these factors when considering proposals to reform mental health law in England and Wales.

Understanding social and clinical associations with unemployment for people with schizophrenia and bipolar disorders: large-scale health records study

PurposePeople with severe mental illness (SMI) experience high levels of unemployment. We aimed to better understand the associations between clinical, social, and demographic inequality indicators and unemployment.MethodsData were extracted from de-identified health records of people with SMI in contact with secondary mental health services in south London, UK. A Natural Language Processing text-mining application was applied to extract information on unemployment in the health records. Multivariable logistic regression was used to assess associations with unemployment, in people with SMI.ResultsRecords from 19,768 service users were used for analysis, 84.9% (n = 16,778) had experienced unemployment. In fully adjusted models, Black Caribbean and Black African service users were more likely to experience unemployment compared with White British service users (Black Caribbean: aOR 1.62, 95% CI 1.45–1.80; Black African: 1.32, 1.15–1.51). Although men were more likely to have experienced unemployment relative to women in unadjusted models (OR 1.36, 95% CI 1.26–1.47), differences were no longer apparent in the fully adjusted models (aOR 1.05, 95% CI 0.97–1.15). The presence of a non-affective (compared to affective) diagnosis (1.24, 1.13–1.35), comorbid substance use (2.02, 1.76–2.33), previous inpatient admissions (4.18, 3.71–4.70), longer inpatient stays (78 + days: 7.78, 6.34–9.54), and compulsory admissions (3.45, 3.04–3.92) were associated with unemployment, in fully adjusted models.ConclusionPeople with SMI experience high levels of unemployment, and we found that unemployment was associated with several clinical and social factors. Interventions to address low employment may need to also address these broader inequalities.

"The uncooperative nearest relative and admission under sections 2 and 3 of the Mental Health Act 1983".

Compulsory admission of patients to hospital for assessment and for treatment is governed by sections 2 and 3, respectively, of the Mental Health Act 1983. The nearest relative of a patient plays an important role in the admission of a patient under those two sections. The term, 'uncooperative nearest relative', is used to describe the nearest relative who objects unreasonably to the making of an application for treatment under section 3 of the Act. The uncooperative nearest relative and admission under sections 2 and 3 is a topic that has been treated in the literature but not to the same extent as this article does. This article aims to contribute to the literature by looking at not only the nearest relative and sections 2 and 3 of the Act generally but also at two problems concerning the uncooperative nearest relative that have been lurking in the background over the years and then proposing solutions for them.

Comparison of coercive practices in worldwide mental healthcare: overcoming difficulties resulting from variations in monitoring strategies.

Coercive or restrictive practices such as compulsory admission, involuntary medication, seclusion and restraint impinge on individual autonomy. International consensus mandates reduction or elimination of restrictive practices in mental healthcare. To achieve this requires knowledge of the extent of these practices. We determined rates of coercive practices and compared them across countries. We identified nine country- or region-wide data-sets of rates and durations of restrictive practices in Australia, England, Germany, Ireland, Japan, New Zealand, The Netherlands, the USA and Wales. We compared the data-sets with each other and with mental healthcare indicators in World Health Organization and Organisation for Economic Cooperation and Development reports. The types and definitions of reported coercive practices varied considerably. Reported rates were highly variable, poorly reported and tracked using a diverse array of measures. However, we were able to combine duration measures to examine numbers of restrictive practices per year per 100 000 population for each country. The rates and durations of seclusion and restraint differed by factors of more than 100 between countries, with Japan showing a particularly high number of restraints. We recommend a common set of international measures, so that finer comparisons within and between countries can be made, and monitoring of trends to see whether alternatives to restraint are successful. These measurements should include information about the total numbers, durations and rates of coercive measures. We urge the World Health Organization to include these measures in their Mental Health Atlas.

Revisiting the psychometric properties of the McArthur admission experience survey: Validating the Portuguese version using a bifactor approach

Cultural factors play a significant role in shaping the perception of coercion during psychiatric admissions. The present study aimed to assess the psychometric properties of the Portuguese Admission Experience Survey(P-AES).The study employed a cross-sectional approach in five psychiatric departments in three regions of Portugal. A total of 208 patients participated in the survey. Reliability was assessed through internal consistency and test-retest procedures. Internal validity was analyzed using a two-parameter logistic item response model, exploring three models, including a bifactor model. Convergent validity was determined by correlating AES scores with the Coercion Ladder (CL), Client Assessment of Satisfaction (CAT), and Global Assessment of Functioning (GAF) scale. Discriminatory power was assessed by comparing scores between patients with voluntary and involuntary admission status.The P-AES demonstrated satisfactory internal consistency and test-retest reliability. The bifactor model exhibited superior fit compared to the one-factor and three-factor models. Correlations between P-AES and CL, as well as CAT scores, indicated good convergent validity. Additionally, P-AES scores were notably higher in patients with compulsory psychiatric hospital admission compared to those admitted voluntarily, confirming its discriminatory power.The bifactor model suggests that all three domains of the AES should be used to measure the subjective experience of coercion.

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Protecting the Autonomy of Patients with Severe Mental Illness Through Psychiatric Advance Directive Peer-Facilitation

Insights and risk factors of involuntary hospitalizations through a retrospective analysis of police records: differences between involuntarily and non-hospitalized patients

Involuntary psychiatric admission poses a challenge in terms of providing the most effective yet least restrictive care in accordance with each country's regulations. Effective communication and coordination between the justice, police, and healthcare systems are essential for the successful implementation of this process. This study examines the sociodemographic, clinical, and parametric factors involved in the status of involuntary admission. A retrospective analysis of 292 cases grounded in the Hellenic Police records was conducted to indicate differences between involuntarily and non-hospitalized patients as well as risk and protective factors for the status of compulsory admission in psychiatric units located in Athens, Greece. Out of a total of 292 cases, 240 (77.4%) concerned involuntarily hospitalized patients, compared to 52 (16.8%) non-hospitalized. The most prevalent diagnosis among involuntarily hospitalized patients was schizophrenia, schizotypal, and delusional disorders (53.5%), in contrast to non-hospitalized patients, for whom it was affective disorders (33.3%). Affective disorders, along with neurotic, stress-related, and somatoform disorders, were found to offer a protective factor against involuntary hospitalizations. Our findings indicate that involuntary hospitalizations are associated with procedural downsides, detrimentally affecting mental health treatment recipients. Therefore, community-based compulsory therapeutic interventions should be incorporated into the mental health agenda of Greece.

Advance Statements for Black African and Caribbean people (AdStAC): protocol for an implementation study

BackgroundThe UK government committed to legislating for Advance Choice Documents/Advance Statements (ACD/AS) following their recommendation by the Independent Review of the MHA (2018). ACDs/AS are yet to be implemented in routine practice despite evidence and high demand; they are associated with improved therapeutic relationships and a reduction (25%, RR 0.75, CI 0.61–0.93) in compulsory psychiatric admission. Barriers to their implementation are well documented, ranging from low knowledge levels to logistical challenges in accessing the content during episodes of acute care. In the UK this is an issue for Black people, who experience detention rates disproportionately (over three times) higher than those of White British people and have poorer care experiences and outcomes. ACDs/AS allow for Black people to have their concerns heard by mental health professionals in a care system where they often feel their views are ignored. AdStAC aims to improve Black service users’ experiences in mental health services in South London by co-producing and testing an ACD/AS implementation resource with Black service users, mental health professionals and carers/supporters of Black service users.Methods/designThe study will take place in South London, England over three phases: 1) formative work through stakeholder workshops; 2) co-production of resources through a consensus development exercise and working groups; and 3) testing of the resources using quality improvement (QI) methods. A lived experience advisory group, staff advisory group and project steering committee will support the study throughout. The implementation resources will comprise: advance choice document/advance statement (ACD/AS) documentation, stakeholder trainings, a manual for mental health professionals to facilitate the processes of creating and revising advance statements, and informatics development.DiscussionThe implementation resources will help increase the likelihood of the new mental health legislation in England being implemented effectively; through aligning evidence-based medicine, policy and law to effectively provide positive clinical, social and financial outcomes for Black people, the National Health Service (NHS) and wider society. This study will likely benefit a wider group of people with severe mental illness, as when marginalised groups who are least engaged, can be supported with these strategies, then the strategies are likely to work for others.

Relationship between antipsychotic medication and aggressive events in patients with a psychotic disorder hospitalized for treatment

BackgroundDisruptive and aggressive behavior is frequent in patients with a psychotic disorder; furthermore, it is a recurrent reason for compulsory admission. Even during treatment, many patients continue to show aggressive behavior. Antipsychotic medication is posed to have anti-aggressive properties; its prescription is a common strategy for the treatment (and prevention) of violent behavior. The present study aims to investigate the relation between the antipsychotic class, according to the dopamine D2-Receptor binding affinity (i.e., “loose” – “tight binding”), and aggressive events perpetrated by hospitalized patients with a psychotic disorder.MethodsWe conducted a four-year retrospective analysis of legally liable aggressive incidents perpetrated by patients during hospitalization. We extracted patients’ basic demographic and clinical data from electronic health records. We used the Staff Observation Aggression Scale (SOAS-R) to grade the severity of an event. Differences between patients with a “loose” or “tight-binding” antipsychotic were analyzed.ResultsIn the observation period, there were 17,901 direct admissions; and 61 severe aggressive events (an incidence of 0.85 for every 1,000 admissions year). Patients with a psychotic disorder perpetrated 51 events (incidence of 2.90 for every 1,000 admission year), with an OR of 15.85 (CI: 8.04–31.25) compared to non-psychotic patients. We could identify 46 events conducted by patients with a psychotic disorder under medication. The mean SOAS-R total score was 17.02 (2.74). The majority of victims in the “loose-binding” group were staff members (73.1%, n = 19), while the majority of victims in the “tight-binding” group were fellow patients (65.0%, n = 13); (X2(3,46) = 19.687; p < 0.001). There were no demographic or clinical differences between the groups and no differences regarding dose equivalents or other prescribed medication.ConclusionsIn aggressive behaviors conducted by patients with a psychotic disorder under antipsychotic medication, the dopamine D2-Receptor affinity seems to have a high impact on the target of aggression. However, more studies are needed to investigate the anti-aggressive effects of individual antipsychotic agents.

Psychiatric ward admissions during the COVID-19 pandemic in Canton of Ticino (Swiss Confederation) and the province of Como (Italy): a comparison between two different systems of care and outbreak response strategies

The aim of the study was to estimate the effect of the COVID- 19 pandemic and response policies on the psychiatric ward admissions in the hospitals referring to the ASST Lariana (province of Como, Italy) and the Hospital of Mendrisio (Canton of Ticino, Switzerland), two similar territories that belong to countries that dealt differently with the pandemic. We compared the two territories for type of admission (voluntary vs. compulsory), the Stringency Index (SI) and the country’s number of admission in Intensive Care Units (ICU). We found a significant reduction in the psychiatric ward admission in the lockdown period in both territories, even in periods with milder lockdown measures. The admission rate’s reduction in the ASST Lariana was significantly associated with the ICU admissions (p&lt;0.001). In the Hospital of Mendrisio, admissions included a weekly seasonality, were significantly correlated with SI (p=0.001) and period (pre-pandemic and pandemic; p&lt;0.001) and we observed also a significant reduction of compulsory admission that is influenced both by the stringency index (p&lt;0.001) and period (p&lt;0.001). The differences between the two territories seem influenced by the different mental health systems.

Psychiatric Admission Among Migrants Before and During Pandemic: a Retrospective Study in Acute Psychiatric Ward in Bologna, Italy.

Previous evidence showed significant discrepancies in psychiatric services utilization between migrants and reference populations. Our study aims were to evaluate incidence and characteristics of psychiatric hospitalizations of migrant patients compared with reference populations and to assess how the COVID-19 pandemic affected admissions. All patients admitted to the psychiatric ward "SPDC-Malpighi" of the Bologna Mental Health Department from 01/01/2018 to 31/12/2020 were included. Differences in sociodemographic and clinical characteristics were tested by migrant status. Incidence rate ratios of hospital admissions by migrant status were estimated via Poisson regression considering population-at-risk, gender, and age-group. Migrants had higher hospitalization rates due to any psychiatric disorder (IRR = 1.16). The risk was especially pronounced among women (IRR = 1.25) and within the youngest age-group (IRR = 3.24). Young migrants had also a greater risk of compulsory admission (IRR = 3.77). Regarding admissions due to a specific diagnosis, we found relevant differences in hospitalization rates for psychosis, mood disorders, and personality disorders. Finally, migrants were more likely to be admitted via Emergency Department and less likely to be referred from a specialist. During the year of pandemic (2020) we observed an increase in the proportion of migrants admitted voluntarily or compulsorily. Migrants, especially those from the youngest age-group, had higher hospitalization rates for any disorder. Younger migrants were also at higher risk of compulsory treatment. The distribution of psychiatric admissions during the pandemic period seemed to have further increased discrepancies in mental healthcare needs and provision between migrants and the reference population. Tailored interventions and policies are urgently needed to address this issue.

Involuntary Admission From the Perspective of RNs and Nursing Assistants at a Mental Health Facility.

The current qualitative research study was performed in a psychiatric hospital in São Paulo, Brazil. The study aimed to identify RNs' and nursing assistants' (NAs) (N = 21) knowledge regarding different types of admission to psychiatric hospitals established by Brazilian legislation. Data were collected through semi-structured interviews and analyzed through content analysis resulting in the following theme: Gaps in the Knowledge of RNs and NAs Regarding the Rules for Admission; and five subthemes: voluntary admission and the requirement of having a responsible person during admission; involuntary admission occurring when the family is the one to hospitalize the patient; involuntary admission is the same as compulsory admission; is there involuntary admission?; and the role of the public attorney in involuntary admissions. Results showed deficits in knowledge about the different types of admissions to psychiatric hospitals. Therefore, policies to promote awareness of the legal framework concerning psychiatric treatment should be developed to enable mental health nurses to support patients' autonomy during involuntary admissions. [Journal of Psychosocial Nursing and Mental Health Services, 61(8), 42-50.].

Compulsory admission: are there differences between migrants and natives? Data from a psychiatric emergency service of an Italian metropolitan area

BackgroundAs compared to natives, higher rates of involuntary admission were found among migrants in most European countries. A possible strategy to reduce this phenomenon is to develop preventive strategies targeting risk and protective factors of compulsory admission specific to the migrant population. AimsThe first aim of the present study was to evaluate compulsory admission rates in the migrant population as compared to natives admitted for an acute mental disorder. The second aim was investigate whether sociodemographic, clinical, and care-related variables associated with compulsory admission differed between migrants and natives. Moreover, in the whole sample we assessed whether migrant status affected the risk of compulsory admission. MethodsRetrospective single-center study on patients hospitalized in the period between January 1, 2018 and December 31, 2020 in a large metropolitan academic hospital. We compared sociodemographic, clinical, and care-related variables between migrants and natives, voluntary or compulsory admitted. We investigated the association between compulsory admission and the variables collected in the whole sample and in the migrants' and natives’ groups with a correlation analysis followed by hierarchical logistic regression models. ResultsThe sample included 185 migrant patients and 933 native patients. The prevalence of compulsory admission was significantly higher in the migrants' group. Male gender, lower education, non-comprehension of the local language, a diagnosis of a schizophrenia spectrum disorder, and aggressive behavior were associated with compulsory admission in the migrants’ sample, partially differing from the natives. ConclusionOur study highlighted how migrant status is associated with a higher risk for compulsory admission. Inclusion policies or the presence of cultural mediators in emergency settings might be preventive strategies in this context.

Full-time hospitalization in child and adolescent psychiatry: an overlook of the Tunisian situation

IntroductionAdmissions in a child psychiatry unit can be voluntary or unvoluntary in some cases when the patient meets specific criteria.ObjectivesThe aim of our study was to assess the frequency and trend over time of admissions of minors in the child psychiatry department in Razi Hospital between 2011 and 2019, and to examine the psychiatric diagnoses in involuntary admissions of minors.MethodsWe conducted a retrospective study of medical records of inpatients admitted to the hospitalization unit of the child psychiatry department in Razi Hospital in Tunisia between 2011 and 2019.ResultsOver the nine years, the total number of hospitalizations was 924. There is a slight female predominance over the total number of hospitalizations (sex ratio = 0.85). There was no consistent and significant change in the number of hospitalizations between 2011 and 2019. A growing increase in the number of compulsory hospitalizations was noted. From 2011 to 2019, the number of compulsory admissions increased from 03 in 2011 to 22 in 2019.Regarding compulsory hospitalizations, admission requests came from child protection delegates, public prosecutors or family judges. Conduct disorder was found in 33.3% of the cases followed by a normal psychiatric examination in 11.8% of the cases. Mood disorders were found in 9.8% of the cases.ConclusionsOur study shows the explosion in the number of compulsory hospitalizations despite a relatively stable total number of hospitalizations. More comprehensive guidance for legal authorities is needed regarding the compulsory admission of minors.Disclosure of InterestNone Declared

Compulsory hospitalization in child psychiatry: clinical and sociodemographic profile of Tunisian inpatients

IntroductionThe department of child psychiatry in Razi Hospital is the unique psychiatric unit in Northern Tunisia offering full-time hospitalization for minors with mental health disorders.ObjectivesThe aim of our study was to explore the clinical and therapeutic characteristics in compulsory admissions of minors in the department of child psychiatry in Razi hospital between 2011 and 2019.MethodsWe conducted a retrospective study of medical records of inpatients admitted to the hospitalization unit of the child psychiatry department in Razi Hospital in Tunisia between 2011 and 2019.ResultsOver the nine years, the total number of compulsory admissions was 74 inpatients, aged from 11 to 16 years old. The number of compulsory admissions increased from 03 in 2011 to 22 in 2019. Most of the inpatients were boys (sex ration=1.46). The mean age was 14, 1 year old. Heteroagressiveness was the reason for admission in half of the cases followed by risk behaviors (30.1%) and suicidal behaviors (18.6%). The diagnosis of conduct disorder was found in 33.3% of the cases followed by a normal psychiatric examination in 11.8% of the cases. Mood disorders were found in 9.8% of the cases. Parental psychoeducation (100%), individual psychotherapy (91%) and family therapy (88,2%) were the treatment of choice for the inpatients. The prevalence of psychiatric medication was 45.1%. The most important forms of medication used were neuroleptics (42.3% of medicated patients) and mood stabilizers (30.7%). Child protection delegates were involved in 86,4% of the cases for social intervention.ConclusionsMinors admitted in an involuntary mode to psychiatric unit have their own specifities in terms of clinical and therapeutic characteristics. More theoretical and empirical research is needed regarding the involuntary admission of minors.Disclosure of InterestNone Declared