Involuntary Psychiatric Research Articles

Involuntary Psychiatric Hospital Admissions According to Public Law - A Retrospective Analysis

We provide an empirical survey of the current practice on involuntary psychiatric hospital admission. Bases on clinical case records, we performed a retrospective analysis of 346 cases with an involuntary hospital admission according to public law in 2020 (21.0% of all inpatient admissions in this period). Announcement of suicide was the most frequent cause for involuntary hospital admission (45.1%). Most common diagnoses were substance-related disorders (30.1%), stress-related disorders (19.9%), and schizophrenic psychoses (18.8%). Only 12.7% of the involuntary admissions resulted in a further involuntary hospitalization, whereas 44.5% of all episodes were followed by a discharge within 24 hours. In many cases, involuntary hospital admissions are reactions to suicidal crises. It will be interesting to see, if the introduction of alternative low-threshold services can help to reduce the frequency of such admissions.

98 EMS Utilization Among Patients on Involuntary Psychiatric Holds in Alameda County, April 2014-2016

98 EMS Utilization Among Patients on Involuntary Psychiatric Holds in Alameda County, April 2014-2016

Power and Society in the GDR Reconsidered: Involuntary Psychiatric Commitment, 1949–1963

AbstractThis article focuses on compulsory psychiatric admissions in the early German Democratic Republic (GDR). Until 1968 there were no East German laws regulating such hospitalizations, a regulatory vaccuum filled by neither the police nor the judicial system. Instead, families made decisions in conjunction with medical personnel about sometimes unlimited stays in psychiatric institutions and clinics—a practice that calls into question popular scholarly characterizations of the relationship between state and society in the GDR. Previous research has explicitly argued that GDR citizens had agency and acted in a so-called eigensinnige manner in many areas, but has not examined this issue with regard to the sensitive practice of forced psychiatric admissions: where there was no state interest, no Eigensinn vis-à-vis authorities was necessary. This was an especially curious constellation given that psychiatric institutions were run by the East German state and that state interventions in this area had been well established under the Third Reich, as well as in the Soviet Union, which served in many areas as a model for the GDR. One might well have expected that continuing state intervention would have thus been path-dependent. This article suggests resurrecting the term Vergesellschaftung (socialization), only shortly discussed in the 1990s, as a way in which to understand the way in which agency on the part of patient families compensated for the absence of formal state regulations regarding such admissions. The term nicely captures such routine forms of compensation by East German society in areas where the state abdicated its responsibility—as was the case in the early GDR when it came to forced psychiatric hospitalizations.

Committed: The Battle Over Involuntary Psychiatric Care Miller Dinah and Johns Annette Hanson Committed: The Battle Over Involuntary Psychiatric Care 328pp US£22.95/£15.99 Hopkins University Press 9781421420783 1421420783 hardback edition

Committed: The Battle Over Involuntary Psychiatric Care Miller Dinah and Johns Annette Hanson Committed: The Battle Over Involuntary Psychiatric Care 328pp US£22.95/£15.99 Hopkins University Press 9781421420783 1421420783 hardback edition

A Review of Treatment Failures Presented inCommitted: The Battle Over Involuntary Psychiatric Care

Committed: The Battle Over Involuntary Psychiatric Careexplores the complex battle over involuntary hospitalization for mental illness. This article aims to explore the flaws of involuntary commitment as the authors presented in their book and seeks to foster a discussion that will improve the lives of the mentally ill. This discussion includes the negative experiences of patients, some of the legal issues surrounding involuntary care, and some issues with the process of commitment that were presented in the book.

Factors Affecting the Agreement Between Emergency Psychiatrists and General Practitioners Regarding Involuntary Psychiatric Hospitalizations.

Important discrepancies exist between physicians in deciding when to perform involuntary hospitalization measures (IHMs). The factors underlying these differences are poorly known.We conducted a two-year single-center retrospective study in France on patients who were referred to the emergency department (ED) with an IHM certificate written by a private-practice General Practitioner (GP). For each consultation, the official IHM motive was categorized into four groups: Suicide; Psychosis, Mania, or Melancholia (PMM); Agitation; and Other. The alcohol status of the patient was also noted. The factors underlying the ED psychiatrists’ confirmation of the use of IHMs were determined using a logistic regression model. One hundred eighty-nine cases were found (165 patients; 44.2 ± 16 years, 41.3% women). The ED psychiatrists confirmed the use of IHMs in 123 instances (65.1% agreement rate). Multivariate analyses found that IHM disagreement was significantly associated with patient alcohol status and the reason for referral. Specifically, there was an increased risk of IHM disagreement when the patient had an alcohol-positive status (OR = 15.80; 95% CI [6.45–38.67]; p < 0.0001) and when the motive for IHM was “agitation” compared with “suicide” (OR = 11.44; 95% CI[3.38–38.78]; p < 0.0001). These findings reflect significant disparities between GPs and ED psychiatrists regarding the decision to proceed to an IHM.

Family Caregivers' Experiences of Involuntary Psychiatric Hospital Admissions of Their Relatives – a Qualitative Study

BackgroundFamily caregivers of people with mental disorders are frequently involved in involuntary hospital admissions of their relatives.ObjectiveTo explore family caregivers' experience of involuntary admission of their relative.Method30 in-depth interviews were conducted with family caregivers of 29 patients who had been involuntarily admitted to 12 hospitals across England. Interviews were analysed using thematic analysis.ResultsFour major themes of experiences were identified: relief and conflicting emotions in response to the relative's admission; frustration with a delay in getting help; being given the burden of care by services; and difficulties with confidentiality.Relief was a predominant emotion as a response to the relative's admission and it was accompanied by feelings of guilt and worry. Family caregivers frequently experienced difficulties in obtaining help from services prior to involuntary admission and some thought that services responded to crises rather than prevented them. Family caregivers experienced increased burden when services shifted the responsibility of caring for their mentally unwell relatives to them. Confidentiality was a delicate issue with family caregivers wanting more information and a say in decisions when they were responsible for aftercare, and being concerned about confidentiality of information they provided to services.ConclusionCompulsory admission of a close relative can be a complex and stressful experience for family caregivers. In order for caregivers to be effective partners in care, a balance needs to be struck between valuing their involvement in providing care for a patient and not overburdening them.

Reassessing the High Proportion of Involuntary Psychiatric Hospital Admissions in South Korea

The 2007 WHO-AIMS report on the mental health system of South Korea documented progress towards a national mental health plan, protection of human rights, and growth of community based services. Yet concern was expressed that the high proportion of involuntary to total psychiatric hospitalizations (92%) may indicate an excessively coercive system. Involuntary hospitalization in Korea rose from 117 to 132 (per 100,000) between 2000 and 2006. In 2000, the median rate in the European Union (EU) was 74 per 100,000 (Range: 6-218). While Korea's involuntary hospitalization rate is within the EU range, its proportion of involuntary hospitalizations is three times that of the highest EU country (30%, Sweden). Underdevelopment of voluntary psychiatric services and culturally mandated family referrals resulting in involuntary hospitalization are apparent reasons for the high proportion of involuntary hospitalizations. Population-based rates per 100,000 more accurately describe involuntary hospitalization than the proportion (ratio) measure used in the WHO-AIMS reports.

Strategies Nurses Use to Overcome Medication Refusal by Involuntary Psychiatric Patients

Nurses seem to play an important role in assisting involuntarily hospitalized psychiatric patients to accept medication. The initial aim of this study was to develop a theoretical understanding of strategies nurses use to overcome medication non-acceptance in involuntary psychiatric patients using a grounded theory approach. Interviews (n = 17) were conducted with psychiatric nurses in inpatient settings. Data analysis using the constant comparative method and validation by nursing literature identified four key themes: Engagement, formulating a therapeutic relationship, finding out why, and persistently trying everything. These themes were frequently encountered in descriptions of getting patients to take medications. The findings indicate that psychiatric nurses use varied and individualized techniques to convince involuntary patients to take their medications.

Short Term Involuntary Psychiatric Examination of Children in Florida

This study describes the use of emergency mental health services by children over a 4-year period. Analysis of a statewide database revealed 51,861 or 15% of all involuntary examinations were conducted on children. These youth were on average a little over 14 years of age and law enforcement officials initiated the majority of examinations. The majority of examinations were initiated due to the children demonstrating harmful behaviors to themselves or others. One-fifth of the children (21%) experienced more than one examination over the 4-year period. Areas of future research on this topic are discussed. The implications of the nature of examinations and patterns of repeated examinations are discussed.

Emergency involuntary psychiatric examinations in Florida.

The authors used statewide data from 2000 on 80,869 examination initiations to determine characteristics of emergency involuntary psychiatric examinations in Florida and the individuals subject to them. Information about the evidence indicated on the initiation forms and the types of professionals who initiated the examinations is presented. These data allow not only description of involuntary examinations and the characteristics of those subject to them for an entire state, but also investigation of the involvement of these individuals with certain services, such as mental health services, and systems, such as the criminal justice system.

Use of an Apprehended Violence Order to Avoid Involuntary Psychiatric Hospitalisation

Use of an Apprehended Violence Order to Avoid Involuntary Psychiatric Hospitalisation

Use of an Apprehended Violence Order to Avoid Involuntary Psychiatric Hospitalisation

Objective: To describe a patient with a delusional disorder who utilised the provisions of an apprehended violence order (AVO) to avoid involuntary hospitalisation under the 1990 NSW Mental Health Act. Method: Case Report. Results: The patient had a well-circumscribed paranoid delusional system involving multiple individuals in a regional centre. The patient made accusations of paedophilia, harassment, assault, bribery and corruption against numerous politicians, a local shopkeeper and several members of the community psychiatry team. The patient applied for an AVO against the Team Leader of the community psychiatry team and team staff to evade execution of a Section 27 Order of the 1990 NSW Mental Health Act, and to block any evaluation of his mental state by the community psychiatry team or others. The patient eventually withdrew the complaint. However, the Area Health Service bore all costs, which were substantial both in time for staff members and in monetary terms. Conclusions: Any patient can attempt to prevent the enactment of the NSW 1990 Mental Health Act by using another legal manoeuvre such as an AVO. Such an action may have major implications for the operation of a community psychiatry team in relation to its functioning, the effect on staff and costs in terms of money and time.

A study of medication refusal by involuntary psychiatric patients.

The authors evaluated 31 patients consecutively admitted to a locked acute treatment unit in California to determine the severity of their symptomatology, their attitudes toward treatment, and whether they would refuse medication if they had the opportunity (patients in California do not have the right to refuse). Fifteen patients indicated that they would refuse medication if given the opportunity. Although they did not differ in diagnosis from the other patients, they showed evidence of more severe psychosis and higher mood elevation and had less positive attitudes toward treatment. Two-week follow-up of 12 patients in the refuser group showed that they were less likely to refuse drugs and were clinically improved; however, six of the patients still preferred to refuse medication despite their clinical improvement. The authors discuss their findings in the context of the broader issue of when a mentally ill person should be forced to give up the power to make decisions about drug treatment.

A Case Study in Involuntary Psychiatric Confinement

Louis Riel was confined against his will in insane asylums from March 6, 1876 to January 23, 1878. Psychiatrists and historians have generally interpreted his certification as an act of benevolence to Riel at a time when he was non compos mentis. However, detailed study of surviving records and manuscript sources shows that the commitment was legally suspect in a number of ways: proper signatures were lacking, pseudonyms were used, records were falsified, and so on. Moreover, while Riel was clearly a religious enthusiast with eccentric ideas, there was no proof that he was dangerous to himself or others at this time. We may thus wish to revise our interpretation of Riel's certification. It was not an act of benevolence but an illegal and unjustifiable deprivation of liberty.