Factors associated with involuntary hospitalisation for psychiatric patients in Switzerland: a retrospective study.

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Serval ID
serval:BIB_1281CE85D3A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Factors associated with involuntary hospitalisation for psychiatric patients in Switzerland: a retrospective study.
Journal
BMC psychiatry
Author(s)
Silva B., Golay P., Morandi S.
ISSN
1471-244X (Electronic)
ISSN-L
1471-244X
Publication state
Published
Issued date
29/12/2018
Peer-reviewed
Oui
Volume
18
Number
1
Pages
401
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Despite the scarce evidence for patients' benefits of coercion and its well-documented negative effects, the use of compulsion is still very common around Europe, with important variations among different countries. These variations have been partially explained by the different legal frameworks, but also by several individual-related, system-related and area-related characteristics, identified as predictors of the use of coercive measures. This study aimed to compare the socio-demographic and clinical profile as well as the referral and hospitalisation process of people voluntarily and involuntarily hospitalized in order to identify which factors could be associated with the use of coercion.
All psychiatric admissions occurred between the 1st January 2015 and the 31st December 2015 were included in this retrospective study (n = 5027). The whole sample was split into two subgroups accordingly to the hospitalisation legal status at admission (voluntary vs involuntary) and differences between the two groups were examined. In order to identify the factors associated with coercion, all the variables reaching a p < .01 level of significance when comparing the two groups were included as independent variables into a multivariate logistic regression model.
Globally, 62% of the admissions were voluntary and 38% were involuntary. Compared to the voluntary group, involuntary patients were significantly older, more frequently widowed and living in one specific district, and had a main diagnosis of schizophrenia (F20-F29) or organic mental disorders (F00-F09). People affected by organic mental disorders (F00-F09), with higher levels of psychotic symptoms, aggression and problems with medication adherence, were more likely to be involuntarily admitted. Moreover, living in District 1, being referred by a general practitioner, a general hospital or a psychiatric hospital and being involuntarily admitted during the previous 12 months, was associated with a higher risk of coercion.
This study identified several individual-related, as well as system-related factors associated with the use of coercion. These results allowed us to trace a clearer profile of high-risk patients and to provide several inputs that could help local authorities, professionals and researchers to develop better-targeted alternative interventions reducing the use of coercion.
Keywords
Adult, Coercion, Commitment of Mentally Ill/legislation & jurisprudence, Female, Hospitals, Psychiatric/statistics & numerical data, Humans, Involuntary Treatment/methods, Involuntary Treatment/statistics & numerical data, Male, Mental Disorders/epidemiology, Mental Disorders/therapy, Middle Aged, Retrospective Studies, Risk Assessment, Risk Factors, Switzerland/epidemiology, Inpatient, Psychiatry, Risk factors
Pubmed
Web of science
Open Access
Yes
Create date
28/11/2018 16:42
Last modification date
19/11/2019 12:01
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