Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH)

2015 ◽  
Vol 34 (1) ◽  
pp. 13-18
Author(s):  
B. Masood ◽  
S. O’Ceallaigh ◽  
T. Thekiso ◽  
M. Nichol ◽  
P. Kowalska-Beda ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Involuntary Admission ◽  
Clinical Predictors ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
Admission Status ◽  
Act Assessment

BackgroundFew studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained.AimsThis study aimed to describe all involuntary admissions to St Patrick’s University Hospital (SPUH) (2011–2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.MethodsAll uses of Mental Health Act 2001 within SPUH 2011–2013 were identified. All uses of Section 23(1) during 2011 were reviewed and relevant documents/case-notes examined using a pro forma covering clinical data, factors recognized to influence involuntary admissions and validated scales were used to determine diagnoses, insight, suicide and violence risk.ResultsOver 2011–2013, 2.5–3.8% of all admissions were involuntary with more detained after use of Section 23(1) than Section 14(2). The majority of initiations of Section 23(1) did not result in an involuntary admission (72%), occurred out of hours (52%) and many occurred early after admission (<1 week, 43%). Initiation of Section 23(1) by a consultant psychiatrist (p=0.001), suicide risk (p=0.03) and lack of patient insight into treatment (p=0.007) predicted conversion to involuntary admission.ConclusionThis study predicts a role for patient insight, suicide risk and consultant psychiatrist decision making in the initiation of Mental Health Act assessment of voluntary patients. Further data describing the involuntary admissions process in an Irish setting are needed.

The Use of Section 136 of the Mental Health Act 1983 in a Family of Rural English Police Forces

2003 ◽  
Vol 43 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Neil Greenberg ◽  
Niki Haines
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Police Officers ◽  
Hospital Admissions ◽  
Rural Setting ◽  
Mental Health Act ◽  
The Mean ◽  
Act Assessment ◽  
Police Forces

Section 136 of the Mental Health Act 1983 is used by police officers to detain persons who they feel might be suffering with mental disorder until a formal Mental Health Act assessment can be undertaken. Previous studies have shown that the outcomes of these assessments result in remarkably different rates of subsequent hospital admissions. Within a rural setting it has also been shown that the rate of use of Section 136 varies considerably. This study examines the use of Section 136 within a family of eight police forces that have been matched to ensure that they cover similar populations. The results show that there are considerable variations in the use of Section 136, with the Devon and Cornwall region using the section over two and a half times the mean for the group. Possible reasons for this discrepancy are discussed.

Assessment of Suicide Risk

1987 ◽  
Vol 150 (2) ◽  
pp. 145-153 ◽  
Author(s):  
K. Hawton
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Suicide Risk ◽  
Clinical Skills ◽  
Clinical Decisions ◽  
Suicide Attempters ◽  
Mental Health Act ◽  
Hospitalised Patients ◽  
The Many

Among the many clinical skills that psychiatrists must acquire, the ability to assess the risk of patients killing themselves is probably the most important and demanding. It is often a crucial factor when making clinical decisions, such as in the choice of treatments, when deciding whether admission to a psychiatric hospital is necessary and when implementing the Mental Health Act. This review first explores the problems in assessing suicide risk. Subsequently, the risks of suicide for patients with major psychiatric disorders and for particular clinical populations, including hospitalised patients and suicide attempters, are examined together with the findings from research investigations which can assist psychiatrists when making decisions about the risk of suicide.

scholarly journals Suicide in mental health in-patients and within 3 months of discharge

2006 ◽  
Vol 188 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Janet Meehan ◽  
Navneet Kapur ◽  
Isabelle M. Hunt ◽  
Pauline Turnbull ◽  
Jo Robinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
Patient Admission ◽  
Post Discharge ◽  
The Social ◽  
Risk Patients ◽  
Clinical Survey ◽  
Service Priority

BackgroundSuicide prevention is a health service priority. Suicide risk may be greatest during psychiatric in-patient admission and following discharge.AimsTo describe the social and clinical characteristics of a comprehensive sample of in-patient and post-discharge cases of suicide.MethodA national clinical survey based on a 4-year (1996–2000) sample of cases of suicide in England and Wales who had been in recent contact with mental health services (n=4859).ResultsThere were 754 (16%) current in-patients and a further 1100 (23%) had been discharged from psychiatric in-patient care less than 3 months before death. Nearly a quarter of the in-patient deaths occurred within the first 7 days of admission; 236 (31%) occurred on the ward, the majority by hanging. Post-discharge suicide was most frequent in the first 2 weeks after leaving hospital; the highest number occurred on the first day.ConclusionsSuicide might be prevented among in-patients by improving ward design and removing fixtures that can be used in hanging. Prevention of suicide after discharge requires early community follow-up and closer supervision of high-risk patients.

The development of the role in Ireland of the Authorised Officer (Section 9:1b Mental Health Act 2001) applicant for the involuntary admission to approved centres of persons suffering from mental disorders

2015 ◽  
Vol 32 (4) ◽  
pp. 353-358 ◽  
Author(s):  
F. J. Browne
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Involuntary Admission ◽  
Health Service Executive ◽  
Mental Health Act

This article outlines the development of the role of the Health Service Executive Authorised Officer in Ireland, the professional applicant for the involuntary admission of an adult to hospital beyond that which was envisioned in the Mental Health Act 2001.

scholarly journals Mental Health Act: Alleged unlawful detention

1987 ◽  
Vol 11 (7) ◽  
pp. 226-227
Author(s):  
Carmel O'Donovan
Keyword(s):  
Mental Health ◽  
Aggressive Behaviour ◽  
The Other ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
At Home

On several occasions in 1979 a GP member was consulted by the father and brother of a young man because they were concerned about his violent and aggressive behaviour. The GP arranged for a consultant psychiatrist to visit the patient at home on three occasions, although once he was not in and on the other two refused to see the psychiatrist and threatened him with violence.

A structured process for reviewing the operation of the Mental Health Act 2001 in an Irish mental health service

2013 ◽  
Vol 30 (2) ◽  
pp. 131-134
Author(s):  
M. Mulligan ◽  
T. Maher ◽  
J. V. Lucey
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Clinical Governance ◽  
University Hospital ◽  
Mental Health Act ◽  
Monitoring Tools ◽  
Monitoring Process ◽  
Governance Committee ◽  
Key Events

This paper provides a description of a structured template which allows review of the operation of the Mental Health Act 2001 at St Patrick's Mental Health Services (incorporating St Patrick's University Hospital, St Edmundsbury Hospital and Willow Grove Adolescent Unit). These structured processes were implemented to ensure rigorous monitoring of all clinical governance activities associated with adherence to the Mental Health Act (MHA) 2001. The paper describes in detail the information contained in the St Patrick's Mental Health Services dashboard for 2012. The dashboard displays the key performance indicators that are monitored and the paper describes how these were reviewed by the Hospital's Clinical Governance Committee on a weekly basis for the three approved centres. The dashboard has also been used by the Clinical Governance Committee to provide ongoing education and engagement with staff in order to improve the operation of the MHA 2001. The use of this structured monitoring process has allowed the hospital to measure adherence to the MHA 2001 and also to measure activities that impact directly on the care and treatment of patients detained under the Act. The use of structured monitoring tools (i.e. the dashboard) to review the operation of the MHA 2001 allows for coherent observation of key events and issues which can cause concern in terms of the operation of the Act.

Examining Clinical Predictors of Change in Recreational Preference Congruence Among Nursing Home Residents Over Time

2015 ◽  
Vol 36 (11) ◽  
pp. 1351-1369 ◽  
Author(s):  
Allison R. Heid ◽  
Kimberly Van Haitsma ◽  
Morton Kleban ◽  
Michael J. Rovine ◽  
Katherine M. Abbott
Keyword(s):  
Mental Health ◽  
Language Comprehension ◽  
Neurological Disorders ◽  
Clinical Characteristics ◽  
Functional Limitations ◽  
Nursing Home Residents ◽  
Mixed Effects ◽  
Regression Analyses ◽  
Clinical Predictors ◽  
Over Time

Objective: There remains a significant gap in the field regarding the measurement of preference-based care over time in nursing homes (NHs). This study discusses the use of a quality indicator that tracks recreational preference congruence (PC; that is, the match between NH residents’ important preferences in recreational activities and their weekly attendance in these preferred activities). Method: Using a sample of 199 older adults, we examine the change in PC over 52 weeks using multilevel-mixed effects regression analyses. Results: PC over time is highly variable and residents with greater functional limitations (vision, language comprehension, incontinence) and no diagnoses of mental health or neurological disorders have lower PC over time. Discussion: Certain clinical characteristics have greater impact on resident PC over time. Particular attention needs to be given to the recreational attendance of residents with incontinence, and visual and language comprehension difficulties.

Rate of involuntary admission in Dublin South West: a 5-year retrospective review

2015 ◽  
Vol 32 (4) ◽  
pp. 341-345 ◽  
Author(s):  
S. McManus ◽  
B. McDonnell ◽  
P. Whitty
Keyword(s):  
Mental Health ◽  
Public Attitudes ◽  
Psychiatric Inpatient ◽  
International Studies ◽  
Involuntary Admission ◽  
Consultant Psychiatrist ◽  
Admission Rates ◽  
South West ◽  
Psychiatric Inpatient Unit ◽  
Number Of Patients

ObjectiveInternational figures for involuntary admissions vary widely. Differences in legislation, professionals’ ethics and public attitudes towards risk have been known to influence this rate. Comparing involuntary admission rates in different parts of the same country can help control for variability found between international studies. This study assessed the rates of involuntary admissions in the Dublin South West Mental Health Service compared with the rest of Ireland.MethodsWe examined the demographic and clinical profiles of all involuntary patients admitted to the acute psychiatric inpatient unit in Tallaght Hospital between 2007 and 2011. We compared the rate of admission in Tallaght with the rest of Ireland. Data gathered included all patients detained on Form 6 and Form 13 (change of status) looking at age, gender, diagnosis and number of patients who had a Mental Health Tribunal. Form 7 (renewal orders) was also examinedWe calculated the rate per 100 000 population per year of Form 6 admissions, Form 13 and Form 7 (certificate and renewal order by responsible consultant psychiatrist) using figures from the 2006 Census. All data were analysed using SPSS.ResultsThe rate of involuntary admission in Tallaght Hospital was significantly lower compared with the rest of Ireland (Form 6: t=−11.2; p<0.001, Form 13: t=−3.1; p=0.04, Form 7: t=−13.9; p=0.001). This difference was evident for all methods of involuntary detention and was also the case for Form 7 (renewal orders). Mental Health Tribunals were held for 59% of patients, a rate comparable with earlier findings described in publications, following the introduction of the new Mental Health Act.ConclusionsRates per 100 000 population were lower in Dublin South West compared with the rest of Ireland. The reasons for this are not clear. Further research comparing similar services in Ireland could explain these findings.

Controlled assessment of alcoholics admitted involuntarily to a general psychiatric hospital

1996 ◽  
Vol 13 (4) ◽  
pp. 140-143
Author(s):  
Fionnula O'Loughlin ◽  
Marcus Webb
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Alcohol Dependence ◽  
Psychiatric Hospital ◽  
Involuntary Admission ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Mental Treatment

AbstractObjective:As the provision for the involuntary admission to hospital of alcoholics is likely to be discarded in a new Irish Mental Health Act, the characteristics of patients committed under the 1945 Irish Mental Treatment Act were explored and compared with those alcoholics admitted voluntarily.Method:All alcoholics admitted compulsorily from 1989-1992 to a general psychiatrichospital in Dublin were compared retrospectively with voluntarily admitted alcoholics. Data was taken from case notes.Results:Results showed that patients admitted compulsorily were older (t = 3.74, df = 62, p < 0.001) and had more physical complications (X2= 8.4, df = 1, p < 0.004) than those admitted voluntarily. Although results did not reach a statistically significant level, there were proportionately more females in the compulsorily admitted group compared with the voluntary group. The outcome of admission overall was better in those admitted voluntarily, although this was influenced both by length of stay and previous admissions for treatment of alcohol dependence. One particularly interesting finding, regardless of admission category, was that duration of admission was statistically significantly longer for women when compared with men.Conclusions:Compulsory admission of alcoholics to a psychiatric hospital for very brief periods was not shown to be strikingly helpful, but this study cannot decide whether or not longer periods of compulsory admission would be valuable.

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