Who Applies to Regional Review Boards and What are the Outcomes?

1997 ◽  
Vol 42 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Susan J Adams ◽  
Nancy L Pitre ◽  
Rosa Cieszkowski
Keyword(s):  
Small Group ◽  
Median Time ◽  
Psychiatric Hospital ◽  
Small Proportion ◽  
Revolving Door ◽  
Involuntary Admission ◽  
Admission Status ◽  
Regional Review ◽  
Review Boards

Objective: To determine the outcomes for patients following applications to regional review boards at an Ontario provincial psychiatric hospital for 1992 through 1994. Method: A retrospective casenote study examined frequency of readmission, time to next admission, status upon readmission, and episodes of dangerous behaviour perpetrated in the community for patients applying to review boards. Results: Over 3 years, 116 hearings took place to review various certificates. Only 57% of applications reached a hearing. Of those, 69% were confirmed and 31% rescinded. A small group of patients made multiple applications to the review board. Median time to next admission for patients who had certificates of involuntary admission rescinded by the review board was 14 days, compared with 53 days for those who remained in hospital until the time of planned discharge. Conclusion: Review boards consume considerable resources, serve only a small proportion of patients, and contribute to the “revolving door” phenomenon.

Intrapartum Basal Ganglia–Thalamic Pattern Injury and Radiologically Termed “Acute Profound Hypoxic–Ischemic Brain Injury” Are Not Synonymous

2020 ◽  
Author(s):  
Johan Smith ◽  
Regan Solomons ◽  
Lindi Vollmer ◽  
Eduard J. Langenegger ◽  
Jan W. Lotz ◽  
...  
Keyword(s):  
Brain Injury ◽  
Basal Ganglia ◽  
Caesarean Section ◽  
Median Time ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Key Points ◽  
Admission Status ◽  
Sentinel Event ◽  
Magnetic Resonance Imaging Mri

Objective Human cases of acute profound hypoxic-ischemic (HI) injury (HII), in which the insult duration timed with precision had been identified, remains rare, and there is often uncertainty of the prior state of fetal health. Study Design A retrospective analysis of 10 medicolegal cases of neonatal encephalopathy-cerebral palsy survivors who sustained intrapartum HI basal ganglia-thalamic (BGT) pattern injury in the absence of an obstetric sentinel event. Results Cardiotocography (CTG) admission status was reassuring in six and suspicious in four of the cases. The median time from assessment by admission CTG or auscultation to birth was 687.5 minutes (interquartile range [IQR]: 373.5–817.5 minutes), while the median time interval between first pathological CTG and delivery of the infant was 179 minutes (IQR: 137–199.25 minutes). The mode of delivery in the majority of infants (60%) was by unassisted vaginal birth; four were delivered by delayed caesarean section. The median (IQR) interval between the decision to perform a caesarean section and delivery was 169 minutes (range: 124–192.5 minutes). Conclusion The study shows that if a nonreassuring fetal status develops during labor and is prolonged, a BGT pattern HI injury may result, in the absence of a perinatal sentinel event. Intrapartum BGT pattern injury and radiologically termed “acute profound HI brain injury” are not necessarily synonymous. A visualized magnetic resonance imaging (MRI) pattern should preferably solely reflect the patterns description and severity, rather than a causative mechanism of injury. Key Points

scholarly journals Coercive Measures and Stigmatization in the Psychiatric Medical Care

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 137-145
Author(s):  
Petronela Nechita ◽  
◽  
Liliana Luca ◽  
Alina-Ioana Voinea ◽  
Codrina Moraru ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Treatment Compliance ◽  
Mental Illnesses ◽  
Internal Conflict ◽  
Involuntary Admission ◽  
Coercive Measures ◽  
Self Harm ◽  
The Law

The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict. The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance. Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036). Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.

scholarly journals The Revolving Door Phenomenon Revisited: Time to Readmission in 17’415 Patients with 37’697 Hospitalisations at a German Psychiatric Hospital

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e75612 ◽  
Author(s):  
Ulrich Frick ◽  
Hannah Frick ◽  
Berthold Langguth ◽  
Michael Landgrebe ◽  
Bettina Hübner-Liebermann ◽  
...  
Keyword(s):  
Psychiatric Hospital ◽  
Revolving Door

scholarly journals The ‘revolving door’: a profile of acute admissions at a South African psychiatric hospital

2012 ◽  
Vol 9 (3) ◽  
pp. 66-68 ◽  
Author(s):  
Zahir Vally ◽  
Nasera Cader
Keyword(s):  
South African ◽  
Psychiatric Hospital ◽  
Cape Town ◽  
Revolving Door ◽  
Psychiatric Facility ◽  
Admission Rates ◽  
Acute Admissions

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

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.

Regional Review Boards of Ontario: A Medico-Legal Review

1986 ◽  
Vol 31 (7) ◽  
pp. 643-648 ◽  
Author(s):  
Ranjith Chandrasena ◽  
Selwyn Smith
Keyword(s):  
Mental Health ◽  
Alcohol Abuse ◽  
Affective Disorder ◽  
Clinical Data ◽  
Chronic Care ◽  
Scientific Data ◽  
Time Of Application ◽  
Organic Brain ◽  
Regional Review ◽  
Review Boards

The functioning of the Regional Review Boards of Ontario (RRB) or their equivalents in other provinces has not been previously reviewed. This study reviews socio-demographic and clinical data of 248 patients seen between 1974 and 1983 by the RRB. The RRB heard 132 applications as 116 were withdrawn. The results are compared with 173 matched inpatient controls. Applications by psychiatrists were infrequently withdrawn or revoked. Long delays between the time of application and the hearing, and a trend towards increasing numbers of applications were noted. Schizophrenia and affective disorder were the most prevalent diagnosis with alcohol abuse and organic brain syndrome being less common among applicants. An increase in duration of stay and transfer to chronic care institutions were found among applicants. Results suggest that RRB's are not ‘rubber stamping bodies’ and should be more readily available and should have increased public accountability. Future changes to the Mental Health Act should be based on scientific data.

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.

The ‘revolving door’: a profile of acute admissions at a South African psychiatric hospital

2012 ◽  
Vol 9 (3) ◽  
pp. 66-68
Author(s):  
Zahir Vally ◽  
Nasera Cader
Keyword(s):  
South African ◽  
Psychiatric Hospital ◽  
Cape Town ◽  
Revolving Door ◽  
Psychiatric Facility ◽  
Admission Rates ◽  
Acute Admissions

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

scholarly journals Odgovornost za institucionalno pridržane osebe po Zakonu o duševnem zdravju

2021 ◽  
pp. 317-330
Author(s):  
Polona Farmany ◽  
Keyword(s):  
Mental Disorder ◽  
Social Environment ◽  
Psychiatric Hospital ◽  
Social Care ◽  
Institutional Care ◽  
The State ◽  
Hospital Treatment ◽  
Involuntary Admission ◽  
Therapeutic Treatment ◽  
Therapeutic Environment

When state (i.e. court) decides on involuntary admission or placement of persons with a mental disorder in institutional care (either in a ward under the special supervision of a psychiatric hospital or in a secure ward of a social care institution, after the hospital treatment finishes), it pursues in particular the protective objective (i.e. protection from endangering the life or health of the person concerned or the life and health of others). However, with the admission of these persons into institutional care comes the duty and responsibility of the state (and its institutions) to provide to the detained persons an appropriate therapeutic treatment, i.e. an appropriate therapeutic environment that will allow these persons to improve their health to such an extent that they will be able to live independently in their social environment.

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