Compulsory Admission to Psychiatric Wards–Who Is Admitted, and Who Appeals Against Admission?

Abstract Background Minority ethnic and migrant groups face an elevated risk of compulsory admission for mental illness. There are overlapping cultural, socio-demographic, and structural explanations for this risk that require further investigation. Methods By linking Swedish national register data, we established a cohort of persons first diagnosed with a psychotic disorder between 2001 and 2016. We used multilevel mixed-effects logistic modelling to investigate variation in compulsory admission at first diagnosis of psychosis across migrant and Swedish-born groups with individual and neighbourhood-level covariates. Results Our cohort included 12 000 individuals, with 1298 (10.8%) admitted compulsorily. In an unadjusted model, being a migrant [odds ratio (OR) 1.48; 95% confidence interval (CI) 1.26–1.73] or child of a migrant (OR 1.27; 95% CI 1.10–1.47) increased risk of compulsory admission. However after multivariable modelling, region-of-origin provided a better fit to the data than migrant status; excess risk of compulsory admission was elevated for individuals from sub-Saharan African (OR 1.94; 95% CI 1.51–2.49), Middle Eastern and North African (OR 1.46; 95% CI 1.17–1.81), non-Nordic European (OR 1.27; 95% CI 1.01–1.61), and mixed Swedish-Nordic backgrounds (OR 1.33; 95% CI 1.03–1.72). Risk of compulsory admission was greater in more densely populated neighbourhoods [OR per standard deviation (s.d.) increase in the exposure: 1.12, 95% CI 1.06–1.18], an effect that appeared to be driven by own-region migrant density (OR per s.d. increase in exposure: 1.12; 95% CI 1.02–1.24). Conclusions Inequalities in the risk of compulsory admission by migrant status, region-of-origin, urban living and own-region migrant density highlight discernible factors which raise barriers to equitable care and provide potential targets for intervention.

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Compulsory admission and involuntary treatment in Portugal

BJPsych International ◽

10.1192/s2056474000000933 ◽

2016 ◽

Vol 13 (1) ◽

pp. 17-19 ◽

Cited By ~ 1

Author(s):

Telma Almeida ◽

Andrew Molodynski

Keyword(s):

Mental Health ◽

Emergency Department ◽

Patient Treatment ◽

Compulsory Treatment ◽

Compulsory Admission ◽

Involuntary Treatment ◽

Mental Health Legislation ◽

Health Legislation

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory out-patient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the ‘move into the community’.

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The Hillsborough football stadium disaster: a single case study

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700013987 ◽

1992 ◽

Vol 9 (1) ◽

pp. 57-59

Author(s):

Raymond F Travers ◽

Gus A Baker

Keyword(s):

Case Management ◽

Service Provision ◽

Single Case ◽

Single Case Study ◽

Compulsory Admission ◽

Medical Control ◽

Risk Patients ◽

Organic Brain ◽

Football Stadium

AbstractExpectations for service provision following a disaster are understandably high but difficult to meet. This report considers the case of a patient with pre-morbid anxiety traits and asthma who suffered organic brain damage as a consequence of the Hillsborough Football Stadium disaster, whose care was reactive rather than proactive and resulted in his compulsory admission to a psychiatric hospital. Aftercare arrangements need to be anticipated in advance and should involve early psychiatric assessment of at-risk patients. Medical control of case management following disasters needs further clarification.

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The law

Oxford Handbook of Learning and Intellectual Disability Nursing ◽

10.1093/med/9780199533220.003.0013 ◽

2009 ◽

pp. 459-498

Keyword(s):

Mental Health ◽

Human Rights ◽

Compulsory Admission ◽

Sexual Offences ◽

Disability Discrimination ◽

Mental Health Act ◽

Assessment And Treatment ◽

Human Rights Act ◽

Disability Discrimination Act ◽

Health Review

Mental Health Act 1983 460 Mental Health Act 2007 462 Compulsory admission to hospital for assessment and treatment 464 Emergency holding powers 466 Mental Health Review Tribunals 468 The Mental Health Act Commission 470 Sexual Offences Act 472 Disability Discrimination Act 2005 474 Human Rights Act ...

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The approach in England to compulsory admission to hospital and issues of consent for children and young people up to their 18th birthday

Neuropsychiatrie de l Enfance et de l Adolescence ◽

10.1016/j.neurenf.2012.05.262 ◽

2012 ◽

Vol 60 (5) ◽

pp. S67

Author(s):

E. Taylor ◽

B. Jacobs

Keyword(s):

Young People ◽

Compulsory Admission ◽

Children And Young People

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Analysis of Hospital Admissions for Psychiatric Care in Portugal: Results from the SMAILE Study

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.037 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S250-S250

Author(s):

M. Silva ◽

A. Antunes ◽

A. Loureiro ◽

P. Santana ◽

J. Caldas-de-Almeida ◽

...

Keyword(s):

Mental Disorders ◽

Hospital Admission ◽

Hospital Stay ◽

Psychiatric Care ◽

Hospital Admissions ◽

Common Mental Disorders ◽

Length Of Hospital Stay ◽

Compulsory Admission ◽

Clinical Factors ◽

Psychiatric Admissions

IntroductionEvidence shows that the prevalence and severity of mental disorders and the need for psychiatric admission is influenced by socio-demographic and contextual factors.ObjectivesTo characterize the severity of hospital admissions for psychiatric care due to common mental disorders and psychosis in Portugal.AimsThis retrospective study analyses all acute psychiatric admissions for common mental disorders and psychosis in four Portuguese departments of psychiatry in the metropolitan areas of Lisbon and Porto, and investigates the association of their severity with socio-demographic and clinical factors.MethodsSocio-demographic and clinical variables were obtained from the clinical charts of psychiatric admissions in 2002, 2007 and 2012 (n = 2621). The number of hospital admissions per year (>1) and the length of hospital stay (31 days) were defined as measures of hospital admission severity. Logistic regression analysis was used to assess which socio-demographic and clinical factors were associated with both hospital admission severity outcomes.ResultsResults showed different predictors for each outcome. Being widowed, low level of education, being retired, having psychiatric co-morbidity, and a compulsory admission were statistically associated (P < 0.05) with a higher number of hospital admissions. Being single or widowed, being retired, a diagnosis of psychosis, and a compulsory admission were associated with higher length of hospital stay, while having suicidal ideation was associated with a lower length of hospital stay.ConclusionsSocio-demographic and clinical characteristics of the patients are determinants of hospital admissions for psychiatric care and of their severity.Funding Fundação para a Ciência e Tecnologia (FCT), Portugal.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Pathways to Care for Patients with a First Episode of Psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.167.6.770 ◽

1995 ◽

Vol 167 (6) ◽

pp. 770-776 ◽

Cited By ~ 121

Author(s):

Eleanor Cole ◽

Gerard Leavey ◽

Michael King ◽

Eric Johnson-Sabine ◽

Amanda Hoar

Keyword(s):

Help Seeking ◽

Minority Groups ◽

Important Variable ◽

Psychiatric Services ◽

Pathways To Care ◽

First Episode ◽

Compulsory Admission ◽

Chronic Patients ◽

Black Patients ◽

First Contact

BackgroundIt is reported that patients from ethnic minority groups, in particular Afro-Caribbeans, are more likely to enter less desirable pathways to psychiatric care. We aimed to determine whether ethnicity significantly affected time to presentation, type of first contact, rates of compulsory admission and police and primary care involvement, in patients with their first episode of psychosis.MethodAs part of a prospective epidemiological study, patients and their carers were interviewed using a semi-structured questionnaire to trace the various persons and agencies seen en route to their first contact with psychiatric services.ResultsWhile compulsory admission was more likely for Black patients, the excess was less striking than in previous studies. Black patients were no more likely than other patients to have police involvement. The most important factors in avoiding an adverse pathway were having a supportive family member or friend and the presence of a general practitioner to assist in gaining access to psychiatric services.ConclusionsThe routes to psychiatric services for first onset patients are different to those for chronic patients. Variables associated with social support were more important than ethnicity in determining pathways to care. Police involvement and compulsory admissions were strongly associated with the absence of GP involvement and the absence of help-seeking by a friend or relative. It may be that ethnicity becomes an important variable after the patient has come into contact with psychiatric services.

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Compulsory admission of dangerous psychopaths.

BMJ ◽

10.1136/bmj.304.6842.1581 ◽

1992 ◽

Vol 304 (6842) ◽

pp. 1581-1582 ◽

Cited By ~ 13

Author(s):

J. W. Coid ◽

C. Cordess

Keyword(s):

Compulsory Admission

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Aspects of morbid jealousy

Advances in Psychiatric Treatment ◽

10.1192/apt.10.3.207 ◽

2004 ◽

Vol 10 (3) ◽

pp. 207-215 ◽

Cited By ~ 58

Author(s):

Michael Kingham ◽

Harvey Gordon

Keyword(s):

Old Age ◽

Forensic Psychiatry ◽

Compulsory Admission

Morbid jealousy is encountered in general, old age and forensic psychiatry, and clinicians in each specialty should be familiar with its recognition and management. As well as clinical matters, the issue of risk to the patient and others is prominent in the consideration of morbid jealousy. Hospitalisation is sometimes required, the use of compulsory admission is not infrequent and treatment in secure settings is occasionally warranted. This review addresses the nature of morbid jealousy, its psychopathology, diagnostic issues, associations, risks and management.

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