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. 1987 Jun 1;136(11):1166–1171.

Factors associated with involuntary admission to psychiatric facilities in Newfoundland.

A Malla, R M Norman, E Helmes
PMCID: PMC1492171  PMID: 3567777

Abstract

To assess what factors determine the involuntary status of psychiatric patients, we reviewed the case records of 5729 patients consecutively admitted to one of four inpatient psychiatric facilities, including a mental hospital, in St. John's between October 1975 and October 1978. Of the 5729 patients 5005 (87.4%) were voluntary and 724 (12.6%) involuntary. Involuntary patients were more likely than voluntary patients to be male, single and unemployed and to have been referred by police or transferred from another facility to the mental hospital, where most of the involuntary admissions occurred. They had higher rates of previous admissions to a psychiatric facility and of suicidal and violent behaviour, were more likely to have a diagnosis of schizophrenia or mania and were less likely to be suffering from depression or a neurotic disorder. In correspondence with differences in diagnosis, involuntary patients stayed in hospital more than twice as long as voluntary patients, were less likely to receive electroconvulsive therapy, minor tranquillizers and antidepressants, and were more likely to receive neuroleptics and lithium carbonate. Stepwise logistic regression analysis revealed that only the source of referral and a diagnosis of neurotic disorder had an independent effect on admission status. The findings are discussed in the context of the controversy over the parens patriae approach v. the legal approach to involuntary admission of psychiatric patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Elliott W. A., Timbury G. C., Walker M. M. Compulsory admission to hospital: an operational review of the Mental Health (Scotland) Act 1960. Br J Psychiatry. 1979 Aug;135:104–114. doi: 10.1192/bjp.135.2.104. [DOI] [PubMed] [Google Scholar]
  2. Gove W. R., Fain T. A comparison of voluntary and committed psychiatric patients. Arch Gen Psychiatry. 1977 Jun;34(6):669–676. doi: 10.1001/archpsyc.1977.01770180055004. [DOI] [PubMed] [Google Scholar]
  3. Ineichen B., Harrison G., Morgan H. G. Psychiatric hospital admissions in Bristol. I. Geographical and ethnic factors. Br J Psychiatry. 1984 Dec;145:600–604. doi: 10.1192/bjp.145.6.600. [DOI] [PubMed] [Google Scholar]
  4. LaWall J. S. Involuntary patients in general hospitals: a positive view. Bull Am Acad Psychiatry Law. 1982;10(3):183–188. [PubMed] [Google Scholar]
  5. Leeman C. P., Berger H. S. The Massachusetts Psychiatric Society's position paper on involuntary psychiatric admissions to general hospitals. Hosp Community Psychiatry. 1980 May;31(5):318–324. doi: 10.1176/ps.31.5.318. [DOI] [PubMed] [Google Scholar]
  6. Leeman C. P. Involuntary admissions to general hospitals: progress or threat? Hosp Community Psychiatry. 1980 May;31(5):315–318. doi: 10.1176/ps.31.5.315. [DOI] [PubMed] [Google Scholar]
  7. Leeman C. P., Sederer L. I., Rogoff J., Berger H. S., Merrifield J. Should general hospitals accept involuntary psychiatric patients? A panel discussion. Gen Hosp Psychiatry. 1981 Sep;3(3):245–253. doi: 10.1016/0163-8343(81)90009-8. [DOI] [PubMed] [Google Scholar]
  8. Malla A. K., Norman R. M. Mental hospital and general hospital psychiatric units: a comparison of services within the same geographic area. Psychol Med. 1983 May;13(2):431–439. doi: 10.1017/s0033291700051060. [DOI] [PubMed] [Google Scholar]
  9. McCready J., Merskey H. Compliance by physicians with the 1978 Ontario Mental Health Act. Can Med Assoc J. 1981 Mar 15;124(6):719–724. [PMC free article] [PubMed] [Google Scholar]
  10. Norman R. M., Malla A. K. The effect of a mental hospital strike on general hospital psychiatric services. Psychol Med. 1984 Nov;14(4):913–921. doi: 10.1017/s0033291700019875. [DOI] [PubMed] [Google Scholar]
  11. Page S. Civil commitment: operational definition of new criteria. Can J Psychiatry. 1981 Oct;26(6):419–420. doi: 10.1177/070674378102600606. [DOI] [PubMed] [Google Scholar]
  12. Page S., Firth J. Civil commitment practices in 1977: troubled semantics and/or troubled psychiatry. Can Psychiatr Assoc J. 1979 Jun;24(4):329–335. doi: 10.1177/070674377902400409. [DOI] [PubMed] [Google Scholar]
  13. Page S., Yates E. Symposium--forensic psychiatry. Civil commitment and the danger mandate. Can Psychiatr Assoc J. 1973 Aug;18(4):267–271. doi: 10.1177/070674377301800402. [DOI] [PubMed] [Google Scholar]
  14. Riley R., Richman A. Involuntary hospitalization in Canadian psychiatric inpatient facilities, 1970-1978. Can J Psychiatry. 1983 Nov;28(7):536–541. doi: 10.1177/070674378302800706. [DOI] [PubMed] [Google Scholar]
  15. Sata L. S., Goldenberg E. E. A study of involuntary patients in Seattle. Hosp Community Psychiatry. 1977 Nov;28(11):834–837. doi: 10.1176/ps.28.11.834. [DOI] [PubMed] [Google Scholar]
  16. Soothill K. L., Harding T. W., Adserballe H., Bernheim J., Erné S., Magdi S., Panpreecha C., Reinhold F. Compulsory admissions to mental hospitals in six countries. Int J Law Psychiatry. 1981;4(3-4):327–344. doi: 10.1016/0160-2527(81)90005-4. [DOI] [PubMed] [Google Scholar]
  17. Strong H. R. Civil commitment: a review of traditional arrangements in the provision of involuntary hospitalization of the mentally ill. Can J Psychiatry. 1983 Jun;28(4):307–313. doi: 10.1177/070674378302800415. [DOI] [PubMed] [Google Scholar]
  18. Toews J., Prabhu V., el-Guebaly N. Commitment of the mentally ill. Can J Psychiatry. 1980 Dec;25(8):611–618. doi: 10.1177/070674378002500801. [DOI] [PubMed] [Google Scholar]
  19. Toews J., el-Guebaly N., Leckie A., Harper D. Patients' attitudes at the time of their commitment. Can J Psychiatry. 1984 Nov;29(7):590–595. doi: 10.1177/070674378402900708. [DOI] [PubMed] [Google Scholar]
  20. Tomelleri C. J., Lakshminarayanan N., Herjanic M. Who are the "committed"? J Nerv Ment Dis. 1977 Oct;165(4):288–293. doi: 10.1097/00005053-197710000-00010. [DOI] [PubMed] [Google Scholar]
  21. Zwerling I., Karasu T., Plutchik R., Kellerman S. A comparison of voluntary and involuntary patients in a state hospital. Am J Orthopsychiatry. 1975 Jan;45(1):81–87. doi: 10.1111/j.1939-0025.1975.tb01168.x. [DOI] [PubMed] [Google Scholar]

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