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Predictors of involuntary hospitalizations to acute psychiatry.

https://arctichealth.org/en/permalink/ahliterature116463
Source
Int J Law Psychiatry. 2013 Mar-Apr;36(2):136-43
Publication Type
Article
Author
Kjetil Hustoft
Tor Ketil Larsen
Bjørn Auestad
Inge Joa
Jan Olav Johannessen
Torleif Ruud
Author Affiliation
Stavanger University Hospital, Division of Psychiatry, Armauer Hansensvei 20, Post Office Box 8100, N-4068 Stavanger, Norway. khu2@sus.no
Source
Int J Law Psychiatry. 2013 Mar-Apr;36(2):136-43
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aggression - psychology
Commitment of Mentally Ill - legislation & jurisprudence
Community Mental Health Centers - legislation & jurisprudence
Female
General Practice - legislation & jurisprudence
Humans
Male
Mental Disorders - diagnosis - psychology - rehabilitation
Middle Aged
Motivation
Norway
Personality Assessment - statistics & numerical data
Psychiatric Department, Hospital - legislation & jurisprudence
Psychometrics - statistics & numerical data
Referral and Consultation - legislation & jurisprudence
Sex Factors
Social Adjustment
Substance-Related Disorders - diagnosis - psychology - rehabilitation
Young Adult
Abstract
There is little knowledge of predictors for involuntary hospitalizations in acute psychiatric units.
The Multi-center study of Acute Psychiatry included all cases of acute consecutive psychiatric admissions in twenty acute psychiatric units in Norway, representing about 75% of the acute psychiatric units during 2005-2006. Data included admission process, rating of Global Assessment of Functioning and Health of the Nation Outcome Scales.
Fifty-six percent were voluntary and 44% involuntary hospitalized. Regression analysis identified contact with police, referral by physicians who did not know the patient, contact with health services within the last 48 h, not living in own apartment or house, high scores for aggression, level of hallucinations and delusions, and contact with an out-of office clinic within the last 48 h and low GAF symptom score as predictors for involuntary hospitalization. Involuntary patients were older, more often male, non-Norwegian, unmarried and had lower level of education. They more often had disability pension or received social benefits, and were more often admitted during evenings and nights, found to have more frequent substance abuse and less often responsible for children and were less frequently motivated for admission. Involuntary patients had less contact with psychiatric services before admission. Most patients were referred because of a deterioration of their psychiatric illness.
Involuntary hospitalization seems to be guided by the severity of psychiatric symptoms and factors "surrounding" the referred patient. Important factors seem to be male gender, substance abuse, contact with own GP, aggressive behavior, and low level of social functioning and lack of motivation. There was a need for assistance by the police in a significant number of cases. This complicated picture offers some important challenges to the organization of primary and psychiatric health services and a need to consider better pathways to care.
PubMed ID
23395506 View in PubMed
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Public attitudes towards involuntary admission and treatment by mental health services in Norway.

https://arctichealth.org/en/permalink/ahliterature294910
Source
Int J Law Psychiatry. 2017 Nov - Dec; 55:1-7
Publication Type
Journal Article
Author
Inge Joa
Kjetil Hustoft
Liss Gøril Anda
Kolbjørn Brønnick
Olav Nielssen
Jan Olav Johannessen
Johannes H Langeveld
Author Affiliation
Network for Clinical Psychosis Research, Division of Psychiatry, Stavanger University Hospital, Norway; Network for Medical Sciences, Faculty of Social Sciences, University of Stavanger, Norway. Electronic address: ijo@sus.no.
Source
Int J Law Psychiatry. 2017 Nov - Dec; 55:1-7
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Analysis of Variance
Attitude to Health
Commitment of Mentally Ill
Female
Hospitalization
Humans
Interviews as Topic
Male
Mental Disorders - psychology - therapy
Mental health services
Middle Aged
Norway
Public Opinion
Surveys and Questionnaires
Young Adult
Abstract
The role of compulsory treatment of serious mental disorders has been the topic of ongoing public debate involving among others mental health professionals, service providers, service user advocates, relatives of service users, media commentators and politicians. However, relatively little is known about general public attitudes towards involuntary admission and compulsory treatment of people with various mental disorders. This article examines the attitudes in a representative sample of Norway's population towards the use of involuntary admission and treatment, and under which circumstances does the general public consider compulsory treatment to be justified in the Norwegian mental health care services.
Data were collected from a representative sample of the population in Norway aged 18 and older. The sample was stratified for gender, geographical region and age distribution (n=2001). The survey was performed in the months of May 2009 (n=1000) and May 2011 (n=1001), using Computer Assisted Telephone Interviews (CATI) by an independent polling company. All respondents were provided a general definition of coercive intervention before the interview was conducted.
Univariate descriptions and bivariate analyses were performed by means of cross-tabulation, analysis of variance (one-way ANOVA) and comparing of group of means. Cohen's d was used as the measure for effect size.
Between 87% and 97% of those surveyed expressed strong or partial agreement with the use of involuntary admissions or compulsory treatment related to specified cases and situations. The majority of interviewees (56%) expressed the opinion that overall, current levels are acceptable. A further, 34% were of the opinion that current levels are too low, while only 9.9% of respondents supported a reduction in the level of involuntary treatment. Lower levels of education were associated with a more positive attitude towards involuntary admission and treatment. There was stronger support for admission to prevent suicide than the possibility of violence by the mentally ill.
The Norwegian adult population largely supports current legislation and practices regarding involuntary admission and compulsory treatment in the mental health services.
PubMed ID
29157507 View in PubMed
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Voluntary or involuntary acute psychiatric hospitalization in Norway: A 24h follow up study.

https://arctichealth.org/en/permalink/ahliterature298276
Source
Int J Law Psychiatry. 2018 Jan - Feb; 56:27-34
Publication Type
Journal Article
Observational Study
Author
Kjetil Hustoft
Tor Ketil Larsen
Kolbjørn Brønnick
Inge Joa
Jan Olav Johannessen
Torleif Ruud
Author Affiliation
Division of Psychiatry, Center of Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway. Electronic address: kjetil.hustoft@sus.no.
Source
Int J Law Psychiatry. 2018 Jan - Feb; 56:27-34
Language
English
Publication Type
Journal Article
Observational Study
Keywords
Acute Disease
Adolescent
Adult
Coercion
Commitment of Mentally Ill - legislation & jurisprudence
Female
Follow-Up Studies
Hospitalization
Humans
Male
Middle Aged
Norway
Patient Rights
Prospective Studies
Young Adult
Abstract
The Norwegian Mental Health Care Act states that patients who are involuntarily admitted to a hospital must be reevaluated by a psychiatrist or a specialist in clinical psychology within 24h to assess whether the patient fulfills the legal criteria for the psychiatric status and symptoms. International research on the use of coercive hospitalization in psychiatry is scarce, and an investigation of Norway's routine re-evaluation of involuntarily referred patients may expand knowledge about this aspect of psychiatric treatment. The aim of this study was to investigate the extent to which Involuntarily Hospitalized (IH) patients were converted to a Voluntary Hospitalization (VH), and to identify predictive factors leading to conversion. The Multi-center Acute Psychiatry study (MAP) included all cases of acute consecutive psychiatric admissions across twenty Norwegian acute psychiatric units in health trusts in Norway across 3months in 2005-06, representing about 75% of the psychiatric acute emergency units in Norway. The incident of conversion from involuntarily hospitalization (IH) to voluntary hospitalization (VH) was analyzed using generalized linear mixed modeling. Out of 3338 patients referred for admission, 1468 were IH (44%) and 1870 were VH. After re-evaluation, 1148 (78.2%) remained on involuntary hospitalization, while 320 patients (21.8%) were converted to voluntary hospitalization. The predictors of conversion from involuntary to voluntary hospitalization after re-evaluation of a specialist included patients wanting admission, better scores on Global Assessment of Symptom scale, fewer hallucinations and delusions and higher alcohol intake.
The 24h re-evaluation period for patients referred for involuntary hospitalization, as stipulated by the Norwegian Mental Health Care Act, appeared to give adequate opportunity to reduce unnecessary involuntary hospitalization, while safeguarding the patient's right to VH.
PubMed ID
29701596 View in PubMed
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