Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-16T18:41:48.764Z Has data issue: false hasContentIssue false

Factors influencing compulsory admission of psychiatric patients

Published online by Cambridge University Press:  09 July 2009

Anita Riecher*
Affiliation:
Central Institute for Mental Health, Mannheim, Federal Republic of Germany
Wulf Rössler
Affiliation:
Central Institute for Mental Health, Mannheim, Federal Republic of Germany
Walter Löffler
Affiliation:
Central Institute for Mental Health, Mannheim, Federal Republic of Germany
Brigitte Fätkenheuer
Affiliation:
Central Institute for Mental Health, Mannheim, Federal Republic of Germany
*
1Address for correspondence: Dr Anita Riecher, Central Institute for Mental Health, J 5, Post Box 122120, 6800 Mannheim 1, FRG.

Synopsis

From 1 January 1984 until 30 June 1986 all 517 compulsorily admitted psychiatric patients of a well-defined mixed rural–urban catchment area in Baden-Württemberg, a southern State of the German Federal Republic, were compared with all 10232 voluntarily admitted patients. Because of the very low frequency of compulsory admissions this population can be regarded as a ‘core group’ of committed patients. In a logit analysis the characteristics distinguishing involuntary from voluntary patients can be reduced to three main factors: the diagnosis ‘schizophrenia/ paranoid disorder’, ‘masculine gender’ and the compound indicator ‘not owning a home’, the latter being mainly associated with youth, masculine gender and low occupational status. The strong association of these characteristics with the criteria ‘severity of disease’ and ‘danger to oneself and others’, both pre-requisites for compulsory admission according to the laws of most countries, is discussed.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adserballe, H. (1977). Frihedsberovelse og twang i psykiatrien. Fadls forlag. Aarhus. Odense (cited according to Spengler & Böhme, 1989).Google Scholar
Bauer, M. (1982). Zwangseinweisungen in die Psychiatrie–Rechtliche und praktische Gegebenheiten in der Bundesrepublik Deutschland. In Zwangseinweisungen in der Psychiatrie (ed. Waller, H.), pp. 1019. Huber: Bern.Google Scholar
Bauer, M. & Berger, H. (1984). Die Rückverlagerung der Psychiatrischen Regelversorgung in die Gemeinde–Erste Erfahrungen am Beispiel Offenbach. In Psychiatrische Abteilungen an Allgemeinkrankenhäusern (ed. Bauer, M. and Rave-Schwank, M.), pp. 135151. Bd. X. Aktion Psychisch Kranke: Köln.Google Scholar
Bauer, M. & Berger, H. (1986). Rechtsprobleme bei der Einweisung und Behandlung von akut Kranken mit einem Anhang zu Pflegschaft und Entmündigung. In Psychiatrie der Gegenwart 2: Krisenintervention, Suizid, Konsiliarpsychiatrie (ed. Kisker, K. P., Lauter, H., Meyer, J. E., Müller, C. and Strömgren, E.), pp. 4586. Springer: Heidelberg.CrossRefGoogle Scholar
Bauer, M. & Haselbeck, H. (1983). Sozialpsychiatrische Dienste in einer Großstadt. Projekt Hannover, Bd 163. Schriftenreihe des BMJFG. Kohlhammer: Stuttgart.Google Scholar
Beels, C. (1981). Social support and schizophrenia. Schizophrenia Bulletin 7, 5872.CrossRefGoogle ScholarPubMed
Bosch, G. (1974). Zwangseinweisungen Psychisch Kranker. Ergebnisse einer empirischen Motivanalyse. Sozialpsychiatrische Informationen 4, 7083.Google Scholar
Briscoe, M. (1982). Sex Differences in Psychological Well-being. Psychological Medicine Monograph Supplement I. Cambridge University Press: Cambridge.Google Scholar
Brown, M. B. (1983). BMDP Statistical Software, Department of Biomathematics, University of California. University of California Press: Los Angeles.Google Scholar
Burda, P. C., Vaux, A. & Schill, T. (1984). Social support resources: variations across sex and sex roles. Personality and Social Psychology Bulletin 10, 119126.CrossRefGoogle Scholar
Cooper, B. (1961). Social class and prognosis in schizophrenia. British Journal of Preventive and Social Medicine 15, 1741.Google ScholarPubMed
Dawson, H. (1972). Reasons for compulsory admission. In Evaluating a Community Psychiatric Service. The Camberwell Register 1964–71 (ed. Wing, J. K. and Hailey, A. M.), pp. 221231. Oxford University Press: London.Google Scholar
Drake, R., Gates, C., Whitaker, A. & Cotton, P. (1985). Suicide among schizophrenics: a review. Comprehensive Psychiatry 26, 90100.CrossRefGoogle ScholarPubMed
Elliott, W. A., Timbury, G. C. & Walker, M. M. (1979). Compulsory admission to hospital: an operational review of the Mental Health (Scotland) Act 1960. British Journal of Psychiatry 135, 104114.CrossRefGoogle ScholarPubMed
Faulkner, L. R., Bloom, J. D. & McFarland, B. H. (1985). The effect of mental health system changes on civil commitment. Bulletin of the American Academy of Psychiatry and the Law 13, 345357.Google ScholarPubMed
Faulkner, L. R., McFarland, B. H. & Bloom, J. D. (1989). An empirical study of emergency commitment. American Journal of Psychiatry 146, 182186.Google ScholarPubMed
Gove, W. & Fain, T. (1977). A comparison of voluntary and committed psychiatric patients. Archives of General Psychiatry 34, 669676.CrossRefGoogle ScholarPubMed
Häfner, H. & Böker, W. (1972). Geistesgestörte Gewalttäter in der Bundesrepublik. Eine epidemiologische Untersuchung. Nervenarzt 43, 285291.Google Scholar
Häfner, H. & Böker, W. (1982). Crimes of Violence by Mentally Abnormal Offenders. A Psychiatric and Epidemiological Study in the Federal German Republic. Cambridge University Press: Cambridge.Google Scholar
Häfner, H. & Schmidtke, A. (1987). Suizid und Suizidversuche Epidemiologie und Ätiologie. Nervenheilkunde 6, 4963.Google Scholar
Haney, C. A. (1969). The interaction of petitioner and deviant social characteristics in the adjudication of incompetency. Sociometry 23, 182193.CrossRefGoogle Scholar
Hardt, R. H. & Feinhandler, S. J. (1959). Social class and mental hospitalization prognosis. American Sociological Review 24, 815821.CrossRefGoogle Scholar
Hollingshead, A. B. & Redlich, F. C. (1958). Social Class and Mental Illness. Wiley: New York.CrossRefGoogle Scholar
Horowitz, A. (1977). The pathways into psychiatric treatment: some differences between men and women. Journal of Mental Health and Social Behaviour 18, 169175.CrossRefGoogle Scholar
Hülsmeier, H. (1980). Justiz und Anstaltsunterbringung. Mensch Medizin Gesellschaft 5, 100110.Google Scholar
Isele, R. & Angst, J. (1982). Life Events und prämorbide soziale Beziehungen bei ersterkrankten Schizophrenen. In Endogene Psychosen: Diagnostik, Basissymptome und biologische Parameter (ed. Huber, G.), pp. 4356. Schattauer: Stuttgart.Google Scholar
Katschnig, H., Grumiller, I. & Strobl, R. (1975). Daten zur stationären Psychiatrischen Versorgung Österreichs. Teil 1: Inzidenz. Österreichisches Bundesinstitut für Gesundheitswesen: Wien.Google Scholar
Krakowski, M., Volavka, J. & Brizer, D. (1986). Psychopathology and violence: a review of literature. Comprehensive Psychiatry 27, 131148.CrossRefGoogle ScholarPubMed
Kreitman, N. (1980). Epidemiologie von Suizid und Parasuizid. Nervenarzt 51, 131138.Google Scholar
Kroll, J. & Mackenzie, T. B. (1983). When psychiatrists are liable: risk management and violent patients. Hospital and Community Psychiatry 34, 2937.Google ScholarPubMed
Kumasaka, Y., Stokes, J. & Gupta, R. K. (1972). Criteria for involuntary hospitalization. Archives of General Psychiatry 26, 399404.CrossRefGoogle ScholarPubMed
Langeheine, R. (1986). Log-lineare Modelle. In Kausalanalyse, Techniken der empirischen Sozialforschung (ed. Hummel, H. J., Jagodzinski, W. and Langeheine, R.), Bd. 8. Oldenbourg: München.Google Scholar
Leygraf, N. (1988). Psychisch kranke Straftäter. Springer: Heidelberg.CrossRefGoogle Scholar
Linsky, A. S. (1970). Who shall be excluded: the influence of personal attributes in community reaction to the mentally ill. Social Psychiatry 5, 166171.CrossRefGoogle Scholar
Lorenzen, D. (1981). Zur Problematik der Unterbringung psychisch Kranker in psychiatrischen Krankenhäusern. In Psychiatrie und Rechtsstaat (ed. Bergener, M.), pp. 130150. Luchterhand: Neuwied Darmstadt.Google Scholar
McNiel, D. E., Binder, R. L. & Greenfield, T. K. (1988). Predictors of violence in civilly committed acute psychiatric patients. American Journal of Psychiatry 145, 965970.Google ScholarPubMed
Malla, A. & Norman, R. M. G. (1988). Involuntary admission in a Canadian province: the influence of geographic and population factors. Social Psychiatry and Psychiatric Epidemiology 23, 247251.CrossRefGoogle Scholar
Mechanic, D. (1978). Sex, illness, illness behavior and the use of health services. Social Science and Medicine 12, 207214.Google Scholar
Miles, C. P. (1977). Conditions predisposing to suicide: a review. Journal of Nervous and Mental Disease 164, 231246.CrossRefGoogle ScholarPubMed
Miller, K. S., Simons, R. L. & Fein, S. B. (1974). Compulsory mental hospitalization in England and Wales. Journal of Mental Health and Social Behaviour 15, 151156.CrossRefGoogle ScholarPubMed
Miller, R. D. & Fiddleman, P. B. (1983). Emergency involuntary commitment: a look at the decision-making process. Hospital and Community Psychiatry 34, 249254.Google Scholar
Müller, U. & Busche, M. (1978). Epidemiologische und ökologische Aspekte der Zuweisungsinstanzen einer psychiatrischen Aufnahmeklientel. Manuskript. Düsseldorf (cited according to Waller, H, 1982).Google Scholar
Okin, R. L. (1986). The relationship between legal status and patient characteristics in State Hospitals. American Journal of Psychiatry 143, 12331237.Google ScholarPubMed
Reynolds, H. T. (1977). Analysis of Nominal Data. Sage, Beverly Hills.Google Scholar
Rössler, W., Häfner, H., an der Heiden, W., Kreuzer, S., Martini, H. & Sundström, G. (1985). Landesprogramm zur Weiterentwicklung der außerstationären psychiatrischen Versorgung Baden-Württemberg. Sachstandsbericht 1985. Beltz: Weinheim, Basel.Google Scholar
Rössler, W., Häfner, H., Martini, H., an der Heiden, W., Jung, E. & Löffler, W. (1987). Landesprogramm zur Weiterentwicklung der außerstationären psychiatrischen Versorgung Baden-Württemberg – Analysen, Konzepte, Erfahrungen. Deutscher Studien Verlag: Weinheim.Google Scholar
Rossi, A. M., Jacobs, M. & Motelecone, M. (1986). Characteristics of psychiatric patients who engage in assaultive or other fearinducing behaviors. Journal of Nervous and Mental Disease 174, 107111.CrossRefGoogle ScholarPubMed
Roy, A. (1982). Risk factors for suicide in psychiatric patients. Archives of General Psychiatry 39, 10891095.CrossRefGoogle ScholarPubMed
Rushing, W. A. (1971). Occupation, income, and the mental hospitalization. Mental Hygiene 55, 248252.Google Scholar
Schubö, W. & Uehlingen, H. M. (1986). SPSS-X, Handbuch der Programmversion 2.2 Gustav Fischer: Stuttgart.Google Scholar
Segal, S. P. (1989). Civil commitment standards and patient mix in England/Wales, Italy, and the United States. American Journal of Psychiatry 146, 187193.Google ScholarPubMed
Skodol, A. E. & Karasu, T. B. (1980). Toward hospitalization criteria for violent patients. Comprehensive Psychiatry 21, 162166.CrossRefGoogle ScholarPubMed
Spengler, A. (1986). Factors influencing assignment of patients to compulsory admission. Social Psychiatry 21, 113122.CrossRefGoogle ScholarPubMed
Spengler, A. & Böhme, K. (1989). Versorgungsepidemiologische Aspekte der sofortigen Unterbringung. Nervenarzt 60, 226232.Google Scholar
Spengler, A., Strege, W., Dörner, K., Hagenah, R. & Meyberg, U. (1981). Erste Erfahrungen in einem psychiatrischen Notdienst. Zur Prävention oder Indikation von Zwangseinweisungen nach dem Hamburgischen Gesetz über Hilfen und Schutzmaßnahmen bei psychischen Krankheiten (HambPsychKG). Psychiatrische Praxis 8, 1824.Google Scholar
Statistisches Jahrbuch für die Bundesrepublik Deutschland (1988). Statistisches Bundesamt Wiesbaden. Kohlhammer: Stuttgart, Mainz.Google Scholar
Stokes, J. P. & Lewine, I. (1986). Gender differences in predicting loneliness from social network characteristics. Journal of Personality and Social Psychology 51, 10691074.CrossRefGoogle ScholarPubMed
Stumpfe, K. D. & Husser, J. (1978). Untersuchung über Zwangseinweisungen von psychisch Kranken. Öffentliches Gesundheitswesen 40, 808814.Google Scholar
Szmukler, G. I., Bird, A. S. & Button, E. J. (1981). Compulsory admissions in a London borough. I. Social and clinical features and a follow-up. Psychological Medicine 11, 617636.CrossRefGoogle Scholar
Tardiff, K. & Sweillam, A. (1980). Assaultive behavior among chronic inpatients. American Journal of Psychiatry 139, 212215.Google Scholar
Toews, J., El-Guebaly, N., Leckie, A. & Harper, D. (1984). Patients' attitudes at the time of their commitment. Canadian Journal of Psychiatry 29, 590595.CrossRefGoogle ScholarPubMed
Tomelleri, C. J., Lakshiminarayanan, N. & Herjanic, M. (1977). Who are the ‘committed’? Journal of Nervous and Mental Disease 165, 288293.CrossRefGoogle ScholarPubMed
Uchtenhagen, A. (1982). Zwangseinweisungen in der Psychiatrie – Rechtliche und praktische Gegebenheiten – Schweiz. In Zwangseinweisung in der Psychiatrie (ed. Waller, H.), pp. 3546. Huber: Bern.Google Scholar
Veiel, H. O. F., Brill, G., Häfner, H. & Welz, R. (1988). The social support of suicide attempters; the different roles of family and friends. American Journal of Community Psychology 16, 839861.CrossRefGoogle ScholarPubMed
Waller, H. (ed.) (1982). Zwangseinweisung in der Psychiatrie. Huber: Bern, Stuttgart, Wien.Google Scholar
Warner, S. L. (1961). Criteria for involuntary hospitalization of psychiatric patients in a public psychiatric hospital. Mental Hygiene 45, 122128.Google Scholar
Wolfersdorf, M., Vogel, R., Bender, St., Freeman, G., Heydt, G., Lexow, U., Neef, J., Nehrer, F., Potschigmann, B., Rösch, Ch., Stoppa, H, Vogel, W. D., Weiskittel, Ch., Wießler, M., Zlatnikova, J. & Hole, G. (1987). Kliniksuizide stationärer psychiatrischer Patienten. In Suizidalität bei stationären psychiatrischen Patienten. Arbeitsgemeinschaft ‘Suizidalität und psychiatrisches Krankenhans’ (ed. Wolfersdorf, M. and Vogel, R.), pp. 253334. Weissenhof: Weinsberg.Google Scholar
Zwerling, J., Karasu, T., Plutchik, R. & Kellerman, S. (1975). A comparison of voluntary and involuntary patients in a State Hospital. American Journal of Orthopsychiatry 45, 8187.CrossRefGoogle ScholarPubMed