Citation

Moss JH, Redelmeier DA. Gen. Hosp. Psychiatry 2010; 32(1): 94-98.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.genhosppsych.2009.10.004

PMID

20114134

Abstract

OBJECTIVE: Psychiatric inpatients may be detained against their will, yet they still retain the right to apply for a hearing to challenge this detention. We tested whether adjudicated decisions over whether to uphold or rescind the detention have implications in subsequent patient morbidity.
METHODS: Consecutive patients applying to the Consent and Capacity Board in Ontario between January 1, 2004, and March 31, 2007, were identified who had a hearing to challenge their involuntary detention. Population based databases provided information on subsequent deaths, hospitalization for a psychiatric illness, or emergency department visit for any reason.
RESULTS: A total of 3498 decisions were rendered for 2321 unique psychiatric patients during the 39 month study period. Almost all patients (90%) had a prior psychiatric admission. Approximately 18% of involuntary detentions were rescinded with subsequent outcomes showing a greater likelihood of emergency department visits within 100 days of discharge in the group whose detention was rescinded compared to the group whose detention was upheld (46% vs. 36%, P=.003).
CONCLUSIONS: When an involuntary detention is rescinded patients have a high likelihood of subsequent utilization of emergency department services for suicide related symptoms but no large increase in risk of dying.

Language: en

Keywords

Humans; Adult; Female; Male; Decision Making; Risk Assessment; Ontario; Outcome Assessment, Health Care; Commitment of Mentally Ill; Mental Disorders