TY  - JOUR
PY  - 2024//
TI  - Factors associated with involuntary mental healthcare in New South Wales, Australia
JO  - BJPsych open
A1  - Corderoy, Amy
A1  - Large, Matthew Michael
A1  - Ryan, Christopher
A1  - Sara, Grant
SP  - e59
EP  - e59
VL  - 10
IS  - 2
N2  - BACKGROUND: There is uncertainty about factors associated with involuntary in-patient psychiatric care. Understanding these factors would help in reducing coercion in psychiatry. AIMS: To explore variables associated with involuntary care in the largest database of involuntary admissions published. <br><br>METHOD: We identified 166 102 public mental health hospital admissions over 5 years in New South Wales, Australia. Demographic, clinical and episode-of-care variables were examined in an exploratory, multivariable logistic regression. <br><br>RESULTS: A total of 54% of eligible admissions included involuntary care. The strongest associations with involuntary care were referral from the legal system (odds ratio 4.98, 95% CI 4.61-5.38), and psychosis (odds ratio 4.48, 95% CI 4.31-4.64) or organic mental disorder (odds ratio 4.40, 95% CI 3.85-5.03). There were moderately strong associations between involuntary treatment and substance use disorder (odds ratio 2.68, 95% CI 2.56-2.81) or affective disorder (odds ratio 2.06, 95% CI 1.99-2.14); comorbid cannabis and amphetamine use disorders (odds ratio 1.65, 95% CI 1.57-1.74); unmarried status (odds ratio 1.62, 95% CI 1.49-1.76) and being born in Asia (odds ratio 1.42, 95% CI 1.35-1.50), Africa or the Middle East (odds ratio 1.32, 95% CI 1.24-1.40). Involuntary care was less likely for people aged >75 years (odds ratio 0.68, 95% CI 0.62-0.74), with comorbid personality disorder (odds ratio 0.90, 95% CI 0.87-0.94) or with private health insurance (odds ratio 0.89, 95% CI 0.86-0.93). <br><br>CONCLUSIONS: This research strengthens the evidence linking diagnostic, socioeconomic and cultural factors to involuntary treatment. Targeted interventions are needed to reduce involuntary admissions in disadvantaged groups.<p />  <p>Language: en</p>
LA  - en
SN  - 2056-4724
UR  - http://dx.doi.org/10.1192/bjo.2023.628
ID  - ref1
ER  -