Assessment of health needs, satisfaction with care, and quality of life in compulsorily admitted patients with severe mental disorders

Ritsner, Michael S.; Farkash, Herman; Rauchberger, Boris; Amrami-Weizman, Avi; Zendjidjian, Xavier

doi:10.1016/j.psychres.2018.05.030

Cited by 28 publications

(9 citation statements)

References 51 publications

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“…In fact, Wyder (2015) reported that IPA may undermine the therapeutic relationship between medical staff and the patients' perception. Other authors found that the staff's interactions with patients play a central role from the point of view of IPs (Khatib et al, 2018;Ritsner et al, 2018). Khatib et al (2018) noted that replacement of bedding, the extent of comfort when a patient is tied or restrained, and the suitability of the room (e.g., temperature and ventilation) emerged as themes about the extent to which staff impact IPs' freedom.…”

Section: Impacts Of Ipa On Patients' Perceptions Of Coercive Treatmentsmentioning

confidence: 99%

“…Nevertheless, there is also a shared perspective concerning critical issues in IPA's clinical and ethical aspects. For instance, one clinical aspect is the questionable correlation between severe mental illness and IPA (Ritsner, 2018). One of the ethical aspects is that involuntary admission is largely debated for its legal regulation and practice, and it is subject to growing criticism from the human rights point of view, particularly expressed by involuntary patients (IPs) (Gowda et al, 2017; Kallert et al, 2008).…”

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confidence: 99%

“…A comparison of studies carried out in different countries indicated that coercive interventions are used in 100% of the wards in Germany, 60% of those in Switzerland, and none in Great Britain (Beghi et al, 2013). Coercive interventions, along with the involuntary placement of the patient, may have a strong impact on specific outcomes, such as quality of life, therapeutic relations, motivation for treatment, likelihood of subsequent involuntary hospitalizations, and satisfaction with treatments (Cornaggia et al, 2011; Fiorillo et al, 2011; Ritsner et al, 2018; Wyder et al, 2015). There is an ongoing debate about what constitutes the right balance between the patient's autonomy and the state's obligation to ensure maximum protection of health and life (Isobel, 2019; Wynn, 2006).…”

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confidence: 99%

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Implications of Involuntary Psychiatric Admission

et al. 2022

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Involuntary psychiatric admission is an increasing, widespread practice adopted throughout the world; however, its legal regulation and practice are still under debate, and it is subject to criticism from the human rights point of view. Only a few studies have strictly focused on the outcomes and subsequent treatment implications of this practice. To perform a scoping review of the literature on involuntary psychiatric admission and systematize and summarize its outcomes and implications for adult psychiatric inpatients.Four overarching issues emerged from the studies: a) symptomatological repercussions, b) impacts on treatment before discharge, c) impacts on treatment after discharge, and d) implications on patients' attitudes, behavior, and functioning. The overall evidence suggested correlations between involuntary psychiatric admission and several implications: length of stay, aggressive behavior, occurrence of psychopathologies, uses of coercive measures, psychiatric service activations after discharge, emotive reactions, and quality of life. The proposal presented here is the major involvement of the patient and of all the other actors involved during the entire treatment process to promote a shift from a delegation perspective to a negotiation perspective in the management of involuntary psychiatric admission.

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Section: Impacts Of Ipa On Patients' Perceptions Of Coercive Treatmentsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Implications of Involuntary Psychiatric Admission

et al. 2022

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“…Studies have often demonstrated that individuals treated involuntarily under MHAs experience a higher illness acuity or severity, and greater complexity, longer hospitalisations, and are more likely to be readmitted compared to those treated voluntarily [7][8][9][10][11]. Poor medication adherence and lower treatment satisfaction have also been reported [8,12].…”

Section: Introductionmentioning

confidence: 99%

Is higher psychotropic medication burden associated with involuntary treatment under the Mental Health Act? A four-year Australian cohort study

Wheeler

Profitt

et al. 2020

BMC Psychiatry

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Background: Involuntary treatment for individuals who lack sufficient capacity to make informed decisions regarding treatment has been associated with increased rates of injectable antipsychotics, antipsychotic polytherapy, and/or high doses. However, little is known about non-antipsychotic psychotropic prescription, or psychotropic medication burden as a more encompassing approach for people treated involuntarily. The aim of this study was to examine the relationship between Mental Health Act (MHA) status and psychotropic polypharmacy and/or high-dose medication prescribing practices in an Australian inpatient mental health unit. Methods: A retrospective cohort study of 800 adults discharged from a large metropolitan Queensland mental health unit was undertaken. Data was collected for 200 individuals, discharged on at least one psychotropic medicine, at four time periods; Cohort 1 (on or before 31st January 2014), Cohort 2 (2015), Cohort 3 (2016) and Cohort 4 (2017). The number of prescribed medicines and total daily doses were recorded and reviewed for alignment with current clinical guidelines. Participant demographics and clinical characteristics were compared by individual MHA status using chi-square test for categorical variables and analysis of variance for continuous variables. Associations between MHA status and prescribing practices (psychotropic polypharmacy and/or highdose prescribing) were assessed using bivariate and multivariate binomial logistic regression models. Age, gender, birth country, year of admission, admissions in previous 12 months, primary diagnosis, ECT/clozapine treatment, and other psychotropic medications were adjusted as covariates. Results: Regression analysis found that compared to their voluntary counterparts, individuals treated involuntarily were 2.7 times more likely to be prescribed an antipsychotic at discharge, 8.8 times more likely to be prescribed more than one antipsychotic at discharge and 1.65 times more likely to be prescribed high-dose antipsychotic treatment at discharge. The adjusted model also found that they were half as likely to be prescribed an antidepressant at discharge.

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“…Regarding clinical symptoms, studies have shown that persons more likely to be involuntarily admitted were those with higher levels of positive psychotic symptoms and aggressive behavior (Canova Mosele et al, 2018;Ritsner et al, 2018;Silva et al, 2018;Zhou et al, 2015), while depressive and/or anxiety symptoms were found to GEORGACA ET AL.…”

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confidence: 99%

Clinical determinants of involuntary psychiatric hospitalization: A clinical profile approach

et al. 2023

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Objectives The study examines the clinical determinants of involuntary psychiatric hospitalization. Specifically, it investigates whether distinct clinical profiles of hospitalized patients can be discerned, what other characteristics they are linked with, and which profiles predict involuntary admission. Methods In this cross‐sectional multicentre population study, data were collected for 1067 consecutive admissions in all public psychiatric clinics of Thessaloniki, Greece, during 12 months. Through Latent Class Analysis distinct patient clinical profiles were established based on Health of the Nation Outcome Scales ratings. The profiles were then correlated with sociodemographic, other clinical, and treatment‐related factors as covariates and admission status as a distal outcome. Results Three profiles emerged. The “Disorganized Psychotic Symptoms” profile, combining positive psychotic symptomatology and disorganization, included mainly men, with previous involuntary hospitalizations and poor contact with mental health services and adherence to medication, indicating a deteriorating condition and chronic course. Τhe “Active Psychotic Symptoms” profile included younger persons with positive psychotic symptomatology in the context of normal functioning. The “Depressive Symptoms” profile, characterized by depressed mood coupled with nonaccidental self‐injury, included mainly older women in regular contact with mental health professionals and treatment. The first two profiles were associated with involuntary admission and the third with voluntary admission. Conclusions Identifying patient profiles allows the examination of the combined effect of clinical, sociodemographic, and treatment‐related characteristics as risk factors for involuntary hospitalization, moving beyond the variable‐centered approach mainly adopted to date. The identification of two profiles associated with involuntary admission necessitates the development of interventions tailored to chronic patients and younger persons suffering from psychosis respectively.

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Assessment of health needs, satisfaction with care, and quality of life in compulsorily admitted patients with severe mental disorders

Cited by 28 publications

References 51 publications

Implications of Involuntary Psychiatric Admission

Implications of Involuntary Psychiatric Admission

Is higher psychotropic medication burden associated with involuntary treatment under the Mental Health Act? A four-year Australian cohort study

Clinical determinants of involuntary psychiatric hospitalization: A clinical profile approach

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