Differences in the use of involuntary admission across the Veneto Region: which role for individual and contextual variables?

Donisi, Valeria; Tedeschi, Federico; Salazzari, Damiano; Amaddeo, Francesco

doi:10.1017/s2045796014000663

Cited by 18 publications

(28 citation statements)

References 26 publications

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“…The criteria for involuntary admission in psychiatric ward are (a) the patient experiences mental changes that require an urgent therapeutic intervention; (b) the patient does not accept treatment; (c) there are no conditions enabling them to take other timely and adequate therapeutic measures outside those achieved in hospitals. The Law states that compulsory admissions need to be formally authorized by the Mayor of the Municipality where the patient lives and can be only undertaken in acute psychiatric wards located in public general hospitals (Amaddeo et al 2012;Bauer et al 2007;Pantusa et al 2007;Zhou et al 2015;Donisi et al 2016). On the other hand, some studies have considered bipolar disorder, especially mixed and manic episodes, as one of the main diagnosis related to the involuntary admission (Lee et al 2007;Schuepbach et al 2008;Amr & Volpe 2012).…”

Section: Objectivementioning

confidence: 99%

Involuntary admissions in Italy: the impact of seasonality

Aguglia

Moncalvo

Solia

et al. 2016

International Journal of Psychiatry in Clinical Practice

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Objective: The aim of this study is to assess the prevalence of involuntary admissions with regard to seasonality and clinical associated features, in a sample of patients admitted to a psychiatric unit in a period of 24 months. Methods: All subjects consecutively admitted to the Psychiatric Inpatient Unit of the San Luigi Gonzaga Hospital, Orbassano (University of Turin, Italy) from September 2013 to August 2015 were recruited. Socio-demographic and clinical characteristics were collected. Results: Seven hundred and thirty admissions in psychiatric ward were recognized. The prevalence of involuntary admission was 15.4%. Patients with involuntary hospitalizations showed a higher education level, a higher prevalence of admission in spring/summer with a significant peak in June, a longer duration of hospitalization and a lower suicide ideation. Among involuntary admissions, physical restraint and suicide attempts were more prevalent during spring compared to the other seasons. Conclusions: Seasonality has an important role in the psychopathology of psychiatric disorders, particularly in bipolar and related disorder, and may represent an influencing factor in hospital admissions and hospitalizations. Seasonal pattern must be considered while managing diagnosis and treatment of mental disorders, with regard to prevention and psychoeducation of patients.

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Section: Objectivementioning

confidence: 99%

Involuntary admissions in Italy: the impact of seasonality

Aguglia

Moncalvo

Solia

et al. 2016

International Journal of Psychiatry in Clinical Practice

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“…Previous research has shown significant geographical variations in involuntary care both between and within countries [ 1 , 5 , 9 ]. Some of these variations arose from different population profiles.…”

Section: Introductionmentioning

confidence: 99%

“…Some of these variations arose from different population profiles. The health needs of the population, approximated by the prevalence of severe mental disorders such as psychotic disorders [ 5 ], were in particular found to be associated with involuntary care, and so were socio-economic characteristics of the population, including social support and deprivation [ 10 , 11 ]. In addition, a large body of literature has underscored the possibility that health care supply could also be associated with geographic variations in the use of care [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, a large body of literature has underscored the possibility that health care supply could also be associated with geographic variations in the use of care [ 12 – 14 ]. A few studies have suggested that this could indeed be the case for variations in the use of involuntary care [ 5 , 10 , 15 , 16 ]. However, they have only focused on limited types of providers or on too few areas [ 5 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…A few studies have suggested that this could indeed be the case for variations in the use of involuntary care [ 5 , 10 , 15 , 16 ]. However, they have only focused on limited types of providers or on too few areas [ 5 , 9 ]. Additional work carried out on a large scale and including a wide number of variables is therefore necessary to better illustrate geographical variations in involuntary care and to understand their associations with the supply of care.…”

Section: Introductionmentioning

confidence: 99%

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Geographic variations in involuntary care and associations with the supply of health and social care: results from a nationwide study

Gandré

Gervaix

Thillard

et al. 2018

BMC Health Serv Res

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BackgroundInvoluntary psychiatric care remains controversial. Geographic disparities in its use can challenge the appropriateness of the care provided when they do not result from different health needs of the population. These disparities should be reduced through dedicated health policies. However, their association with the supply of health and social care, which could be targeted by such policies, has been insufficiently studied. Our objectives were therefore to describe geographic variations in involuntary admission rates across France and to identify the characteristics of the supply of care which were associated with these variations.MethodsInvoluntary admission rate per 100,000 adult inhabitants was calculated in French psychiatric sectors’ catchment areas using 2012 data from the national psychiatric discharge database. Its variations were first described numerically and graphically. Several factors potentially associated with these variations were then considered in a negative binomial regression with an offset term accounting for the size of catchment areas. They included characteristics of the supply of care (public and private care, health and social care, hospital and community-based care, specialised and non-specialised care) as well as adjustment factors related to epidemiological characteristics of the population of each sector’s catchment area and its level of urbanization. Such variables were extracted from complementary administrative databases. Supply characteristics associated with geographic variations were identified using a significance level of 0.05.ResultsSignificant variations in involuntary admission rates were observed between psychiatric sectors’ catchment areas with a coefficient of variation close to 80%. These variations were associated with some characteristics of the supply of health and social care in the sectors’ catchment areas. Notably, an increase in the availability of community-based private psychiatrists and the capacity of housing institutions for disabled individuals was associated with a decrease in involuntary admission rates while an increase in the availability of general practitioners was associated with an increase in those rates.ConclusionsThere is evidence of considerable variations in involuntary admission rates between psychiatric sectors’ catchment areas. Our results provide lines of thoughts to reduce such variations, in particular by supporting an increase in the availability of upstream and downstream care in the community.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3064-3) contains supplementary material, which is available to authorized users.

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Measuring the level of compulsory hospitalisation in mental health care: The performance of different measures across areas and over time

Hofstad

Rugkåsa

Ose

et al. 2021

Int J Methods Psych Res

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Objective: A variety of measures are used for reporting levels of compulsory psychiatric hospitalisation. This complicates comparisons between studies and makes it hard to establish the extent of geographic variation. We aimed to investigate how measures based on events, individuals and duration portray geographical variation differently and perform over time, how they correlate and how well they predict future ranked levels of compulsory hospitalisation.Methods: Small-area analysis, correlation analysis and linear regressions of data from a Norwegian health registry containing whole population data from 2014 to 2018. Results:The average compulsory hospitalisation rate per 100,000 inhabitant was 5.6 times higher in the highest area, compared to the lowest, while the difference for the compulsory inpatient rate was 3.2. Population rates based on inpatients correlate strongly with rates of compulsory hospitalisations (r = 0.88) and duration (r = 0.78). 68%-81% of ranked compulsory hospitalisation rates could be explained by each area's rank the previous year. Conclusion:There are stable differences in service delivery between catchment areas in Norway. In future research, multiple measures of the level of compulsory hospitalisation should ideally be included when investigating geographical variation.It is important that researchers describe accurately the measure upon which their results are based. K E Y W O R D Scompulsory hospitalisation, geographic variation, measurement, small area analysis | INTRODUCTIONHealth service delivery is based on ethical principles of voluntariness and respect for autonomy (Etchells et al., 1996). Compulsory care, such as compulsory psychiatric hospitalisation represents a breach of individual autonomy and should therefore be used as a last resort and in the patient's best interest, and this is usually reflected in legislation that regulates such practice (Saya et al., 2019). Nonetheless, considerable concerns about current practice have been raised (Molodynski et al., 2016). This is, among other things, due toThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Differences in the use of involuntary admission across the Veneto Region: which role for individual and contextual variables?

Cited by 18 publications

References 26 publications

Involuntary admissions in Italy: the impact of seasonality

Involuntary admissions in Italy: the impact of seasonality

Geographic variations in involuntary care and associations with the supply of health and social care: results from a nationwide study

Measuring the level of compulsory hospitalisation in mental health care: The performance of different measures across areas and over time

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