Involuntary admissions in a Canadian province: The influence of geographic and population factors

Abstract

The present study investigated the effects of community size and the availability of admitting facilities on rates of involuntary admissions in a Canadian province with a very small population. The rate was much higher for areas within close proximity of the admitting facility and for communities with populations either less than 500 or greater than 30,000. These findings are discussed in the context of factors such as geographic distribution of population in the province and availability of appropriate psychiatric and social support facilities.

Factors influencing compulsory admission of psychiatric patients

“…Because of the significant differences between urban and rural compulsory admission rates shown in other studies (e.g. Miller & Fiddleman, 1983;Toews et al 1984;Malla & Norman, 1988;Spengler & Bohme, 1989), generalizing conclusions cannot be drawn from these studies either, as Szmukler himself points out. Similarly, the studies from the FRG are limited either to 'State Mental Hospitals' (Muller & Busche, 1978;Hulsmeier, 1980), a psychiatric department of a university (Bosch, 1974) or a psychiatric emergency service (Spengler, 1986).…”

“…Furthermore, the frequency of compulsory detainment differs not only between countries and states governed by different laws but also within them. These differences are due to different regional administrative regulations of the process of detention (Uchtenhagen, 1982;Bauer & Berger, 1986;Spengler & Bohme, 1989), to the specific provisions for care in different regions (Spengler et al 1981;Bauer, 1982;Bauer & Haselbeck, 1983;Bauer & Berger, 1984;Faulkner et al 1985Faulkner et al , 1989 and even different hospitals (Katschnig et al 1975;Spengler & Bohme, 1989), and to the considerable urban-rural variation with a lower frequency of committals in rural areas (Miller & Fiddleman, 1983;Toews et al 1984;Malla & Norman, 1988;Spengler & Bohme, 1989).…”

The mental health care delivery system in greece: regional variation and socioeconomic correlates

“…[3][4][5][7][8][9][10] In the socially disadvantaged areas the patients are treated in mental hospitals due to the lack of alternatives to mental hospital treatment. 7,8,25 In the case of Greece, despite the current reorganization of the whole mental health care delivery system towards a more decentralized form and the continuous board certification of new psychiatrists and mental health professionals, e.g. psychologists, social workers, occupational therapists, there are still serious problems in several prefectures of some regions, related to the inadequate number of local mental health staff and services.…”

Involuntary commitment in Greenland, the Faroe Islands and Denmark

“…The geography of Greenland, a vast country, sparsely populated and without local opportunities for psychiatric treatment, complicates the contact between patient and the mental health care services, causing an increased commitment risk, a pattern that has been found in Canada (9). The lack of ready access to psychiatric treatment because of commu-Engberg cially men, for commitment.…”

“…Interest has grown recently in geographic variation in the use of health services, especially within a country (7,8), as the nationwide registers of health services provide good conditions for evaluation of regional variation in health care. Community size, bed availability, different handling of the legislation and composition of the population in social class and ethnic minorities have been proposed as being related to commitment rates (9)(10)(11)(12)(13)(14). The common commitment legislation and registration for Greenland, the Faroe Islands and Denmark, because of shared administration in some fields, offer a special opportunity to compare the use of commitment in 3 countries.…”