Quality criteria of involuntary psychiatric admissions - before and after the revision of the civil code in Switzerland

Abstract

BackgroundThe goal was to investigate the quality in terms of formal and content-based comprehensiveness of the forms for involuntary admission before and after the introduction of the new law (KESR, “Kindes- und Erwachsenenschutzrecht”) for the regulation of involuntary admission. Moreover, the study aimed at assessing if the quality of the admission forms was associated with the professional qualifications of the professionals ordering them. Finally, the patients were characterized.MethodsRetrospective evaluation of all commitment reports at the University Hospital of Psychiatry within a six month period before and after the introduction the KESR (N(2012) = 489; N(2013) = 651). Formal and content-related criteria for the commitment certificates were recorded as well as the socio-demographic and clinical data of the cases admitted. There were no exclusion criteria. The data was descriptively evaluated, formal and content-based criteria were compared between groups of admitting professionals. The Chi-Square-Test following Pearson and T-Test were used to test for group differences.ResultsFormal and content-related quality criteria deficiencies were noted. The best-documented forms came from psychiatrists and emergency physicians, followed by general practitioners and hospital doctors. There have been improvements in the quality of the documents since the new KESR within all professional subsamples.ConclusionsPsychiatrists and those who regularly deal with emergency commitments were likely to issue forms of high quality. Due to the considerable consequences associated with involuntary admission for affected individuals, their relatives and also professionals, the considerable deficits in the quality of the documentation must be intensively addressed in training, advanced training, continuing education and in daily routines.

Involuntary admission in Norwegian adult psychiatric hospitals: a systematic review

“…Compared to these figures, the rates described in the Norwegian studies seem to be on the high end. Differences in rates between countries may in part be due to differences in legislation [ 118 , 119 ]. Recently, changes have been introduced to the Norwegian legislation, including a requirement of a lack of capacity to consent and for an exhaustive written justification for involuntary admission [ 12 ].…”

Clinical and socio-demographic characteristics associated with involuntary admissions in Switzerland between 2008 and 2016: An observational cohort study before and after implementation of the new legislation

“…It therefore rather seems likely that it is due to cultural aspects and the legal requirements for IA laid down in the respective legislation [6, 8]. In this respect, the range of professionals who are entitled to issue IAs - psychiatrists, public health officers, physicians without a psychiatric specialization and/or non-medical authorities - [6, 40] might be worth considering: In a previous study, we found that physicians with different specializations and professional backgrounds differ in the quality of their commitment documents and the patients` clinical course after admission [45–47]. Comparable differences regarding the referring authorities have also been found in other countries [48–51].…”

Socio-demographic and clinical characteristics of adults under involuntary hospitalization in the acute mental health services of Cyprus

“…Special focus needs to be given in the sub-group of individuals with psychotic symptoms, and mainly schizophrenia and relevant psychotic disorders. Overall, the present study confirmed previous data which show that those with schizophrenia and relevant psychotic disorders are more often involuntary hospitalized 27−38 . Furthermore, additional emphasis needs to be given on educational programmes in pharmacotherapy and treatment options in order to enhance adherence to therapy, since the main cause of relapse herein as well as internationally seems to be non-adherence to pharmacotherapy 27 − 31,39−40 . As for other risk factors for involuntary admission and subsequent compulsory treatment, male gender has been well documented in international literature 3,[28][29][32][33][34][35][36][37][38][41][42][43][44][45][46][47][48][50][51] . Yet, other studies present data which report increased frequency of compulsory treatment among females 9,30,[52][53]55 .…”

“…Regarding the age of those more frequently involuntary admitted for compulsory treatment in high security units, international data show an age range between 18 to 57 years, with a mean value approximately 45 years 3,9,27,28,[30][31][32][33][34][35][41][42][45][46][50][51]53,56,60 . In the present study the majority of the participants were in the age group of 45 to 65 years, while other studies provide a range closer to 45 years 29,37,43−44,47−48 .…”