Severe mental illness and airports – the scope of the problem

Abstract

Aims and MethodMental illness may cause specific problems in the environment of an international airport. The aim of our study was to assess frequency, presentation and safety implications of mental disorders requiring formal admission at an international airport. We performed a retrospective study over 4 years including patients who were detained by the police and admitted.ResultsThe frequency of admissions was one per million passengers, the frequency of incidents raising safety concerns was four per 10 million passengers. An in-flight disturbance occurred in 1.4 per 10 million arriving passengers. Most common were schizophrenia or schizotypal disorder (46.8%) and mania (22.6%). Twenty per cent of patients presented with wandering.Clinical ImplicationsEmergency admissions and incidents causing safety concerns were rare. Airport wandering was a frequent presenting sign that should be recognised.

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“…Fisher's exact test showed a significant association between mode of contact with the MHT and MHA status on admission (P < 0.001), with only 5% voluntary hospitalisations via the police, compared to 73% voluntary admissions via the MHT. The proportion of overseas patients' admissions via the police (65%) (Table 2) is similar to reports from London [19], and Jerusalem [4], and differs from rates reported among UK (24%) and local patients (6%) admitted under the MHT (Parshall & Carranza, European Congress of Psychiatry, Madrid, 2001). Offences by overseas patients leading to contact with the police were mainly behavioural and non-violent (e.g.…”

“…Rates of overseas patients with schizophrenia or related disorders (74%) (Table 3) are comparable to figures from studies of travellers in New York -74% [2], London -50% [7], 46% [19], Jerusalem -63% [10], 85% [4], and Florence -68% [5]. These rates differ from figures of admissions with schizophrenic psychosis in inner London -30% [22], and Westminster -38% [23].…”

“…Overseas patients' admissions under section of the MHA (77%) correspond with reports of admissions from Heathrow airport -81% [7], 69% [19], and the local Hospital – 76% (Hospital MHA Officer's data), and differ from rates for England, where less than one third of admissions are under the MHA [21]. …”

Air travel by passengers with mental disorder

“…The majority of these people were found to suffer from a psychotic illness and travel to the airport was in some way a product of this illness, with a tendency in some cases for repeated visits. Subsequent studies have indicated similar findings (see, for example, Wieshmann et al, 2001). 'Airport wandering' is rare, but should be recognised as a possible manifestation of severe mental illness.…”

The most vulnerable travelers: patients with mental disorders

“…There is research evidence that 11.3% of travelers experience some kind of psychiatric problem, with 2.5% suffering from severe psychosis and 1.2% requiring more than two months of therapy at home 5,6. The acute psychotic attacks represent about one fifth of travel‐related psychiatric problems.…”