Variables Affecting the Decision Making of a Review Panel

Abstract

This study was designed to identify the variables that influence a review panel's decision to discharge or detain an involuntary patient. A group of fifty patients consecutively discharged by the review panel of a provincial mental hospital were compared according to thirty-five variables, with a group of forty-five patients consecutively detained by the panel. The variable set included information on the patient's psychiatric history, current hospitalization and treatment as well as ratings of dangerousness, insight and psychopathology, as reflected in the attending physician's case summary prepared for the review panel. The released and detained groups were found to be remarkably similar. They differed on ten of the thirty-five variables measured, but they did not differ on some variables that one would expect to form the basis of the panel's decision, including diagnosis and a history of suicide attempts. On the other hand, when the predictive value of the variable set as a whole was examined using discriminant analysis, the results indicated that there was a substantial amount of predictability to the review panel process. The group membership of 77.5% of the patients can be predicted from only nine variables that contribute to the discriminant function. The results will be of interest to clinicians who deal with review panels on a regular basis and the findings have implications for other practical issues including discharge planning and readiness for community living.

Social Workers' and Physicians' Experiences with Review Panels in British Columbia

“…The decision-making process of review panels in British Columbia was investigated by Higenbottam, Ledwidge, Paredes, Hansen, Kogan, and Lambert (1985). The following factors were found to be predictive of discharges: (a) being capable, (b) being represented by a lawyer, (c) having more than two years of community living prior to admission, (d) being on boarding home waiting lists, (e) having a positive…”

Mental Health Review Tribunal Decision-making: A Therapeutic Jurisprudence Lens

“…The incidence of this representation varies from jurisdiction to jurisdiction, depending upon the availability of specialist organisations prepared to undertake such advocacy and the existence of legal aid. Some information suggests that represented persons are likely to be more successful before a tribunal (see, e.g., Higgenbottam, Ledwidge, Paredes, Hansen, Kogan, & Lambert, 1985;Grant, Ogloff, & Douglas, 2000). Such a result is not surprising, given the likelihood that represented patients will be able to assemble information likely to assist their case more systematically and in ways which are more focused upon statutorily prescribed considerations.…”

Why are Patients Discharged by Review Boards?

“…The reasons given by RBs for revoking certificates were not reported by Adams or Paredes in the Canadian studies. Higenbottam, however, did note that discharge by RBs from the Riverview Hospital was associated with several demographic and clinical variables (7). Although anecdotal information from single case reports identifies reasons for mental health certificates being rescinded (8), we are unaware of any systematic study ofthis issue in Canada.…”