Determinants of emergency involuntary admission

Background

Although this was not intended by the deinstitutionalization of psychiatric services, the overall number of involuntary admissions has steeply increased across Europe. In the Netherlands, the number of compulsory admissions has more than doubled since 1979, rising from 23 to over 46 per 100.000 inhabitants in 2004. In the Amsterdam area, the number of compulsory admissions has increased with 340% to 86 per 100,000 in the same period.

Method

In our current prospective cohort study (started in 2004) we seek to examine on the one hand the predictors of compulsory admissions (part I) and on the other hand the effect of these admissions on compliance with treatment and treatment outcome on the long run (part II). Part I of the study comprises all consecutive crisis consultations by the Amsterdam Emergency Psychiatry Service (SPA) and Mentrum's regional crisis center in the period from September 2004 to October 2006, around 4600 consultations in total.

Results

We will present the first data from our part I cross-sectional study: which variables, apart from severity of illness, danger and lack of compliance predict a compulsory admission as the outcome of an emergency consultation? We are especially interested in the influence of social support, quality of actual treatment before the emergency consultation and ethnicity as co-predictors.