Community treatment orders in Western Switzerland: A retrospective epidemiological study

Silva, Benedetta; Golay, Philippe; Boubaker, K; Bonsack, Charles; Morandi, Stéphane

doi:10.1016/j.ijlp.2019.101509

Cited by 4 publications

(2 citation statements)

References 36 publications

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“…Focusing on studies from Switzerland, organic psychotic disorders, or schizophrenia spectrum disorders were the most consistent risk factor associated with compulsory admissions ( Arnold et al, 2019 ; Eytan et al, 2013 ; Hotzy et al, 2019 ), whereas the association of age and gender was inconclusive in the studies mentioned above. Aggressive behavior ( Silva et al, 2019 ) and admission during nighttime or on weekends ( Arnold et al, 2019 ) were also associated with compulsory admissions. Furthermore, a history of previous compulsory admissions was associated with an increased risk of re-admissions ( Lay et al, 2019 ; Silva et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Compulsory psychiatric admissions in the canton of Basel-Stadt between September 2013 and April 2022: Analysis of the cantonal database of the Health Department of Basel-Stadt

Schneider

Back²,

Krückl

et al. 2022

Int J Soc Psychiatry

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Background: According to federal and cantonal law, persons with an acute mental illness can be admitted to a psychiatric hospital or another suitable institution against their will, when other therapeutic options are not available or have been exhausted. In the canton of Basel-Stadt, this is the responsibility of public health officers employed by the division of Social Medicine of the cantonal Health Department. Aims: This study aims to elucidate which factors influence the decision-making of public health officers regarding compulsory admissions over the period from September 2013 to April 2022 in the canton of Basel-Stadt. Method: Leveraging comprehensive clinical data from the health department of the canton Basel-Stadt ( N = 5,′550), we estimated a mixed effects logistic regression model to identify factors contributing to the decision of public-health officers to compulsorily admit patients, while controlling for potential clustering effects among public health officers. Results: The risk for compulsory admissions was most strongly predicted by the presence of potential self-harm. In comparison, while being a strong predictor, potential harm to others played a considerably lesser role. Furthermore, psychiatric syndrome, previous compulsory admissions, and the specific context of evaluation were significant predictors. Finally, we found no meaningful personal bias among public health officers. Conclusion: The results suggest that public health officers’ decision-making regarding compulsory admissions focuses on preventing self-harm and, to a lesser degree, harm to others. This indicates that such measures are only used as a measure of last resort, which is in line with current evidence regarding the detrimental effects of compulsory measures on treatment outcomes in psychiatry. Our findings suggest that all relevant stakeholders, including the police, share this perspective. Decision-making regarding compulsory admissions was mostly free of personal biases, suggesting adherence to shared professional standards by public health officers.

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Section: Discussionmentioning

confidence: 99%

Compulsory psychiatric admissions in the canton of Basel-Stadt between September 2013 and April 2022: Analysis of the cantonal database of the Health Department of Basel-Stadt

Schneider

Back²,

Krückl

et al. 2022

Int J Soc Psychiatry

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“…To the best of our knowledge, this was the first study to explore the experience of coercion among both voluntary and involuntary patients in Switzerland. The Swiss Confederation has one of the most highly developed psychiatric health systems in the world [ 21 ]. According to World Health Organization data, in 2014, Switzerland had 91 psychiatric beds per 100,000 inhabitants, well above the European average of 73 [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

et al. 2023

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Various coercive measures can be used to legally compel a person suffering from psychiatric disorder to undergo treatment. However, evidence suggests that patients’ feeling of being coerced is not determined solely by their being submitted to formal coercion. This study aimed to explore voluntary and involuntary patients’ experience of coercion during psychiatric hospitalisation and to identify which factors, from their perspective, most affected it. We chose a qualitative design inspired by a hermeneutic-phenomenological approach. Participants were purposively selected from six psychiatric hospitals in Switzerland. Maximum variation sampling was used to ensure the inclusion of patients with different levels of perceived coercion and different admission statuses. In-depth, semi-structured interviews were co-conducted by a research psychologist and a service-user researcher. The transcribed data underwent thematic analysis. All twelve interviewed patients described the hospitalisation as an experience of loss of control over their life due to either external or internal pressures. During the process, perceptions of these pressures varied and sometimes overlapped, leading some patients to describe their admission as a form of simultaneous protection and violation. The balance between these two contradictory feelings was affected by a variety of contextual and relational factors, as well as by the meaningfulness of the experience and the patient’s subsequent satisfaction with it. Increasing policy-makers’ and clinicians’ awareness about the main factors influencing patients’ experience of loss of control is of paramount importance in order to develop skills and strategies able to address them, reinforcing patients’ empowerment, reducing their feeling of coercion and improving their well-being.

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Feeling coerced during psychiatric hospitalization: Impact of perceived status of admission and perceived usefulness of hospitalization

Golay

Morandi

Silva

et al. 2019

International Journal of Law and Psychiatry

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Community treatment orders in Western Switzerland: A retrospective epidemiological study

Cited by 4 publications

References 36 publications

Compulsory psychiatric admissions in the canton of Basel-Stadt between September 2013 and April 2022: Analysis of the cantonal database of the Health Department of Basel-Stadt

Compulsory psychiatric admissions in the canton of Basel-Stadt between September 2013 and April 2022: Analysis of the cantonal database of the Health Department of Basel-Stadt

Exploring Patients’ Feeling of Being Coerced During Psychiatric Hospital Admission: A Qualitative Study

Feeling coerced during psychiatric hospitalization: Impact of perceived status of admission and perceived usefulness of hospitalization

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