Mental health care in Athens: Are compulsory admissions in Greece a one-way road?

Stylianidis, Stelios; Peppou, Lily Εvangelia; Drakonakis, Nektarios; Douzenis, Athanasios; Panagou, Aimilia; Tsikou, Kyriaki; Pantazi, Amalia; Rizavas, Yannis; Saraceno, Benedetto

doi:10.1016/j.ijlp.2017.04.001

Cited by 44 publications

(51 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, a weak medication adherence contributed substantially to the decision to mandate an IA in about a third of cases. Discontinuation of medication has been described as a main reason to refer for IA in different countries (41, 43, 50), and a Norwegian study found treatment with neuroleptics to be the most frequently named expectation of general practitioners who referred for IA (40). Nevertheless, a meta-analysis showed that measures to enhance adherence did not significantly reduce the number of IA (56).…”

Section: Discussionmentioning

confidence: 99%

“…There is limited literature describing the course of the PES and the decision-making process leading to IA from the referring physicians' perspectives. Some studies analyzed who initiated the IA (40, 41). Others investigated reasons for the IA and found that patient's aggressiveness, risk of harm to self or others, discontinuation/reinstatement of medical treatment and various other reasons were named with different frequency and importance depending on the setting of the PES and the referring agent (40–43).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

et al. 2019

View full text Add to dashboard Cite

Introduction: Involuntary admissions to psychiatric hospitals, regardless of their beneficial effects, violate the patients' autonomy. To keep such measures at a minimum and develop less restricting and coercive alternatives, a better understanding of the psychiatric emergency situations which end up in involuntary admissions is needed. This descriptive and exploratory study investigates the consultations leading to involuntary admission and the decision-making process of the referring physicians.Methods: We developed an online questionnaire to collect data on the characteristics of the consultation leading to an involuntary admission, including influencing factors from the referring physicians‘ perspective, as well as their professional background. We included 107 physicians who completed the questionnaire after they had referred patients for involuntary admission to one major psychiatric hospital in Switzerland.Results: The referring physicians were heterogeneous regarding their medical background and experience with psychiatric emergency situations. The consultations were time consuming and took place in various locations. Clinical findings, third-party anamnesis and a known psychiatric diagnosis contributed strongest to the decision to admit involuntarily. “Protection from danger to self” was named most frequently as purpose of the admission.Discussion: This study emphasizes the variety of psychiatric emergency situations leading to involuntary admissions. In most cases, several parties are involved and influence the decision together with medical and social factors. To reduce the number of involuntary admissions, alternatives for patients with a high symptom load and at risk of harming themselves are needed. Possible approaches to achieve that reduction and recommendations for further research are provided.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

et al. 2019

View full text Add to dashboard Cite

show abstract

“…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 .…”

Section: Discussionmentioning

confidence: 99%

“…Marital status was also identified herein as a risk factor, since singles were more likely to be involuntary admitted at the APH. Indeed, international literature poses singles with no supportive family or social network in increased risk for compulsory treatment 3,9,[29][30]33,[35][36][41][42][43][46][47][52][53]56 .…”

Section: Discussionmentioning

confidence: 99%

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

Kaikoushi¹,

Bella²,

Middleton³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The clinical and demographic characteristics of the adults involuntary admitted for compulsory mental health treatment have not been reported adequately. Purpose: Investigation of the socio-demographic and clinical characteristics of the adults who are involuntary hospitalized in the acute Mental Health Services in Cyprus. Method: A descriptive correlation study with cross-sectional comparisons was applied. Data collection was performed from December 2016 to February 2018 via a structured questionnaire including demographic and clinical variables. Each questionnaire was accompanied by a consent form, which was assigned by the participants before their discharge. Results: The sample consisted of 406 people, of whom 262 were male and 144 were female. The vast majority were Greek-Cypriots. The largest age groups were 45-65 years (33%) and 25-34 years (31.8%), respectively. 172 of the participants reported current substance use and 117 of them fulfilled the criteria of dual diagnosis. The most frequent diagnosis was schizophrenia or a relevant psychotic disorder (86.4%). The main cause of relapse and subsequent admission was medication non-adherence along with lack of insight (57.1%). 52% of the sample had been previously involuntary hospitalized in a psychiatric hospital. Conclusions: A high percentage of involuntary hospitalizations was noted due to non-adherence to pharmacotherapy. Re-evaluation of the effectiveness of relevant community interventions is suggested, as well as implementation of structured educational programs on therapy adherence during hospitalization. The goal is the limitation of the frequency of relapse while being in the community. Also, education on substance use prevention is also suggested for clinical populations.

show abstract

“…Previous research on the system-related factors associated with involuntary hospitalizations is somehow scarce and inconclusive. Factors such as previous mental health service utilization [53,69,70], availability of inpatient beds [34,52,71], availability of alternative less restrictive forms of care, such as temporary housing or residential crisis stabilization [72− 74], adequacy of community services [4], availability of home visits [75,76], lower levels of service integration [62,77], referral procedures such as contact with police, referral by physicians who did not know the patient or the professional that requires a compulsory admission [63,65,67], and longer waiting times for obtaining appropriate mental health care [62,75] may be associated with involuntary hospitalization. This study found variation across psychiatric services, suggesting that services organization plays a role in predicting involuntary hospitalizations.…”

Section: Association Between Involuntary Hospitalization(s) and Sociomentioning

confidence: 99%

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Silva

Antunes

Azeredo‐Lopes

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundIdentifying which factors contribute to involuntary psychiatric hospitalization may support initiatives to reduce its frequency. This study examines the sociodemographic, clinical, and contextual factors associated with involuntary hospitalization of patients from five Portuguese psychiatric departments in 2002, 2007 and 2012.MethodsData from all admissions were extracted from clinical files. A Poisson generalized linear model estimated the association between the number of involuntary hospitalizations per patient in one year and sociodemographic, clinical, and contextual factors.ResultsMale gender [exp(β̂) = 1.31; 95%CI:1.06-1.62, p<0.05], having secondary and higher education [exp(β̂) = 1.45; 95%CI:1.05-2.01, p<0.05, and exp(β̂) = 1.89; 95%CI:1.38-2.60, p<0.001, respectively], a psychiatric diagnosis of psychosis [exp(β̂) = 2.02; 95%CI:1.59-2.59, p<0.001], and being admitted in 2007 and in 2012 [exp(β̂) = 1.61; 95%CI:1.21-2.16, p<0.01, and exp(β̂) = 1.73; 95%CI:1.31-2.32, p<0.001, respectively] were associated with an increment of involuntary hospitalizations. Being married/cohabitating [exp(β̂) = 0.74; 95%CI:0.56-0.99, p<0.05], having experienced a suicide attempt [exp(β̂) = 0.26; 95%CI:0.15-0.42, p<0.001], and belonging to the catchment area of three of the psychiatric units evaluated [exp(n) =0.65; 95%CI:0.49-0.86, p<0.01, exp(β̂) = 0.67; 95%CI:0.49-0.90, p<0.01, and exp(β̂) = 0.67; 95%CI:0.46-0.96, p<0.05 for Hospital de Magalhães Lemos, Centro Hospitalar Psiquiátrico de Lisboa and Unidade Local de Saúde do Baixo Alentejo, respectively] were associated with a decrease in involuntary hospitalizations.ConclusionsThe findings suggest that involuntary psychiatric hospitalizations in Portugal are associated with sociodemographic, clinical, and contextual factors. This information may help to recognize high-risk patients, and to inform the development of better-targeted preventive interventions to reduce these hospitalizations.

show abstract

Mental health care in Athens: Are compulsory admissions in Greece a one-way road?

Cited by 44 publications

References 25 publications

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

Characteristics of Psychiatric Emergency Situations and the Decision-Making Process Leading to Involuntary Admission

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

Factors Associated With Involuntary Psychiatric Hospitalization in Portugal

Contact Info

Product

Resources

About