To Commit or Not to Commit: The Psychiatry Resident as a Variable in Involuntary Commitment Decisions

Sattar, S. Pirzada; Pinals, Debra A.; Din, Amad U.; Appelbaum, Paul S.

doi:10.1176/appi.ap.30.3.191

Cited by 27 publications

(28 citation statements)

References 21 publications

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“…Previous study found that psychiatrists’ high risk-taking behaviors may be related to their decisions not to seek involuntary admission (Pirzada Sattar, Pinals, Din, & Appelbaum, 2006). Thus it seemed that male psychiatrist should more unwilling to seek involuntary admission since their higher risk-taking propensity compared to female (Hojat, & Zuckerman, 2008; Killgore, Grugle, Killgore, & Balkin, 2010).…”

Section: Discussionmentioning

confidence: 99%

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Shao

Xie

2011

Int J Soc Psychiatry

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Background In order to protect the rights of the mentally ill, legislation on the standards and procedures of compulsory detention has been made at the local and national level in China. Aims This study aims to examine psychiatrists’ attitude to seeking involuntary admission in China mainland. Method Three hundred and fourteen qualified members of Chinese Psychiatrist Association (CPA) were surveyed using a questionnaire to assess their attitudes about the procedure of involuntary admission to mental hospitals. Data were analyzed using chi-squares and logistic regression. Results Some psychiatrists in CPA had several arbitrary attitudes in the process of admission. Female, age under 35, low education level and low position in institution are associated with stricter attitudes in the procedure of involuntary admission. Areas with mental health legislation showed significant positive relations with stricter attitudes. Conclusions Every effort needs to be made to minimize these arbitrary attitudes to prevent negative outcomes. Protecting the rights of people diagnosed with mental illness still has a long way to go.

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Section: Discussionmentioning

confidence: 99%

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Shao

Xie

2011

Int J Soc Psychiatry

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“…Pharmacological treatment, use of psychotherapy, treatment by staff including limit setting, activities for patients, ward atmosphere, treatment philosophy and ideology, regulations and guidelines on use of restraint and seclusion, transitions in ward routines [1,12,28,29,34,35,37]. …”

Section: Introductionmentioning

confidence: 99%

A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics

Husum

Bjørngaard

Finset

et al. 2010

BMC Health Serv Res

141

127

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BackgroundPrevious research on mental health care has shown considerable differences in use of seclusion, restraint and involuntary medication among different wards and geographical areas. This study investigates to what extent use of seclusion, restraint and involuntary medication for involuntary admitted patients in Norwegian acute psychiatric wards is associated with patient, staff and ward characteristics. The study includes data from 32 acute psychiatric wards.MethodsMultilevel logistic regression using Stata was applied with data from 1016 involuntary admitted patients that were linked to data about wards. The sample comprised two hierarchical levels (patients and wards) and the dependent variables had two values (0 = no use and 1 = use). Coercive measures were defined as use of seclusion, restraint and involuntary depot medication during hospitalization.ResultsThe total number of involuntary admitted patients was 1214 (35% of total sample). The percentage of patients who were exposed to coercive measures ranged from 0-88% across wards. Of the involuntary admitted patients, 424 (35%) had been secluded, 117 (10%) had been restrained and 113 (9%) had received involuntary depot medication at discharge. Data from 1016 patients could be linked in the multilevel analysis. There was a substantial between-ward variance in the use of coercive measures; however, this was influenced to some extent by compositional differences across wards, especially for the use of restraint.ConclusionsThe substantial between-ward variance, even when adjusting for patients' individual psychopathology, indicates that ward factors influence the use of seclusion, restraint and involuntary medication and that some wards have the potential for quality improvement. Hence, interventions to reduce the use of seclusion, restraint and involuntary medication should take into account organizational and environmental factors.

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“…Nevertheless, there is only one study about the influence of the psychiatrist's gender. This is based on five theoretical vignette scenarios, rather than clinical practice [2]. Interestingly, no significant differences were observed between male and female residents' attitude towards theoretical vignettes scenarios.…”

Section: Discussionmentioning

confidence: 96%

“…Yet there is little data regarding the influence of psychiatrist gender on the same parameters. The only study that examines this issue is an analysis of responses to five theoretical vignettes scenarios sent to 208 residents, with a 42% response rate [2]. The level of training, and residents' risk-taking behavior, may be linked to the likelihood of their seeking involuntary commitment for their patients [2].…”

Section: Introductionmentioning

confidence: 99%

“…The only study that examines this issue is an analysis of responses to five theoretical vignettes scenarios sent to 208 residents, with a 42% response rate [2]. The level of training, and residents' risk-taking behavior, may be linked to the likelihood of their seeking involuntary commitment for their patients [2]. Therefore, we decided to examine and report on this issue using, for the first time, observational data from a real life psychiatry emergency room environment.…”

Section: Introductionmentioning

confidence: 99%

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Are Female Psychiatry Residents Better to Propose in Emergency a Voluntary Hospitalization?

et al. 2009

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This study analyses assessment, intervention and admission decisions made by emergency psychiatry residents, to determine whether these differ depending on the gender of the resident. Data from all patients presenting to a psychiatric emergency room were collected prospectively for a 3 months period as part of a local quality check project. A questionnaire was used to collect patient demographic data, diagnosis, treatment decisions and the personal and professional characteristics of the residents who performed the assessments. During the 3 months of the study period we obtained data on all 251 emergency assessments carried out by all six residents working in the service. These were 3 female and 3 male 3rd year residents in psychiatry. There was no difference between male and female residents concerning ICD-10 diagnostic assessment, adherence to local hospitalization criteria guidelines, psychotherapeutical and pharmacological treatments administered. A similar distribution between male and female residents was found for diagnoses. No difference was found in the rate of hospitalization decisions between male and female residents. However, surprisingly, there were more voluntary hospitalizations by the women residents (P = 0.035; χ2 = 4.443) and more involuntary admissions by the men residents (P = 0.005; χ2 = 7.643). There was no correlation between the gender of the patient and the assessment or hospitalization decision of either male or female residents. Although this study has methodological limitations, it suggests that female emergency psychiatry residents are more likely to propose voluntary hospitalizations.

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To Commit or Not to Commit: The Psychiatry Resident as a Variable in Involuntary Commitment Decisions

Abstract: Psychiatric residency training should address nonpatient variables that might inappropriately influence the residents' decisions to seek involuntary commitment.

Cited by 27 publications

References 21 publications

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

Psychiatrists’ attitudes towards the procedure of involuntary admission to mental hospitals in China

A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics

Are Female Psychiatry Residents Better to Propose in Emergency a Voluntary Hospitalization?

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