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To establish if the relatively low rate of involuntary psychiatric admission in a suburban area between 2007 and 2011 was maintained in 2014/2015, and explore key correlates of involuntary status.
We used existing hospital records and data sources to extract rates and selected potential correlates of voluntary and involuntary admission in south west Dublin (catchment area: 273 419 people) over 18 months in 2014/2015 and compared these with published national data from the census and Health Research Board.
The rate of involuntary admission in the suburban area studied between 2007 and 2011 was 33.8 involuntary admissions per 100 000 population annually, which was lower than the national rate (48.6). By 2014/2015, the rate of involuntary admission in this area had risen to 46.8 involuntary admissions per 100 000 population annually, similar to the national rate (44.9). Nevertheless, the overall (voluntary and involuntary) admission rate in the suburban area (346.7 admissions per 100 000 population annually) was still lower the national rate (387.9), owing to a lower rate of voluntary admission in the suburban area (299.9) compared to Ireland as a whole (342.9). Multi-variable testing demonstrated that diagnosis was the strongest driver of involuntary admission in the suburban area: this area had 28.5 involuntary admissions per 100 000 population annually with schizophrenia or related disorders, compared to 18.9 nationally. Schizophrenia and related disorders accounted for 60.9% of involuntary admissions in the suburban area compared to 42.1% nationally.
Schizophrenia is the strongest driver of involuntary admission in the suburban area in this study.
Clinical practice in the prison environment is part of a special epistemological and praxeological clinic generally classified in the field of the clinical of extreme. The last one is itself defined as: «… clinical practice where all the practitioner technic, personal and ethical abilities are simultaneously and extremely requested i.e. with a particular intensity, in a way generally recognized as excessive, in the limit of what is usually tolerable for a human being.
We find necessary to pose a very particular look on the activities of the staffs implied in this clinical practice. Our experiment allows us to think that it is more complex to consider a neutral clinical practice in such situations where our human condition is exposed by a constant tension carried by the distress of the patient in front of us, his potential dangerousness and factors of guiltiness that sometimes are invited in the encounter.
understand how to escape the real or imagined aggressive of the patient, presented as a sex offender, offender, murderer…?
Consider care of patients whose guilty countertransference are moderate and do not impede the clinics.
It is very important to consider the countertransferencial process in support of the jailed patient. However, it should in no way be confused with compassion for the victim. The countertransference will in this case take into account all the emotions of the patient (shame, guilt …).