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Procedures for involuntary admission to public and private psychiatric facilities

Published online by Cambridge University Press:  13 June 2014

Conor Farren
Affiliation:
Eastern Health Board
Declan McLoughlin
Affiliation:
The Maudsley Hospital, Denmark Hill, London SE5 8AZ (formerly Registrar, Dept. of Psychiatry, Trinity College Medical School, St. James's Hospital, James's St. Dublin 8)
Anthony Clare
Affiliation:
St. Patrick's Hospital, Dublin 8

Abstract

Objective: The aims of this study were to assess the procedures for involuntary admission to both public and private psychiatric hospitals as determined by the Mental Treatment Act, 1945 which is one of the oldest pieces of mental health legislation in the EC. Method: Over a prospective five month period all involuntary admissions to both a public and a private hospital in Dublin were studied. Social-demographic data and clinical features of 54 involuntary admissions were recorded and analysed. Results: 11.2% of public admissions were involuntary as were 3.4% of admissions to the private hospital. The most common diagnoses were schizophrenia and mania. 74.1% of the patients had been previously admitted. 81.5% of the patients were detained in hospital for less than three months although they were committed for a potential six months. There was no formal method of decertification. Conclusions: There appears to be little need nowadays for differentiating between legislation for public and private patients. The duration of the initial reception order should be reduced from six months to a period of forty-eight hours for initial assessment and treatment. If necessary this could be extended to three months. Formal methods for decertification are required. Mental health legislation in Ireland needs to be modernised.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 1992

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References

1.Szasz, T. Psychiatric justice. Br J Psychiatry 1989; 154: 864869.CrossRefGoogle ScholarPubMed
2.Chodoff, P. Involuntary hospitalisation of the mentally ill as a moral issue. Am J Psychiatry 1984; 141: 384389.Google Scholar
3.Chodoff, P. The case for involuntary hospitalisaion of the mentally ill. Am J Psychiatry 1976; 133: 496501.Google ScholarPubMed
4.Kane, J, Quitkin, F, Rifkin, A, Wegner, J, Rosenberg, G, Borenstein, M. Attitudinal changes of involuntarily committed patients following treatment. Arch Gen Psychiatry 1983; 40: 374377.CrossRefGoogle ScholarPubMed
5.Appelbaum, P, Roth, L. Involuntary treatment in medicine and psychiatry. Am J Psychiatry 1984; 141: 202205.Google ScholarPubMed
6.Robins, J. Fools and mad. Dublin: Institute of Public Administration, 1986.Google Scholar
7. Mental Treatment Act, 1945. Dublin: The Stationery Office.Google Scholar
8. Mental Treatment Act, 1961. Dublin: The Stationery Office.Google Scholar
9. Health (Mental Services) Act, 1981. Dublin: The Stationery Office.Google Scholar
9a. Department of Heatlh. Green paper on mental health. Dublin: The Stationery Office, 1992.Google Scholar
10.Szmuckler, GI, Bird, AS and Button, EJ. Compulsory admissions in a London borough -I: social and clinical features and a follow-up. Psychol Med 1981: 11: 617636.CrossRefGoogle Scholar
11.Szmuckler, GI, Bird, AS and Button, EJ. Compulsory admissions in a London borough - II: circumstances surrounding admission: service implications. Psychol Med 1981; 11: 825838.CrossRefGoogle Scholar
12.Harrison, G, Ineichen, B, Smith, J, Morgan, GH. Psychiatric hospital admissions in Bristol - II: social and clinical aspects of compulsory admission. Br J Psychiatry 1984; 145: 605611.CrossRefGoogle ScholarPubMed
13.Tomelleri, CJ, Lakshminarayanan, N, Herjanic, M. Who are the “committed”? J Nerv Ment Dis 1977; 165: 288293.CrossRefGoogle ScholarPubMed
14.Mahler, H, Co, BT. Who are the “committed”? [update]. J Nerv Ment Dis 1984; 172: 189196.CrossRefGoogle ScholarPubMed
15.McKechnic, AA, Corser, A, McMillan, VR. Outcome of patients committed to hospital under the Mental Health (Scotland) Act 1960. Br J Psychiatry 1986; 148: 3337.CrossRefGoogle Scholar
16.Perris, C, Kemali, D, Dencker, SJ, Malm, U, Rutz, W, Amati, A, et al.Patients admitted for compulsory treatment to selected psychiatric units in Italy and in Sweden. Acta Psychiatr Scand 1985; 316 Suppl: 135149.CrossRefGoogle ScholarPubMed
17.Riley, R, Richman, A. Involuntary hospitalisation in Canadian psychiatric inpatient facilities, 1970–1978. Can J Psychiatry 1983; 28: 536541.CrossRefGoogle Scholar
18.Segal, SP. Civil committment standards and patient mix in England/Wales, Italy and the United States. Am J Psychiatry 1989; 146: 187193.Google Scholar
19.Schwartz, HI, Appelbaum, PS, Kaplan, RD. Clinical judgements in the decision to commit. Arch Gen Psychiatry 1984; 41: 811815.CrossRefGoogle Scholar
20.Weir, H, Webb, M. Procedures for involuntary hospitalisaion for mental illness and addiction. Journal of the Irish Medical Association 1980; 73: 112116.Google ScholarPubMed
21.O'Connor, A, Walsh, D. Activities of Irish psychiatric hospitals and units 1988. Dublin: Health Research Board, 1991.Google Scholar