Rates and determinants of involuntary hospitalizations in Athens region: Are there any differences between psychiatric and general hospitals?

Abstract

Involuntary hospitalizations have come to the fore due to growing concerns that Europe may be in the throes of reinstitutionalization. In Greece, the topic is of sheer importance in light of the incomplete deinstitutionalization process. In this context, the aim of the study is to explore differences in the rates and determinants of involuntary hospitalizations between a psychiatric and a general hospital. A total of 600 patients participated in the study. Information about their socio-demographic and clinical characteristics as well as previous contact with mental health services was garnered from their clinical record and through patient and physician interviews. Symptom severity was assessed with HoNOS. Overall, 60.7% of admissions were involuntary: 63.1% in the psychiatric hospital and 52.5% in the general hospital. In the general hospital, number of previous involuntary admissions and level of aggression constituted risk factors for detention; whereas previous hospitalization amid the last month was the only protective factor. In the psychiatric hospital, no contact with mental health services during the last month was the only risk factor for detention and suicidality the only protective. There is imperative need to design interventions geared towards curbing compulsory admissions. Psychiatric hospitals and other contextual factors should be prioritized.

Keywords

• Compulsory admissions
• Detention
• Deinstitutionalization
• Mental health services
• Psychiatric reform
• Coercion