Communicating a Plan for Involuntary Psychiatric Admission: A Standardized Patient Workshop Intervention for General Psychiatry Residents

Abstract

Introduction One important and often difficult act of communication common in psychiatry is communication regarding the need for involuntarily commitment for psychiatric treatment. Thus, we designed an educational workshop for psychiatry residents on how to communicate the plan for involuntarily commitment to a psychiatric hospital. Methods Using faculty expertise, we created a protocol to guide trainees on how to structure conversations around involuntary commitment. Residents first attended a didactic on the protocol, followed by a 1-hour workshop with standardized patients (SPs) 1 week later. The workshop consisted of three 14-minute simulated scenarios with the SP with debriefing. Trainees filled out pre- and postworkshop surveys. Results Fifteen and 12 residents completed the pre- and postworkshop surveys, respectively. Residents' perceived comfort level in their ability to deliver involuntary commitment news significantly improved after the workshop when compared to before (3.0 vs. 3.7 for pre- and postworkshop surveys, respectively). Residents trended toward intending to make more changes to their approach after the workshop when compared to before (2.2 vs. 2.6, respectively). Feedback on the didactic and workshop were largely positive. Discussion To our knowledge, our intervention is the first designed specifically to teach psychiatry residents how to communicate to patients that they are being involuntarily committed to emergent psychiatric treatment. This educational model has potential for improving resident skills and confidence in having difficult conversations around involuntary commitment.

Keywords

• Difficult News
• Involuntary Commitment
• Patient Communication
• Psychiatry Residency
• Psychiatry
• Simulation