Mortality among involuntarily admitted psychiatric patients: a survival analysis

Only a few studies have examined mortality among committed psychiatric patients, and most of them suffer methodologically from selected populations, small samples, and inappropriate methods of data analysis. The purpose of this study was to determine whether involuntarily admitted psychiatric inpatients are a high risk group for mortality compared to a group of voluntarily admitted psychiatric inpatients.

A retrospective cohort design was used with a maximum 9-year variable follow-up. A multistage sampling procedure was used to generate the sample, which consisted of 1064 involuntarily admitted patients and 1078 voluntarily admitted patients.

During the follow-up period, 107 deaths were identified, 58 involuntary and 49 voluntary [chi 2 (1) = 0.9255, P = 0.336]. No significant differences were observed between the cohorts when survival analysis was used to examine survival experiences in the community.

Compared to voluntary patients, involuntary patients do not appear to be at a higher risk for mortality. The high standard mortality ratios observed in both cohorts, however, are consistent with previous findings of high mortality among psychiatric patients in general, and support the need for intensive follow-up in the community following discharge from a psychiatric inpatient unit.