Factors predictive of changes in the legal status of psychiatric inpatients

The objective of this study was to identify factors predictive of duration of involuntary hospitalization, i.e., factors that would predict early versus late conversion to voluntary status. Charts of 209 patients admitted involuntarily to an acute psychiatric inpatient unit were studied using a naturalistic, prospective design. Multivariate regression analysis was used to determine the effect of a number of variables in predicting duration of involuntary hospitalization. Of all variables studied, only smoking preference was found to be a statistically significant predictor of duration of involuntary hospitalization. Smokers were converted to voluntary status earlier than non-smokers. The authors concluded that clinicians may not be using commitment statutes as per recommended legal guidelines. Patients who smoke may be applying overt and covert pressure on clinicians with regard to conversion to voluntary status to gain smoking privileges.