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Related Experiment Videos

Decision making in psychiatric civil commitment: an experimental analysis.

R M Bagby1, J S Thompson, S E Dickens

  • 1Department of Psychology, Clarke Institute of Psychiatry, Toronto, Ont., Canada.

The American Journal of Psychiatry
|January 1, 1991
PubMed
Summary
This summary is machine-generated.

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Psychiatrists in Ontario prioritize legal factors like psychosis and dangerousness when deciding on involuntary hospital admissions. These factors significantly influence commitment decisions, despite legislative intent to reduce such admissions.

Area of Science:

  • Psychiatry
  • Mental Health Law
  • Health Policy

Background:

  • Legislation in Canada and the US aimed to reduce civil commitment.
  • Paradoxically, these laws have led to an increase in involuntary hospital admissions.
  • Understanding the factors influencing commitment decisions is crucial.

Purpose of the Study:

  • To assess the relative importance of various factors in psychiatric commitment decisions.
  • To elucidate reasons for the increase in involuntary hospital admissions.
  • To analyze the decision-making process of psychiatrists regarding civil commitment.

Main Methods:

  • A questionnaire-based study was distributed to psychiatrists in Ontario.
  • Hypothetical case vignettes with systematically varied factors were used.
Keywords:
Empirical ApproachLegal ApproachMental Health TherapiesOntario Mental Health Amendment Act 1978

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  • Factors included legal commitability, clinical treatability, alternative resources, and psychotic symptoms.
  • 495 psychiatrists returned completed questionnaires with three vignettes each.

    • Main Results:

    • All four varied factors (legal commitability, treatability, resources, psychosis) were statistically significant.
    • Legal commitability (dangerousness, inability to self-care) and psychotic symptoms were the primary drivers of commitment decisions.
    • These two factors accounted for the majority of the variance in commitment decisions.

    Conclusions:

    • Ontario psychiatrists primarily rely on legally mandated factors for commitment decisions.
    • Psychosis and dangerousness are key determinants in the commitment process.
    • Significant individual variation exists among psychiatrists in their decision-making.