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Voluntary and Involuntary Psychiatric Admissions in China
Jian-Song Zhou1, Yu-Tao Xiang1, Xiao-Min Zhu1
1Dr. Zhou, Dr. Zhu, Dr. Hao, Dr. Lingjiang Li, and Dr. Wang are with Hunan Province Technology Institute of Psychiatry and Key Laboratory of Psychiatry and Mental Health of Hunan Province, Second Xiangya Hospital, Central South University, Changsha, China (e-mail: zhoujs2003@aliyun.com ). Dr. Xiang is with the Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macau, China. Dr. Liang is with Hui Long Guan Hospital, Beijing. Dr. Haien Li is with the Psychiatric Hospital of Jidong County, Heilongjiang, China. Dr. Yi is with the Sixth Hospital of Peking University, Beijing. Dr. Liu is with the Affiliated Hospital of Tongji University, Shanghai, China. Dr. Zhao is with the Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang. Dr Chen is with the Third People's Hospital of Huai'an, Anhui, China. Dr. Shi is with Shuangliu County Mental Health Institute, Sichuan, China. Dr. Guoping Li is with the Seventh Hospital of Liuyang County, Hunan. Dr. Shen is with the West China Hospital of Sichuan University, Sichuan. Dr. Wei is with the First Affiliated Hospital and the Department of Mental Health, Zhejiang University School of Medicine, Hangzhou, China. Dr. Qi is with the Mental Health Center of Henan Province, Henan, China. Dr. Tan is with the Zigong Mental Health Center, Sichuan. Dr. Ungvari is with the School of Psychiatry & Clinical Neurosciences, University of Western Australia, Perth, Australia. Dr. Ng is with the Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
Objective:
This study examined admission patterns, including voluntary, involuntary, and partly voluntary admissions to Chinese psychiatric hospitals, in relation to sociodemographic and clinical factors, before a new mental health law was implemented in 2013.
Methods:
Previously admitted patients were interviewed within one week after discharge from 16 psychiatric hospitals across China. Patients' basic sociodemographic and clinical data, including results from the Modified Overt Aggression Scale (MOAS) and the Insight and Treatment Attitudes Questionnaire (ITAQ), were collected.
Results:
Among 797 patients, 224 (28%) had voluntary admissions, 336 (42%) had involuntary admissions, and 237 (30%) had partly voluntary admissions. Male gender, history of hospitalization, diagnosis of schizophrenia and related disorders, and high MOAS score were the risk factors for involuntary admissions, whereas more years of education, higher ITAQ score, and outpatient treatment before the index admission were its protective factors. A diagnosis of schizophrenia-related disorder and high MOAS score were the risk factors for partly voluntary admission, whereas more education and high ITAQ score were its protective factors.
Conclusions:
Perception of dangerousness and poor insight about mental illness were significant factors in involuntary psychiatric admissions in China. Factors contributing to the changes in patterns of psychiatric admissions after China's implementation of the mental health law are important topics for further research.
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