Return of the asylum.

Area of Science:

• Mental Health Services Research
• Forensic Psychiatry
• Clinical Psychology

Background:

• Increasing rates of involuntary admission in England necessitate a review of current criteria and practices.
• Existing policies may not adequately differentiate between treatable illness and risk prediction for involuntary care.
• The role of personality disorder in involuntary admission decisions requires critical examination.

Discussion:

• Excluding personality disorder as a sole criterion for involuntary admission is proposed to align care with treatable conditions.
• Implementation of robust restraint reduction programs is crucial for improving patient safety and therapeutic environments.
• Shifting the basis of involuntary care from violence prediction to illness management is advocated for ethical and clinical reasons.

Key Insights:

• Personality disorder should not be a criterion for involuntary admission.
• Stronger restraint reduction programs are needed.
• Involuntary care should focus on treating illness, not predicting violence.

Outlook:

• Future policy development should prioritize evidence-based treatment over risk assessment for involuntary admissions.
• Further research into effective restraint reduction strategies is warranted.
• This approach could lead to more ethical and effective mental healthcare for individuals requiring involuntary treatment.