Risk factors for repeated emergency compulsory psychiatric admissions

Area of Science:

• Psychiatry
• Public Health
• Mental Healthcare Research

Background:

• Characteristics of patients with repeated compulsory psychiatric admissions remain largely unknown.
• Understanding these patient profiles is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate the frequency and risk factors associated with repeated emergency compulsory psychiatric admission (ECPA).
• To identify potential targets for interventions aimed at reducing recurrent ECPAs.

Main Methods:

• Analysis of electronic patient files from three Dutch psychiatric emergency services (PES) between 2010-2015.
• Inclusion of adult patients (18-75 years) with a first PES contact.
• Descriptive statistics and regression analysis to identify baseline factors associated with repeated ECPA and time to readmission within a 2-year follow-up.

Main Results:

• 15.6% of 6059 included patients had two or more ECPAs; 66% of second ECPAs occurred within 6 months.
• Previous mental healthcare treatment and lower self-care were linked to higher ECPA frequency.
• Other ethnicity, older age, and suicidality were associated with lower ECPA frequency.
• Lower Global Assessment of Functioning (GAF) scores and housing problems correlated with shorter time to readmission.

Conclusions:

• A significant proportion of patients experience repeated ECPAs, often within six months of the first.
• Identified risk factors, including self-care, daily functioning, and housing issues, highlight areas for intervention.
• Targeted interventions focusing on these factors may reduce the incidence of repeated compulsory psychiatric admissions.