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Factors associated with involuntary admissions: a register-based cross-sectional multicenter study.

G Maina1,2, G Rosso3,4, C Carezana5

  • 1Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Torino, Italy.

Annals of General Psychiatry
|January 8, 2021
PubMed
Summary

Involuntary admission rates in Italy's Piedmont Region were evaluated, finding significant variations among psychiatric units. Younger patients with schizophrenia or substance use disorders were more likely to be admitted involuntarily.

Keywords:
Compulsory treatmentInvoluntary admissionMechanical restraint

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Area of Science:

  • Psychiatry
  • Public Health
  • Health Services Research

Background:

  • Involuntary admission in Italy remains under-researched, with a fragmented understanding.
  • EU recommendations highlight the need for more data on mental health services.

Purpose of the Study:

  • To assess involuntary admission rates in the Piedmont Region.
  • To identify clinical and service-related factors associated with involuntary admission.

Main Methods:

  • Cross-sectional, retrospective, multicenter study of psychiatric inpatients in Piedmont.
  • Analysis of 6018 first hospitalizations and 7881 inpatient episodes from 2016.
  • Statistical analysis including t-tests, Chi-square tests, and multilevel logistic regression.

Main Results:

  • First hospitalizations showed a 10.1% involuntary admission rate; overall compulsory treatment was 9.1%.
  • Rates varied widely (0.8%–21%) across study centers.
  • Involuntary admissions linked to younger age, schizophrenia/substance use disorders, longer stays, and mechanical restraint.

Conclusions:

  • Piedmont's involuntary admission rate is lower than global averages.
  • Significant inter-unit variability exists, unrelated to ward or area characteristics.