[Involuntary Psychiatric Hospitalizations: From request to a call center to hospitalization]

Area of Science:

• Psychiatry
• Emergency Medicine
• Public Health

Background:

• Involuntary psychiatric hospitalization (IPH) is a critical measure for patients in psychiatric decompensation.
• In low-density medical areas, out-of-hours general practitioners (GPs) evaluate patients for IPH.
• GPs report challenges with the IPH procedure once patients reach emergency rooms.

Purpose of the Study:

• To evaluate the outcomes of patients referred for IPH by out-of-hours GPs.
• To assess the effectiveness of GP-initiated IPH requests in emergency settings.

Main Methods:

• Retrospective study of IPH requests from a Seine-Saint-Denis emergency medical call center in 2016.
• Collected data on call characteristics, patient demographics, and GP/regulator decisions.
• Focused on patients referred for IPH to determine hospitalization decisions.

Main Results:

• Out of 7541 decompensation calls, 539 were for IPH, primarily during non-working hours (55%).
• GPs requested IPH for 79% of evaluated patients (240/304).
• IPH was confirmed for 61% of referred patients, a rate comparable to literature (65%). Voluntary hospitalization occurred for 17%.

Conclusions:

• GP-initiated IPH rates are comparable to those from attending physicians.
• The intervention of GPs mandated by call centers is validated in critical psychiatric contexts.
• This study supports the role of GPs in managing psychiatric emergencies.