Patient Characteristics and Emergency Treatment Orders in Three Florida Inpatient Psychiatric Units

Florida law defines emergency treatment orders (ETOs) as an immediate administration of psychotropic medications to a person to expeditiously treat symptoms that may present an immediate danger to the safety of the person or others.1 There is currently little information on who receives ETOs. In this study, we aim to explore correlations between patients' demographics and administering ETOs in order to understand this cohort, which could allow for improved services and alternative interventions.

This retrospective study examined data from 1,460 adult patients who were admitted to an acute inpatient psychiatric unit from January 2015 to December 2017 and who received at least one ETO during their hospital admission.

Results revealed that younger patients (18-25 years) were at increased risk of receiving more than one ETO (p=0.039) than patients who were 26 and older. Patients with an elevated body mass index (BMI) (25 kg/m2 or more) also had a significantly increased likelihood of being administered more ETOs (≥4 ETOs) than patients with a lower BMI (defined as less than 25 kg/m2 [p=0.037]). Moreover, patients with a length of stay (LOS) of more than 14 days were more likely to receive more ETOs compared to patients with LOS less than or equal to 14 days (p<0.001). Lastly, patients with a neurocognitive disorder and/or within the schizophrenia spectrum or other psychotic disorders were more likely to receive ETOs (p<0.001) than patients with other diagnoses.

There are some correlations in administering ETOs in that younger patients with an elevated BMI, longer LOS and certain diagnoses receive more ETOs. The reason for these findings is not clear. Therefore, prospective studies should be conducted in order to analyze these correlations.