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Violence, civil commitment, and hospitalization.

D E McNiel, R L Binder

    The Journal of Nervous and Mental Disease
    |February 1, 1986
    PubMed
    Summary
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    Psychiatric patient admissions for violence did not change between 1973 and 1983. However, involuntary commitments for danger to others tripled, suggesting inconsistent application of civil commitment laws.

    Area of Science:

    • Psychiatry
    • Criminology
    • Public Health Policy

    Background:

    • Civil commitment laws aim to balance patient rights with public safety.
    • Understanding trends in psychiatric hospitalization and legal status is crucial for policy evaluation.

    Purpose of the Study:

    • To compare the frequency of violent behavior and civil commitment among psychiatric patients between 1973 and 1983.
    • To investigate changes in the legal status of patients admitted to psychiatric units over a decade.

    Main Methods:

    • Randomly selected 150 patients from admissions to a locked acute psychiatric unit in each study year (1973 and 1983).
    • Reviewed medical charts for data on violent behavior, demographics, and legal status.
    • Compared preadmission violence rates and involuntary admission proportions between the two years.

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    Main Results:

    • No significant change was observed in the rate of preadmission violence between 1973 and 1983.
    • A threefold increase was found in the proportion of patients admitted involuntarily due to being a danger to others.
    • The study highlights a potential shift in the application of civil commitment criteria.

    Conclusions:

    • While pre-hospitalization violence remained stable, the criteria for involuntary psychiatric commitment appear to have been applied more stringently for danger to others.
    • The findings suggest inconsistencies in the interpretation and application of civil commitment statutes over time.
    • Further research is needed to explore the factors influencing these changes in psychiatric patient legal status.