Macroeconomic antecedents of involuntary psychiatric commitments in Denmark

Economic downturns may increase involuntary psychiatric commitments in a population through several mechanisms. This study examines the population-level association between economic downturns and involuntary psychiatric commitments in Denmark, and assesses whether this relation differs across Danes and non-western immigrants.

We examined the relation between quarterly aggregated counts of unemployed persons (exposure) and involuntary psychiatric commitments (outcomes) in the (1) overall population, (2) among Danes (excluding non-western immigrants), and (3) among non-western immigrants in Denmark, over 72 quarters, from 2001 to 2018, using Danish register data. We specified our exposure as the quarterly counts of unemployed persons in Denmark (0, 1 quarterly lags). We used time-series analyses to control for autocorrelation, change in underlying population and quarterly volume of voluntary (i.e. non-coercive) psychiatric inpatient admissions.

Results from time-series analyses indicate 15 additional involuntary psychiatric commitments in the overall Danish population, one quarter after increase in 50,000 additional unemployed persons (p-value <0.05). We also observe 7 additional involuntary commitments among non-western immigrants at exposure lag 1 (p-value <0.05). Our discovered coefficients correspond with a 2.3 % increase in involuntary commitments in the overall population and a 9 % increase among non-western immigrants one quarter following a 1 standard deviation increase in unemployed persons in Denmark.

Our findings show an increase in involuntary psychiatric commitments following macroeconomic downturns in Denmark.