2009 issue 1

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Volume 18, issue 1

Original article

Territorial differentiation of involuntary commitment and direct coercion in psychiatric facilities in the year 2006

Wanda Langiewicz1, Monika Pasiorowska1
1. Zakład Organizacji Ochrony Zdrowia Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2009; 18 (1): 51-58
Keywords: involuntary admissions, direct coercion

Abstract

Objectives. The main aim of the study was to establish territorial differentiation in the freąuency of involuntary commitment and the use of direct coercion. Data collected within the framework of monitoring the Mental Health Act implementation allow to analyze events associated with involuntary admissions and direct coercion use registered in particularprovinces.
Methods. Questionnaires were analyzed including ąuarterly data for the year 2006, including the number of patients admitted without consent, the use of direct coercion, and the location of guardianship courtproceedings. The data were obtained from 46 mental hospitals and 71 psychiatric departments of general or other specialist hospitals (including clinical teaching hospitals).
Results. A considerable territorial differentiation regarding involuntary commitment was found at the province level. The mean rates of involuntary admissions ranged from 4.3 to 15%, with the mean national rate of 8.7%. Admissions on the grounds of Art. 23 predominated nationwide, constituting 75% of all involuntary admission cases, while in particular provinces this rate ranged from 57.2%o (łódzkie) to 92.2%o (kujawsko-pomorskie). A statistically significant positive correlation was noted bettween the rate of involuntary admissions per 10.000popu-lation and the freąuency of involuntary admissions. Moreover, marked differences were found between particular provinces as regards the location of guardianship court proceedings. The percentage of psychiatric and general hospitals in which the guardianship court proceedings takeplace ranged from 20%o (in the zachodniopomorskieprovince) to 100% (in opolskie). The analyzed data show how very differentiated are the rates of involuntary admissions in particularprovinces, but offer no explanatory arguments, suggesting either possible causes of this state of affairs, or some specific characteristics common for a group of provinces that might serve as an explanation.
Conclusions. Higher rates of involuntary admissions calculated in relation to the province population size generally correspond to higher mean percentages of involuntary admissions to all theprovince facilities. Higherpercentages of admissions on the grounds of Art. 23 correspond to lower percentages of admissions on the grounds of Art. 24. The guardianship court proceedings nationwide more often take place on the hospital premises, but distribution of this variable shows a very large territorial differentiation.

Address for correspondence:
Zakład Organizacji Ochrony Zdrowia Instytutu Psychiatrii i Neurologii
ul. Sobieskiego 9, 02-957 Warszawa
tel. 0-22-4582615.