Involuntary Psychiatric Admissions and Development of Psychiatric Services as an Alternative to Full-Time Hospitalization in France. 2017

Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
Ms. Gandré, Ms. Gervaix, Mr. Thillard, Dr. Roelandt, and Pr. Chevreul are with the Épidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables team, Unité Mixte de Recherche, Université Paris Diderot, Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale, Paris. With the exception of Dr. Roelandt, they are also with the Parisian Health Economics and Health Services Research Unit, URC Eco, AP-HP, Paris. Dr. Roelandt is also with the World Health Organization Collaborative Centre, Lille, France. Pr. Macé is with the Laboratoire Interdisciplinaire de Recherches en Sciences de l'Action, National Conservatory of Arts and Crafts, Paris.

OBJECTIVE The development of alternatives to full-time hospitalization in psychiatry is limited because consensus about the benefits of such alternatives is lacking. This study assessed whether the development of such alternatives in French psychiatric sectors was associated with a reduction in involuntary inpatient care, taking into account other factors that are potentially associated with involuntary admission. METHODS Data on whether a patient had at least one involuntary full-time admission in 2012 were extracted from the French national discharge database for psychiatric care. The development of alternatives to full-time hospitalization was estimated as the percentage of human resources allocated to these alternatives out of all human resources allocated to psychiatry, measured at the level of the hospital hosting each sector. Other factors potentially associated with involuntary admission (characteristics of patients, health care providers, and the environment) were extracted from administrative databases, and a multilevel logistic model was carried out to account for the nested structure of the data. RESULTS Significant variations were observed between psychiatric sectors in rates of involuntary inpatient admissions. A large portion of the variation was explained by characteristics of the sectors. A significant negative association was found between involuntary admissions and the development of alternatives to full-time hospitalization, after adjustment for other factors associated with involuntary admissions. CONCLUSIONS Findings suggest that the development of alternatives to full-time hospitalization is beneficial for quality of care, given that it is negatively associated with involuntary full-time admissions. The reduction of such admissions aligns with international recommendations for psychiatric care.

UI MeSH Term Description Entries
D008297 Male Males
D008605 Mental Health Services Organized services to provide mental health care. Mental Hygiene Services,Health Services, Mental,Services, Mental Health,Services, Mental Hygiene,Health Service, Mental,Hygiene Service, Mental,Hygiene Services, Mental,Mental Health Service,Mental Hygiene Service,Service, Mental Health,Service, Mental Hygiene
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003134 Commitment of Mentally Ill Legal process required for the institutionalization of a patient with severe mental problems. Outpatient Commitment,Commitment, Outpatient,Mentally Ill Commitments
D005260 Female Females
D005602 France A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris. Corsica,Saint Pierre and Miquelon,Miquelon and Saint Pierre,Miquelon and St. Pierre,St. Pierre and Miquelon
D006778 Hospitals, Psychiatric Special hospitals which provide care to the mentally ill patient. Mental Hospitals,Hospitals, Mental,Mental Institutions,Psychiatric Hospitals,Hospital, Mental,Hospital, Psychiatric,Institution, Mental,Institutions, Mental,Mental Hospital,Mental Institution,Psychiatric Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders

Related Publications

Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
January 1981, Community mental health journal,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
August 2007, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
November 2014, The International journal of social psychiatry,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
April 1977, Diseases of the nervous system,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
January 1966, Psychiatric research reports,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
January 1964, Psychosomatics,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
September 1985, The Psychiatric clinics of North America,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
September 1986, The Nursing clinics of North America,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
January 1986, The Israel journal of psychiatry and related sciences,
Coralie Gandré, and Jeanne Gervaix, and Julien Thillard, and Jean-Marc Macé, and Jean-Luc Roelandt, and Karine Chevreul
April 2023, Psychiatric services (Washington, D.C.),
Copied contents to your clipboard!