Involuntary admission of psychiatric patients: Referring physicians' perceptions of competence. 2019

Florian Hotzy, and Silvan Marty, and Sonja Moetteli, and Anastasia Theodoridou, and Paul Hoff, and Matthias Jaeger
1 Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland.

Involuntary admissions can be detrimental for patients. Due to legal, ethical and clinical considerations, they are also challenging for referring physicians. Nevertheless, not much is known about the subjective perceptions of those who have to decide whether to conduct an involuntary admission or not. This study aimed at answering the question whether psychiatrists' perceptions of confidence during psychiatric emergency situations and consecutive involuntary admissions differ from those of physicians without a psychiatric training. We assessed the professional background and subjective perceptions during psychiatric emergency situations in physicians who executed involuntary admissions to the University Hospital of Psychiatry Zurich. We used one-way analysis of variance (ANOVA) with Bonferroni-adjusted post hoc tests and chi-square tests to compare the responses of 43 psychiatrists with those of 64 other physicians. Psychiatrists felt less time constraints compared with non-psychiatric residents. The latter also had more doubts on the necessity of the involuntary admission issued. Psychiatrists considered themselves significantly more experienced in handling psychiatric emergency situations and in handling the criteria for involuntary admissions than other physicians. Psychiatrists and other physicians did not differ in their satisfaction concerning course and results of psychiatric emergency situations which was overall high. About half of all participants felt pressure from third parties. Psychiatric emergency situations are challenging situations not only for patients but also for the involved physicians. Physicians with a specialized training might be more confident in the handling of psychiatric emergency situations and exertion of involuntary admissions. Non-psychiatric physicians might benefit from specialized training programs.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010820 Physicians Individuals licensed to practice medicine. Physician
D011570 Psychiatry The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders.
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D004637 Emergency Services, Psychiatric Organized services to provide immediate psychiatric care to patients with acute psychological disturbances. Emergency Psychiatric Services,Psychiatric Emergency Services,Services, Emergency Psychiatric,Services, Psychiatric Emergency,Emergency Psychiatric Service,Emergency Service, Psychiatric,Psychiatric Emergency Service,Psychiatric Service, Emergency,Psychiatric Services, Emergency,Service, Emergency Psychiatric,Service, Psychiatric Emergency
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000079243 Involuntary Commitment Non-voluntary institutionalization or isolation following refusal or failure to take medication, to complete treatment, or to adhere to infection control precautions, or behavior that may or does endanger self or others. Commitment, Involuntary,Commitments, Involuntary,Involuntary Commitments
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

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