Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T06:59:04.024Z Has data issue: false hasContentIssue false
  • English
  • Français

How to improve clinical practice on involuntary hospital admissions of psychiatric patients: Suggestions from the EUNOMIA study

Published online by Cambridge University Press:  16 April 2020

A. Fiorillo ,
C. De Rosa ,
V. Del Vecchio ,
L. Jurjanz ,
K. Schnall ,
G. Onchev ,
S. Alexiev ,
J. Raboch ,
L. Kalisova  and
A. Mastrogianni
...Show all authors
A. Fiorillo*
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Naples, Italy
C. De Rosa
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Naples, Italy
V. Del Vecchio
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Naples, Italy
L. Jurjanz
Affiliation:
Department of Psychiatry and Psychotherapy, Dresden University of Technology, Dresden, Germany
K. Schnall
Affiliation:
Department of Psychiatry and Psychotherapy, Dresden University of Technology, Dresden, Germany
G. Onchev
Affiliation:
Department of Psychiatry, Medical University of Sofia, Sofia, Bulgaria
S. Alexiev
Affiliation:
Department of Psychiatry, Medical University of Sofia, Sofia, Bulgaria
J. Raboch
Affiliation:
Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
L. Kalisova
Affiliation:
Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
A. Mastrogianni
Affiliation:
Psychiatric Hospital, Thessaloniki, Greece
E. Georgiadou
Affiliation:
Psychiatric Hospital, Thessaloniki, Greece
Z. Solomon
Affiliation:
School of Social Work and Geha Mental Health Center, University of Tel Aviv, Tel Aviv, Israel
A. Dembinskas
Affiliation:
Psychiatric Clinic, Vilnius Mental Health Centre, University of Vilnius, Vilnius, Lithuania
V. Raskauskas
Affiliation:
Psychiatric Clinic, Vilnius Mental Health Centre, University of Vilnius, Vilnius, Lithuania
P. Nawka
Affiliation:
Psychiatric Hospital, Michalovce, Slovak Republic
A. Nawka
Affiliation:
Department of Psychiatry, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
A. Kiejna
Affiliation:
Department of Psychiatry, Medical University, Wroclaw, Poland
T. Hadrys
Affiliation:
Department of Psychiatry, Medical University, Wroclaw, Poland
F. Torres-Gonzales
Affiliation:
Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Spain and Hospital Regional Carlos Haya, Malaga, Spain
F. Mayoral
Affiliation:
Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Spain and Hospital Regional Carlos Haya, Malaga, Spain
A. Björkdahl
Affiliation:
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
L. Kjellin
Affiliation:
School of Health and Medical Sciences, Psychiatric Research Centre, Örebro University, Örebro, Sweden
S. Priebe
Affiliation:
Unit for Social and Community Psychiatry, Barts’ and the London School of Medicine and Dentistry, Queen Mary College, University of London, United Kingdom
M. Maj
Affiliation:
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, Naples, Italy
T. Kallert
Affiliation:
Department of Psychiatry and Psychotherapy, Dresden University of Technology, Dresden, Germany Park Hospital Leipzig, Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, Leipzig & Soteria Hospital Leipzig, Leipzig & Faculty of Medicine, Dresden University of Technology, Dresden, Germany
*
* Corresponding author Tel.: +390815666531; fax: +390815666523. E-mail address: anfioril@tin.it (A. Fiorillo).
Get access

Abstract

Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.

Keywords

Ethics and human rightsPsychiatry in EuropeQuality of care
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 4 , May 2011 , pp. 201 - 207
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abas, M, Vanderpyl, J, Robinson, E, Crampton, PMore deprived areas need greater resources for mental health. Aust N Zeal J Psychiatry 2003; 37: 437–444.CrossRefGoogle ScholarPubMed
Abas, M, Vanderpyl, J, Le Prou, T, Kydd, R, Emery, B, Foliaki, SAPsychiatric hospitalization: reasons for admission and alternatives to admission in South Auckland, New Zealand. Aust N Zeal J Psychiatry 2003; 37: 620–625.CrossRefGoogle ScholarPubMed
Abas, MA, Vanderpyl, J, Robinson, E, Le Prou, T, Crampton, PSocioeconomic deprivation and duration of hospital stay in severe mental disorder. Br J Psychiatry 2006; 188: 581–582.CrossRefGoogle ScholarPubMed
Amenson, CS, Liberman, RPDissemination of educational classes for families of adults with schizophrenia. Psychiatr Serv 2001; 52: 589–592.CrossRefGoogle ScholarPubMed
Assemblée Parlementaire. Recommendation 1235 on psychiatry and human rights. http://assembly.coe.int/Main.asp?link=/Documents/AdoptedText/ta94/EREC1235.htl.Google Scholar
Baca-Garcia, E, Diaz-Sastre, C, García Resa, E, Blasco, H, Braquehais Conesa, D, Oquendo, MA, et al.Suicide attempts and impulsivity. Eur Arch Psychiatry Clin Neurosci 2005; 255: 152–156.CrossRefGoogle ScholarPubMed
Berg, JE, Johnsen, EAre immigrants admitted to emergency psychiatric departments more often than ethnic Norwegians? Tidsskr Nor Laegeforen 2004; 124: 634–636.Google ScholarPubMed
Cascardi, M, Poythress, NGCorrelates of perceived coercion during psychiatric hospital admission. Int J Law Psychiatry 1997; 20: 445–458.CrossRefGoogle ScholarPubMed
Clark, L, Iversen, SD, Goodwin, GMSustained attention deficit in bipolar disorder. Br J Psychiatry 2002; 180: 313–319.CrossRefGoogle ScholarPubMed
Council of Europe. Committee of Ministers. Recommendation No. R (83) 2. Legal protection of person suffering from mental disorder placed as involuntary patients. Adopted by the Committee of Ministers on 22 February 1983 at the 356th meeting of the Ministers’ Deputies.Google Scholar
Department of Health and Welsh Office. Government Guidance. Code of Practice Mental Health Act 1983. London, UK: The Stationary Office; 1999.Google Scholar
Dressing, H, Salize, HJCompulsory admission of mentally ill patients in European Union Member States. Soc Psychiatry Psychiatr Epidemiol 2004; 39: 797–803.CrossRefGoogle ScholarPubMed
Forchuk, C, Reynolds, WClients’ reflections on relationships with nurses: comparisons from Canada and Scotland. J Psychiatr Ment Health Nurs 2001; 8: 45–51.CrossRefGoogle ScholarPubMed
Fornari, U, Jourdan, SLa responsabilità professionale dello psichiatra. Torino, Italia: Centro Scientifico Editore: 2006Google Scholar
Gardner, W, Hoge, S, Bennett, N, Roth, L, Lidz, C, Monahan, J, et al.Two scales for measuring patients’ performance perceptions of coercion during hospital admission. Behav Sci and Law 1993; 20: 307–321.CrossRefGoogle Scholar
Hoge, SK, Lidz, CW, Eisenberg, M, Monahan, J, Bennett, N, Gardner, W, et al.Family, clinician, and patient perceptions of coercion in mental hospital admission. A comparative study. Int J Law Psychiatry 1998; 21: 131–146.CrossRefGoogle ScholarPubMed
http://www.portaledibioetica.it/documenti/001316/001316.htm. Convention for the protection of human rights and dignity of the human being with regard to the application of biology and medicine. Oviedo: Convention on Human Rights and Biomedicine.Google Scholar
Kallert, TWCoercion in psychiatry. Curr Opin Psychiatry 2008; 21: 485–489.CrossRefGoogle Scholar
Kallert, TW, Torres-González, FLegislation on coercive mental health care in Europe; legal documents and comparative assessment of twelve European countries. Frankfurt/M., Germany: Peter Lang Publishing Group: 2006Google Scholar
Kallert, TW, Glöckner, M, Onchev, G, Raboch, J, Karastergiou, A, Solomon, Z, et al.The EUNOMIA project on coercion in psychiatry: study design and preliminary data. World Psychiatry 2005; 4: 168–172.Google ScholarPubMed
Kallert, TW, Rymaszewska, J, Torres-González, FDifferences of legal regulations concerning involuntary psychiatric hospitalization in twelve European countries: implications for clinical practice. Int J Forens Ment Health 2007; 6: 197–207.CrossRefGoogle Scholar
Kallert, TW, Jurjanz, L, Schnall, K, Glöckner, M, Gerdjikov, I, Raboch, J, et al.Practice recommendation for administering mechanical restraint during acute psychiatric hospitalization – a contribution to harmonize best clinical practice across Europe (in German). Psychiat Prax 2007;34(Suppl 2):S233–S240.CrossRefGoogle Scholar
Kallert, TW, Glöckner, M, Schützwohl, MInvoluntary vs. voluntary hospital admission – a systematic review on outcome diversity. Eur Arch Psychiatry Clin Neurosci 2008; 258: 195–209.CrossRefGoogle ScholarPubMed
Künzler, N, Garcia-Brand, E, Schmauss, M, Messer, TGerman language skills among foreign psychiatric patients: influence on voluntariness and duration of hospital treatment. Psychiatr Prax 2004;31(Suppl 1):S21–S23.CrossRefGoogle ScholarPubMed
Laffont, I, Priest, RGA comparison of French and British mental health legislation. Psychol Med 1992; 22: 843–850.CrossRefGoogle ScholarPubMed
Law of the European Convention on human rights. Council of Europe Press, 1994.Google Scholar
Lidz, CW, Hoge, SK, Gardner, W, Bennett, NS, Monahan, J, Mulvey, EP, et al.Perceived coercion in mental hospital admission. Pressures and process. Arch Gen Psychiatry 1995; 52: 1034–1039.CrossRefGoogle ScholarPubMed
Magliano, L, Fiorillo, A, Malangone, C, De Rosa, C, Maj, MPatient functioning and family burden in a controlled, real-world trial of family psychoeducation for schizophrenia. Psychiatr Serv 2006; 57: 1784–1791.CrossRefGoogle Scholar
Magliano, L, Fiorillo, A, Malangone, C, Del Vecchio, H, Maj, MUsers’ Opinions Questionnaire Working Group Views of persons with schizophrenia on their own disorder: an Italian participatory study. Psychiatr Serv 2008; 59: 795–799.CrossRefGoogle Scholar
Malm, U, Ivarsson, B, Allebeck, P, Falloon, IRIntegrated care in schizophrenia: a 2-year randomized controlled study of two community-based treatment programs. Acta Psychiatr Scand 2003; 107: 415–423.CrossRefGoogle ScholarPubMed
McFarlane, WR, Dixon, L, Lukens, E, Lucksted, AFamily psychoeducation and schizophrenia: a review of the literature. J Marital Fam Ther 2003; 29: 223–245.CrossRefGoogle ScholarPubMed
McKenna, BG, Simpson, AI, Coverdale, JHWhat is the role of procedural justice in civil commitment? Aust N Zeal J Psychiatry 2000; 34: 671–676.CrossRefGoogle ScholarPubMed
McKenna, BG, Simpson, AI, Coverdale, JH, Laidlaw, TMAn analysis of procedural justice during psychiatric hospital admission. Int J Law Psychiatry 2001; 24: 573–581.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence. Clinical practice guidelines for violence: The short-term management of disturbed/violent behaviour in psychiatric in-patient settings and emergency departments. London: National Institute for Clinical Excellence, 2005.Google Scholar
Priebe, S, Badesconyi, A, Fioritti, A, Hansson, L, Kilian, R, Torres-Gonzales, F, et al.Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. BMJ 2005;15(330):123–126.CrossRefGoogle Scholar
Priebe S, Katsakou C, Glöckner M, Dembinskas A, Fiorillo A, Karastergiou A et al. Patients’ views of involuntary hospital admission after one and three months: a prospective study in eleven European countries. Br J Psychiatry 2010;196:179–85.CrossRefGoogle Scholar
Quirk, A, Lelliott, P, Seale, CService users’ strategies for managing risk in the volatile environment of an acute psychiatric ward. Soc Sci Med 2004; 59: 2573–2583.CrossRefGoogle ScholarPubMed
Sartorius, N, Ustün, TB, Korten, A, Cooper, JE, van Drimmelen, JProgress toward achieving a common language in psychiatry. II: Results from the international field trials of the ICD-10 diagnostic criteria for research for mental and behavioral disorders. Am J Psychiatry 1995; 152: 1427–1437.Google ScholarPubMed
United Nation. General Assembly Convention on the Rights of Persons with Disabilities. http://www.un.org/esa/socdev/enable/rights/convtexte.htm.Google Scholar
Vevera, J, Jirák, R, Uhrová, T, Žukov, IMožnosti farmakologického ovlivnění násilného chování u pacientů s demencí. CS Psychiatrie 2003; 3: 142–144.Google Scholar
World Health Organization. “Mental health legislation & human rights” (Mental health policy and service guidance package); 2003.Google Scholar
World Health Organization. WHO European Ministerial Conference on mental health. Mental health declaration for Europe. Facing the challenges, building solutions EUR/04/5047810/6 14 January 2005;52:667.Google Scholar
World Psychiatric Association approves Declaration of Madrid (25 Aug 1996). Int Dig Health Legis 1997;48:240–2.Google Scholar
Zinkler, M, Priebe, SDetention of the mentally ill in Europe – a review. Acta Psychiatr Scand 2002; 106: 3–8.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.