Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-11T07:29:21.819Z Has data issue: false hasContentIssue false

A comparison of voluntary and involuntary patients admitted to hospital

Published online by Cambridge University Press:  13 June 2014

Kieran C Murphy
Affiliation:
Department of Psychological Medicine, University Hospital of Wales, Heath Park, Cardiff, Wales.
Fiona Mulvaney
Affiliation:
St John of God Hospital, Stillorgan, Co Dublin, Ireland
Eadbhard O'Callaghan
Affiliation:
Consultant Psychiatrist, Cluain Mhuire, Child and Family Centre, Newtownpark Ave, Blackrock, Co Dublin, Ireland
Conall Larkin
Affiliation:
Medical Director and Consultant Psychiatrist, St John of God Hospital, Stillorgan, Co Dublin, Ireland

Abstract

Objectives: In view of the apparent public discontent that has been expressed by individuals towards temporary certification and involuntary treatment, this study was set up to assess patients' reactions to their involuntary admission. The study compared the demographic characteristics of voluntary and involuntary patients and assessed their attitudes towards and knowledge of the certification process that presently exists in Ireland.

Method: A total of 68 patients, 38 involuntary patients consecutively admitted over a six month period and 30 voluntary patients selected over the same period, were interviewed with a standard questionnaire, on average six months after discharge.

Results: Involuntary patients were more likely to be single, live with their families and showed no demonstrable gender bias. Involuntary patients had limited knowledge of specific aspects of their individual certifications, particularly with regard to knowledge of their rights, admission status and knowledge of the identity of the applicant of the certificate. Of these, 10% were aware of their rights on admission and only 14% could recall that their rights had been explained to them on admission.

Conclusion: Although patients initially expressed strong feelings of anger on admission towards committal, these feelings were found to reduce over time. Recommendations for improving the present Mental Health Act were suggested by those interviewed and these included a need for an initial assessment period before certification is completed and a need for improved communication by medical staff regarding information on the admission status, the identity of the applicant and on the person's rights.

Type
Orginal Papers
Copyright
Copyright © Cambridge University Press 1996

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

1.Mental Treatment Act 1945. Dublin: The Stationary Office, 1945.Google Scholar
2.Health [Mental Services] Act 1981. Dublin: The Stationary Office, 1981.Google Scholar
3.Carey, TG, Owens, JM. Involuntary admissions to a district mental hospital health Service:- Implications for a new Mental Treatment Act. Ir J Psych Med 1993; 10(3): 139–44.CrossRefGoogle Scholar
4.Gove, WR, Fain, T. A comparison of voluntary and committed patients. Arch Gen Psychiatry 1977; 34: 669–76.CrossRefGoogle Scholar
5.Toews, J, el-Guebaly, N, Leckie, A. Patients' reactions to their commitment. Can J Psychiatry 1981; 26(4): 251–4.CrossRefGoogle ScholarPubMed
6.Toews, J, el-Guebaly, N, Leckie, A, Harper, D. Patients' attitudes at the time of their commitment. Can J Psychiatry 1984; 29(7): 590–5.CrossRefGoogle ScholarPubMed
7.Toews, J, el-Guebaly, N, Leckie, A, Harper, D. Change with time in patients' reactions committal. Can J Psychiatry 1986; 31(5): 413–5.CrossRefGoogle ScholarPubMed
8.Allen, JE, Barton, GH. Patients' comments about hospitalisation: implications for change. Compr Psychiatry 1976; 17(5): 631–40.CrossRefGoogle ScholarPubMed
9.Conlon, P, Merskey, H, Zilli, C, Frommhold, K. The attitudes toward committal of patients hospitalised in a psychiatric facility for the first time. Can J Psychiatry 1990; 35(4): 324–7.CrossRefGoogle Scholar
10.Edelsohn, GA, Hiday, VA. Civil commitment: A range of patient attitudes. Bull Am Acad Psychiatry Law 1990; 18(1): 6577.Google ScholarPubMed
11.Kjellin, L, Nilstun, T. Medical and social paternalism: regulation of and attitudes towards compulsory psychiatric care. Acta Psychiatr Scand 1993;88:415–9.CrossRefGoogle ScholarPubMed
12.Spence, ND, Goldney, RD, Costain, WF. Attitudes towards psychiatric hospitalisation: a comparison of involuntary and voluntary patients. Aust Clin Rev 1988; 8(30): 108–16.Google ScholarPubMed
13.Spensley, J, Edwards, DW, White, E. Patient satisfaction and involuntary treatment. Am J Orthopsychiatry: 1980; 50(4): 725–7.CrossRefGoogle ScholarPubMed
14.Kane, JH, Dulkin, F, Rifkin, A, Wegener, J, Rosenberg, G, Borenstein, M. Attitudinal challenges of involuntarily committed patients following treatment. Arch Gen Psychiatry 1983; 40: 374–7.CrossRefGoogle Scholar
15.Adams, NH, Hafner, RJ. Attitudes of psychiatric patients and their relatives to involuntary treatment. Aust NZ J Psychiatry 1991; 25(2): 231–7.CrossRefGoogle ScholarPubMed
16.Schwartz, HI, Vingiano, W, Perez, CB. Autonomy and the right to refuse treatment: patients' attitudes after involuntary medication. Hosp Community Psychiatry 1988; 39(10): 1049–54.Google ScholarPubMed
17.Farren, C, McLoughlin, D, Clare, A. Proceduresfor involuntary admission to public and private facilities. Ir J Psych Med 1993; 96100.Google Scholar
18.Walsh, D, Moran, R. Activities of Irish psychiatric hospitals and units. Health Research Board Report 1992.Google Scholar
19.Schacter, D, Kleinman, I, Prendergast, P, Remington, G, Schertzer, S. The effect of psychopathology on the ability of schizophrenic patients to give informed consent. J Nerv Ment Dis 1994; 182:360–2.CrossRefGoogle Scholar
20.The Green Paper on Mental Health. Dublin: Government Publications Office.Google Scholar
21.The White Paper on Mental Health. Dublin: Government Publications Office.Google Scholar