Factors influencing assignment of patients to compulsory admission

Summary

The factors determining assignment of patients (AP) to compulsory admission (CA) were analyzed for a sample of patients (n=122) who were admitted involuntarily to public psychiatric hospitals in Hamburg over a 21-month period (January 1980–September 1981). The control groups consisted of patients admitted voluntarily (n=84) and of patients who could be treated without admission (n=93). The data originate from outpatient emergency contacts made prior to admission to hospital and were taken from a new “psychiatric emergency service”. A descriptive evaluation was made of all 299 cases. Of these cases 272 could be included in a multivariate analysis by the log-linear model. It was shown that the decision regarding CA was not greatly influenced by sociodemographic factors. The type and severity of the illness, danger to oneself and others, and the quality of the doctor-patient contact were all important and indispensible factors influencing assignment to CA. An exploratory model based on the type and severity of illness and the doctor-to-patient relationship proved a better predictor of CA than an alternative model, based on prevention of danger, which was only valid for certain sub-groups of patients.