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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study

Authors: Mark H. de Jong, Margreet Oorschot, Astrid M. Kamperman, Petra E. Brussaard, Esther M. Knijff, Roland van de Sande, Arthur R. Van Gool, Cornelis L. Mulder

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

Compulsory admissions have a strong effect on psychiatric patients and represent a deprivation of personal liberty. Although the rate of such admissions is tending to rise in several Western countries, there is little qualitative research on the mental health-care process preceding compulsory admission. The objective of the study was to identify crucial factors in the mental health-care process preceding compulsory admission of adult psychiatric patients.

Methods

This retrospective, qualitative multiple-case study was based on the patient records of patients with severe mental illness, mainly schizophrenia and other psychotic disorders. Twenty two patient records were analyzed. Patients’ demographic and clinical characteristics were heterogeneous. All were treated by Flexible Assertive Community Treatment teams (FACT teams) at two mental health institutions in the greater Rotterdam area in the Netherlands and had a compulsory admission in a predefined inclusion period. The data were analyzed according to the Prevention and Recovery System for Monitoring and Analysis (PRISMA) method, assessing acts, events, conditions, and circumstances, failing protective barriers and protective recovery factors.

Results

The most important patient factors in the process preceding compulsory admission were psychosis, aggression, lack of insight, care avoidance, and unauthorized reduction or cessation of medication. Neither were health-care professionals as assertive as they could be in managing early signs of relapse and care avoidance of these particular patients.

Conclusion

The health-care process preceding compulsory admission is complex, being influenced by acts, events, conditions and circumstances, failing barriers, and protective factors. The most crucial factors are patients’ lack of insight and cessation of medication, and health-care professionals’ lack of assertiveness.
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Metadata
Title
Crucial factors preceding compulsory psychiatric admission: a qualitative patient-record study
Authors
Mark H. de Jong
Margreet Oorschot
Astrid M. Kamperman
Petra E. Brussaard
Esther M. Knijff
Roland van de Sande
Arthur R. Van Gool
Cornelis L. Mulder
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1512-y

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