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Open Access Research article

Local psychiatric beds appear to decrease the use of involuntary admission: a case-registry study

Lars Henrik Myklebust1, Knut Sørgaard12 and Rolf Wynn23*

Author Affiliations

1 Psychiatric Research Centre of Northern Norway, Nordland Hospital Trust, Bodø N-8092, Norway

2 Department of Clinical Medicine, University of Tromsø, Tromsø N-9037, Norway

3 Division of Addictions and Specialized Psychiatric Services, University Hospital of North Norway, Tromsø N-9291, Norway

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BMC Health Services Research 2014, 14:64  doi:10.1186/1472-6963-14-64

Published: 10 February 2014

Abstract

Background

Studies on the effect of organizational factors on the involuntary admission of psychiatric patients have been few and yielded inconclusive results. The objective was to examine the importance of type of service-system, level of care, length of inpatient stay, gender, age, and diagnosis on rates of involuntary admission, by comparing one deinstitutionalized and one locally institutionalized service-system, in a naturalistic experiment.

Methods

5538 admissions to two specialist psychiatric service-areas in North Norway were studied, covering a four-year period (2003-2006). The importance of various predictors on involuntary admission were analyzed in a logistic regression model.

Results

Involuntary admission to the services was associated with the diagnosis of psychosis, male sex, being referred to inpatient treatment, as well as type of service-system. Patients from the deinstitutionalized system were more likely to be involuntarily admitted.

Conclusions

Several factors predicted involuntary status, including male sex, the diagnosis of psychosis, and type of service-system. The results suggests that having psychiatric beds available locally may be more favourable than a traditional deinstitutionalized service system with local outpatient clinics and central mental hospitals, with respect to the use of involuntary admission.

Keywords:
Involuntary admission; Health service; Social psychiatry