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Service Characteristics and Geographical Variation in Compulsory Hospitalisation

An Exploratory Random Effects Within–Between Analysis of Norwegian Municipalities, 2015–2018

Bibliographic Data

ID15523664
AuthorsTore Hofstad (0000-0003-0718-7931, University of Oslo, corresponding author), Jorun Rugkåsa (0000-0001-5842-2845, University of South-Eastern Norway), Solveig Osborg Ose (0000-0001-5361-7571, SINTEF), Olav Nyttingnes (0000-0003-0991-7176, Akershus University Hospital), Solveig Helene Høymork Kjus (0000-0002-1770-1386, NTNU Samfunnsforskning), Tonje Lossius Husum (0000-0002-0151-1262, OsloMet – Oslo Metropolitan University)
Year2021
Volume12
Pages737698-737698
Publication date2021-12-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2021.737698
PMID34955909
OpenAlexW4200055496
LanguageEN
Citations received2
References cited34

Background: Compulsory hospitalisation in mental healthcare is contested. For ethical and legal reasons, it should only be used as a last resort. Geographical variation could indicate that some areas employ compulsory hospitalisation more frequently than is strictly necessary. Explaining variation in compulsory hospitalisation might contribute to reducing overuse, but research on associations with service characteristics remains patchy. Objectives: We aimed to investigate the associations between the levels of compulsory hospitalisation and the characteristics of primary mental health services in Norway between 2015 and 2018 and the amount of variance explained by groups of explanatory variables. Methods: We applied random-effects within-between Poisson regression of 461 municipalities/city districts, nested within 72 community mental health centre catchment areas ( N = 1,828 municipality-years). Results: More general practitioners, mental health nurses, and the total labour-years in municipal mental health and addiction services per population are associated with lower levels of compulsory hospitalisations within the same areas, as measured by both persons (inpatients) and events (hospitalisations). Areas that, on average, have more general practitioners and public housing per population have lower levels of compulsory hospitalisation, while higher levels of compulsory hospitalisation are seen in areas with a longer history of supported employment and the systematic gathering of service users' experiences. In combination, all the variables, including the control variables, could account for 39-40% of the variation, with 5-6% related to municipal health services. Conclusion: Strengthening primary mental healthcare by increasing the number of general practitioners and mental health workers can reduce the use of compulsory hospitalisation and improve the quality of health services

Catchment area · Environmental health · Geography · Mental health · Mental health service · Norwegian · Poisson regression · Population · Psychiatry · Demography · Healthcare Decision-Making and Restraints · Homelessness and Social Issues · Medicine · Schizophrenia research and treatment

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Unique citing works2
Citations per year1
Citation span2024 - 2026 (3)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 2

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