The association between objective necessity for involuntary treatment as measured during admission, legal admission status and clinical factors in an inpatient psychiatry setting
Bibliographic Data
| ID | 21458831 |
|---|---|
| Authors | Aoife K O'Callaghan, Aoife K O’Callaghan (0000-0001-7081-3689, Tallaght University Hospital, corresponding author), Róisín Plunkett (0000-0003-2322-4480, Trinity College Dublin), Brendan D Kelly (0000-0002-6113-1384, Tallaght University Hospital) |
| Year | 2022 |
| Volume | 81 |
| Pages | 101777 |
| Publication date | 2022-03-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Law and Psychiatry (JOURNAL) |
| Journal identifiers | ISSN: 0160-2527 • E-ISSN: 1873-6386 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.ijlp.2022.101777 |
| PMID | 35051849 |
| OpenAlex | W4205420198 |
| Language | EN |
| Citations received | 2 |
| References cited | 26 |
Involuntary psychiatric admission is a common feature of mental health services around the world, but there is limited research about tools to support clinical assessment of objective necessity for compulsory care. Our study aimed to determine the relationships between objective necessity for involuntary treatment as measured by the Compulsory Treatment Checklist (CTC), legal admission status (voluntary or involuntary) and various clinical parameters (e.g. symptoms, insight) in an Irish inpatient psychiatry setting. The CTC is relatively new tool, developed and described by Brissos et al. (2017) in Portugal and designed to evaluate the necessity for compulsory treatment; its total score ranges from 0 to 50 (with higher scores indicating greater need for involuntary care). In our study, we used validated tools, including the CTC, to perform detailed assessments of 107 adult patients admitted to the acute psychiatry inpatient units of two general hospitals in Dublin, Ireland over a 30-month period. The most common diagnoses were affective disorders (46.7%), schizophrenia and related disorders (27.1%), and personality and behavioural disorders (11.2%). Over a quarter (27.1%) of patients had involuntary legal status. Higher CTC scores were significantly and independently associated with involuntary status (p < 0.001), more positive symptoms of schizophrenia (p < 0.001), and younger age (p = 0.031). The original Portuguese study of the CTC identified an optimal cut-off score of 23.5, which detected compulsory treatment with a sensitivity of 75% and specificity of 93.6% in that sample. In our sample, the optimal cut-off score was 16.5, which detected compulsory treatment with a sensitivity of 82.8% and specificity of 69.2%. We conclude that the CTC is a useful tool not only in Portugal but in other countries too, and that its performance will likely vary across jurisdictions, resulting in different optimal cut-off scores in different countries
Checklist · Global Assessment of Functioning · Health care · Inpatient care · Involuntary treatment · Mental health · Personality · Personality disorders · Psychiatry · Healthcare Decision-Making and Restraints · Medicine · Mental Health and Psychiatry · Psychiatric care and mental health services · Psychology
| Citations per year | 1 |
|---|---|
| Citation span | 2024 - 2026 (3) |
| Highly cited | No |