Current Status and Issues of Involuntary Admission in the Super Emergency Ward Ayaka Saito 1 , Hiroki Yamada 1 , Atsuko Harada 1 , Mari Yamada 1 , Hiromitsu Uno 1 , Hideaki Kawai 1 , Fuminori Ishikawa 1 , Akihito Hirata 1 , Takahiro Tokumasu 1 , Osamu Takashio 1 , Akira Iwanami 1 1Department of Psychiatry, Showa University, Tokyo, Japan Keyword: Diagnosis , Forenstic mental health , Legal forced admission , Psychiatric emergency unit , Tactic act pp.717-726
Published Date 2019/6/15
DOI https://doi.org/10.11477/mf.1405205853
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 Showa University Karasuyama Hospital is an acute care psychiatric hospital and has two wards, called super-emergency wards, which charge special fees and accept patients of psychiatric emergencies, including involuntary admitted patients. In this study, we investigated clinical characteristics of the involuntarily admitted patients by performing retrospective chart reviews of all 2326 patients who were admitted to the two super-emergency wards between the years 2010 and 2014. In total, 392 patients were involuntarily admitted, and when compared to patients who were admitted voluntarily or with legal guardian consent under the Mental Health and Welfare Law, there were significantly more males than females, the average age was younger, and number of previous hospitalizations was less. Moreover, involuntary admission was associated with higher rate of isolation room usage, haloperidol infusion, lower rate of electroconvulsive therapy performed and home-discharge. In lights of diagnosis, F1, F2, and F6 of ICD-10 criteria were at high rates whereas F3, F4, and F8 were at low in involuntarily admitted patients, in comparison to patients admitted voluntarily or with legal guardian consent. Furthermore, several cases met the criteria for Medical Treatment and Supervision Act, highlighting the issues of involuntary admissions covering part of forensic psychiatry practice.

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