Psychiatric commitment: patients' perspectives.
OBJECTIVE
The literature pertaining to patients' perceptions of commitment and its consequences is limited. The object of this study was to learn more about these experiences from the patient's perspective.


METHODS
108 court-committed patients (78% of whom were schizophrenic) were identified for inclusion in a retrospective follow-up study. After an interval varying from one to 4.5 years from time of commitment to follow-up, 76 patients could be contacted, of whom 47 were included in the follow-up.


RESULTS
The majority of patients felt that their court commitment had not been justified and could have been avoided. Events and circumstances identified as particularly stressful about commitment were confinement in a locked ward, side effects of medication, feelings of helplessness, and certain staffbehaviors. Adverse psychological, somatic, and social consequences were common. Coercive measures during hospitalization were strongly associated with negative feelings about the effect of commitment on mental health and about subsequent treatment. The majority, however, also remained in treatment after commitment was terminated, said they would return to hospital in event of future crisis, and had pertinent comments about how commitment could have been avoided.


CONCLUSIONS
Many patients who had been court-committed reported negative feelings about their experiences, but the great majority had continued in treatment, both at the termination of commitment and later. They also had ideas about how to reduce the negative impact of commitment that are worth including in future contingency plans.
Längle
G
G
Department of Psychiatry and Psychotherapy of the Eberhard-Karls-University, Tübingen, Germany.
Renner
G
G
Günthner
A
A
Stuhlinger
M
M
Eschweiler
G
G
U'Ren
R
R
Foerster
K
K
D000328:Adult; D000368:Aged; D001290:Attitude; D002961:Civil Rights; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010351:Patient Discharge; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies