Rates of unemployment and incidence of police-initiated examinations for involuntary hospitalization in Florida.
OBJECTIVE
This study tested the hypothesis that contraction of regional economies affects the incidence of involuntary admissions to psychiatric emergency services by reducing community tolerance for persons perceived as threatening to others.


METHODS
This hypothesis was tested with time-series analyses of the relationship between initial claims for unemployment in Florida between July 4, 1999, and June 28, 2003, and the weekly number of men and women presented by police to be examined for involuntary psychiatric hospitalization because of danger to others. The analyses controlled for admissions presented by mental health professionals because of danger to others and for admissions presented by police because of neglect or disability.


RESULTS
When the analyses controlled for autocorrelation and other covariates, claims for unemployment insurance were significantly associated with the number of men presented by police for danger to others. During the study period, police presented 5,897 men for examination because of danger to others. Increased unemployment claims were associated with approximately 309 more men being presented for examination than expected from prior presentation rates and from the number presented by mental health professionals for danger to others and by police for neglect or disability. No such association was found for women.


CONCLUSIONS
Consistent with theory, this study found that presentations for involuntary admission to psychiatric services increased after contractions in the labor market. Combining the methods of this study with econometric forecasting may allow providers to anticipate better the need for psychiatric services.
Kessell
Eric R
ER
School of Public Health, University of California, Berkeley, 22 Warren Hall, Berkeley, CA 94720, USA. ekessell@berkeley.edu
Catalano
Ralph A
RA
Christy
Annette
A
Monahan
John
J
D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D003617:Dangerous Behavior; D005260:Female; D005431:Florida / Q000453:epidemiology; D005544:Forecasting; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric; D006801:Humans; D015994:Incidence; D035846:Law Enforcement; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology* / Q000534:rehabilitation*; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D010808:Physical Examination / Q000706:statistics & numerical data*; D016495:Police; D012959:Socioeconomic Factors; D014478:Unemployment / Q000706:statistics & numerical data*