title: [The influence of statutory representation for mentally ill involuntarily committed on the duration of the admission and the time for readmission].
abstract: BACKGROUND
  About 25% of psychiatric admissions in Israel are involuntary. In 2004 the Israeli law was reformed and an addition to the law declared that the patients involuntarily committed are entitled to have a statutory representation during the psychiatric committee discussions on the prolongation of their hospitalization. This amendment raised concern in the psychiatric society that the representation will result in the premature discharge of some of the patients and will increase the "revolving door" phenomenon, meaning that many of the patients will be quickly readmitted.
  
  
  OBJECTIVE
  To examine whether the amendment to the law, which entitles statutory representation to patients in psychiatric committees discussing the prolongation of their admission caused shortening of the time for readmission.
  
  
  METHODS
  We retrospectively examined the records of 2 groups of patients that were admitted to "Shalvata" Mental Health Center in the periods 1/6/03-31/5/04 (n = 108) and 1/1/05-31/12/05 (n = 167)--before and after the amendment. We compared the extent of prolongation of the commitment and the time for readmission.
  
  
  RESULTS
  There were no differences between the groups in terms of total duration of hospitalization and the extent of prolongation of the commitment, and there was no difference in the time to readmission. It was found that for patients who appealed against the decision of the district psychiatrist in the early stages of hospitalization and whose appeal had been granted, there was a shortening of the time for readmission.
  
  
  CONCLUSIONS
  Statutory representation for patients who are involuntarily admitted did not shorten the time to rehospitalization and did not increase the "revolving door phenomenon, except for patients who were discharged by the committee during their first week of hospitalization, following an appeal against the original order for their involuntary commitment, issued by the district psychiatrist.
authors.affiliation: Shalvata Mental Health Center, Hod Hasharon and the Sackler Faculty of Medicine. Tel Aviv University. hagaima@clalit.org.il
authors.forename: Hagai
authors.initials: H
authors.lastname: Maoz
authors.forename: Israel
authors.initials: I
authors.lastname: Kriger
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors