title: Use of longer periods of temporary detention to reduce mental health civil commitments.
abstract: OBJECTIVE
  This study examined whether lengthening the holding period for an individual experiencing a mental health crisis under a temporary detention order (TDO) can reduce the number and length of post-TDO involuntary hospital commitments.
  
  
  METHODS
  Data from the Virginia Court System were matched to the Commonwealth of Virginia Medicaid claims database for July 1, 2008, through March 30, 2009. The final data set included 500 Medicaid recipients who had a mental health diagnosis and at least one TDO during the study period. Covariates included sex, race, age, primary diagnosis, and Community Service Board serving the individual. Logistic and multivariate regression models were used.
  
  
  RESULTS
  Longer TDO periods were correlated with an increased probability of a dismissal of the commitment petition rather than hospitalization after a TDO. Among individuals who were hospitalized, longer TDO periods were correlated with an increased likelihood of voluntary hospitalization, rather than involuntary commitment, and shorter hospitalizations, although the net care time (TDO period plus post-TDO hospitalization) increased for individuals whose TDO length was greater than 24 hours.
  
  
  CONCLUSIONS
  Longer TDO periods were correlated with shorter hospital stays and fewer involuntary commitments. These findings support previous work showing that short TDO periods provide insufficient time to stabilize and evaluate individuals. More research is needed to establish a causal link between TDO length and health outcomes.
authors.affiliation: Weldon Cooper Center for Public Service, University of Virginia, Charlottesville, VA 22908, USA. tnw4j@virginia.edu
authors.forename: Tanya Nicole
authors.initials: TN
authors.lastname: Wanchek
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bonnie
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D013997:Time Factors; D014481:United States; D014768:Virginia