title: Impact of social-psychiatric services and psychiatric clinics on involuntary admissions.
abstract: BACKGROUND
  Germany provides a wide range of highly developed mental health care to its citizens. The aim of this study was to identify factors influencing the voluntariness of admissions to psychiatric hospitals. Especially the impact of demographic factors of the region, characteristics of the psychiatric hospitals and characteristics of the psychosocial services was analyzed.
  
  
  METHODS
  A retrospective analysis of hospital admission registers from 13 German adult psychiatric hospitals in 2009 was conducted. Public data on the regional psychiatric accommodation and demographic situation were added. Hospitals were dichotomously divided according to their index of involuntary admissions. Group comparisons were performed between the clinics with low and high involuntary admission indices. Analysis was conducted with clinical, psychiatric provision and demographic data related to inpatients in the Landschaftsverbands Westfalen-Lippe (LWL)-PsychiatryNetwork.
  
  
  RESULTS
  Especially the range of services provided by the social-psychiatric services in the region such as number of supervised patients and home visits had an influence on the proportion of involuntary admissions to a psychiatric hospital. Some demographic characteristics of the region such as discretionary income showed further influence. Contrary to our expectations, the characteristics of the individual hospital seem to have no influence on the admission rate.
  
  
  CONCLUSIONS
  Social-psychiatric services show a preventive impact on involuntary acute psychiatry interventions. Sociodemographic factors and patient variables play a role with regard to the number of involuntary hospitalizations, whereas characteristics of hospitals seemed to play no role.
authors: LWL-Institute of Mental Health, LWL-University Hospital Bochum, Germany barbara.emons@wkp-lwl.org.
authors: Barbara
authors: B
authors: Emons
authors: LWL-Institute of Mental Health, LWL-University Hospital Bochum, Germany.
authors: Ida Sybille
authors: IS
authors: Haussleiter
authors: Social-Psychiatric Service, Health Authority Bochum, Germany.
authors: Jörg
authors: J
authors: Kalthoff
authors: Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Anja
authors: A
authors: Schramm
authors: Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Knut
authors: K
authors: Hoffmann
authors: Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Jasmin
authors: J
authors: Jendreyschak
authors: LWL-Institute of Mental Health, LWL-University Hospital Bochum, Germany.
authors: Markus
authors: M
authors: Schaub
authors: Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Carina
authors: C
authors: Armgart
authors: LWL-Institute of Mental Health, LWL-University Hospital Bochum, Germany Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Georg
authors: G
authors: Juckel
authors: Department of Psychiatry, LWL-University Hospital Bochum, Germany.
authors: Franciska
authors: F
authors: Illes
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000639:trends*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012949:Social Work, Psychiatric / Q000379:methods* / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: Psychiatric epidemiology; involuntary admission; psychiatric clinics; risk factors; social-psychiatric services