title: Local psychiatric beds appear to decrease the use of involuntary admission: a case-registry study.
abstract: BACKGROUND
  Studies on the effect of organizational factors on the involuntary admission of psychiatric patients have been few and yielded inconclusive results. The objective was to examine the importance of type of service-system, level of care, length of inpatient stay, gender, age, and diagnosis on rates of involuntary admission, by comparing one deinstitutionalized and one locally institutionalized service-system, in a naturalistic experiment.
  
  
  METHODS
  5538 admissions to two specialist psychiatric service-areas in North Norway were studied, covering a four-year period (2003-2006). The importance of various predictors on involuntary admission were analyzed in a logistic regression model.
  
  
  RESULTS
  Involuntary admission to the services was associated with the diagnosis of psychosis, male sex, being referred to inpatient treatment, as well as type of service-system. Patients from the deinstitutionalized system were more likely to be involuntarily admitted.
  
  
  CONCLUSIONS
  Several factors predicted involuntary status, including male sex, the diagnosis of psychosis, and type of service-system. The results suggests that having psychiatric beds available locally may be more favourable than a traditional deinstitutionalized service system with local outpatient clinics and central mental hospitals, with respect to the use of involuntary admission.
authors: Lars Henrik
authors: LH
authors: Myklebust
authors: Knut
authors: K
authors: Sørgaard
authors: Department of Clinical Medicine, University of Tromsø, Tromsø N-9037, Norway. rolf.wynn@gmail.com.
authors: Rolf
authors: R
authors: Wynn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data / Q000600:supply & distribution*; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012737:Sex Factors; D055815:Young Adult