Involuntary detention: comparison of clinical practices of psychiatry residents and faculty.
OBJECTIVE
The objective of this study is to study if involuntary detention criteria in legal certificates filed by psychiatry residents and faculty psychiatrists are consistent with observations in clinical documentation.


METHODS
Eighty-nine involuntarily hospitalized patients were retrospectively selected from medical records; eight patients were excluded due to change in involuntary status or immediate discharge on clinical grounds. Medical certificates filed by the residents and faculty psychiatrists were compared with clinical documentation of the same day for consistency in criteria for detention (substantial risk of harm to self or others and/or inability to care for self).


RESULTS
Of 81 included patients, 38.3 % lacked sufficient documentation of clinical justification for involuntary hospitalization. The rate of inconsistency of documented clinical justification showed a greater trend among psychiatry residents compared to faculty psychiatrists (p = 0.069, not statistically significant).


CONCLUSIONS
Inconsistency of documented clinical justification for involuntarily detention was higher among residents compared to faculty. There is a need for structured training and supervision of psychiatry residents as well as updated training for faculty psychiatrists with regard to involuntary detention procedures.
University of Texas Health Science Center at Houston, Houston, TX, USA, aqeel.hashmi@uth.tmc.edu.
Aqeel
A
Hashmi
Mujeeb
M
Shad
Howard
H
Rhoades
Monica
M
Grover
Ajay K
AK
Parsaik
D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000379:methods / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology; D055815:Young Adult