title: [Involuntary hospitalization under the Act of July 5th 2011: A study of patients' experience and understanding of their hearing with the judge ruling on civil detention cases].
abstract: OBJECTIVE
  To assess involuntary admitted patients' experience and understanding of their hearing with the judge ruling on civil detention cases according to the Act of July 5th 2011.
  
  
  METHODS
  The evaluation was conducted through face-to-face interviews, from a semi-structured questionnaire, with 48 involuntary admitted patients under psychiatric care admission on a third party request (ASPDT) or on state representative decision (ASPDRE) (participation rate=96%).
  
  
  RESULTS
  Few participants knew the name of the hearing place (13%) and the judge's exact title (21%). About 58% of them had benefited from lawyer services. During the hearing, half of the patients contested the need for hospitalization. The judge was perceived as clear (79%), listening (69%) and benevolent (58%), but only 46% of patients believed that he/she was impartial and 35% that he/she was independent from medical decisions. More than half of the patients disagreed with the judge's decision (56%). However, only 19% of them planned to appeal. Three out of four were in favour of a judicial review of involuntary hospitalization. A feeling of protection was more common in people with a higher educational level (65% versus 35%, Chi(2) (1) = 3.9, P = 0.05) and who suffered from mood disorders (75% versus 46%, Chi(2) (1) = 3.8, P = 0.05). A feeling of being accused was more frequent in persons with hospitalization under psychiatric care admission on state representative decision (ASPDRE) than on a third party request (ASPDT) (37% vs 10%, Chi(2) (1) = 4.9, P = 0.03). Persons under guardianship were also more likely to report such feelings (32% versus 10%, Chi(2) (1) = 3.4, P=0.06). The feeling that "everything was preordained" was more common in younger patients (m = 36.4 years [SD = 13.9] vs m = 46.2 years [SD = 17.8], t-test [46] = 2.01, P = 0.04), as well as among those who used the advice of a lawyer, with an association at a trend level (73% versus 46%, Chi(2) (1) = 3.5, P = 0.06).
  
  
  CONCLUSIONS
  Systematic judicial review of involuntary hospitalization represents a major evolution in the patients' rights field. This study shows that their experience and understanding of the hearing with the judge ruling on civil detention cases are quite mixed. In clinical practice, informing the patient about the upcoming hearing may allow the physician who initiates the hospitalization to reassure him/her as the intervention of a third party will be required to confirm the legality of involuntary admission. Furthermore, such information about the judicial intervention might avoid unproductive confrontation between the patient and the physician when the person remains opposed to the hospitalization. However, some patients may be disappointed as they are heavily invested in the preparation of their "defence" and have high hopes in the intervention of a judge who most often maintains the hospitalization.
authors.affiliation: Pôle PUMA, centre hospitalier Charles-Perrens, 33000 Bordeaux, France.
authors.forename: K
authors.initials: K
authors.lastname: Rossini
authors.affiliation: U657, université de Bordeaux, 33000 Bordeaux, France; U657, Inserm, 33000 Bordeaux, France; Pôle universitaire de psychiatrie adulte, CH Charles-Perrens, 121, rue de la Béchade, 33076 Bordeaux cedex, France. Electronic address: helene.verdoux@u-bordeaux2.fr.
authors.forename: H
authors.initials: H
authors.lastname: Verdoux
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D004522:Educational Status; D005602:France; D006801:Humans; D007407:Interviews as Topic; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D028701:Patient Rights / Q000331:legislation & jurisprudence*; D011795:Surveys and Questionnaires
keywords: Act of July 5th 2011; Hospitalisation sans consentement; Involuntary hospitalization; Judge ruling on civil detention cases/judge of liberty and detention; Juge des libertés et de la détention; Loi du 5 juillet 2011; Patient's experience; Vécu du patient