title: The Low Proportion and Associated Factors of Involuntary Admission in the Psychiatric Emergency Service in Taiwan.
abstract: BACKGROUND
  The involuntary admission regulated under the Mental Health Act has become an increasingly important issue in the developed countries in recent years. Most studies about the distribution and associated factors of involuntary admission were carried out in the western countries; however, the results may vary in different areas with different legal and socio-cultural backgrounds.
  
  
  OBJECTIVE
  The aim of this study was to investigate the proportion and associated factors of involuntary admission in a psychiatric emergency service in Taiwan.
  
  
  METHODS
  The study cohort included patients admitted from a psychiatric emergency service over a two-year period. Demographic, psychiatric emergency service utilization, and clinical variables were compared between those who were voluntarily and involuntarily admitted to explore the associated factors of involuntary admission.
  
  
  RESULTS
  Among 2,777 admitted patients, 110 (4.0%) were involuntarily admitted. Police referrals and presenting problems as violence assessed by psychiatric nurses were found to be associated with involuntary admission. These patients were more likely to be involuntarily admitted during the night shift and stayed longer in the psychiatric emergency service.
  
  
  CONCLUSIONS
  The proportion of involuntary admissions in Taiwan was in the lower range when compared to Western countries. Dangerous conditions evaluated by the psychiatric nurses and police rather than diagnosis made by the psychiatrists were related factors of involuntary admission. As it spent more time to admit involuntary patients, it was suggested that multidisciplinary professionals should be included in and educated for during the process of involuntary admission.
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
authors.forename: Jen-Pang
authors.initials: JP
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Medical Affairs Division, Department of Health, Taipei City Government, Taipei, Taiwan.
authors.forename: Tsu-Hui
authors.initials: TH
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Tzong-Hsien
authors.initials: TH
authors.lastname: Liu
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Chia-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data* / Q000639:trends; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003617:Dangerous Behavior; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D028642:Persons with Psychiatric Disorders; D008875:Middle Aged; D024802:Nurse's Role; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D016495:Police; D013624:Taiwan; D014754:Violence / Q000523:psychology