title: Assessing the Need for Hospitalization in Order to Conduct a Psychiatric Evaluation as part of Criminal Law Procedure.
abstract: BACKGROUND
  In criminal law, psychiatrists are consulted regarding the "insanity defense" and the defendant's competency to stand trial. Court-ordered hospital admissions for such evaluations are on the increase, creating a major burden on the health system.
  
  
  OBJECTIVE
  To assess, in a hospital setting, whether hospitalization of the defendant is necessary for conducting a psychiatric evaluation.
  
  
  METHODS
  A 6 month prospective observational study exploring the phenomenon was conducted at the Beer Yaakov Mental Health Center. The psychiatrist was asked both at the initiation and at the end of the assessment process whether the subject was competent to stand trial and responsible for his/her actions and if hospitalization was necessary in order to conduct the evaluation.
  
  
  RESULTS
  During the study period there were 112 admissions with a court request for a psychiatric evaluation. In 73 of the cases (65.2%) the evaluating psychiatrist believed there was no need for hospitalization. This assessment did not change by the end of the hospitalization in all cases. Employment and alcohol use were the only factors associated with a lower need for hospitalization (OR 0.24, 95% CI 0.07-0.77, and OR 0.34, 95% CI 0.13-0.90, respectively).
  
  
  CONCLUSIONS
  In the majority of cases, based on the evaluating psychiatrist's responses, the evaluation could have been conducted without need for hospitalization. The findings indicate that an outpatient unit designated to write court-requested psychiatric evaluations could significantly reduce the rates of hospital admissions for this purpose.
authors.forename: Ahikam
authors.initials: A
authors.lastname: Olmer
authors.forename: Binyamin
authors.initials: B
authors.lastname: Greenberg
authors.forename: Rael D
authors.initials: RD
authors.lastname: Strous
mesh_terms: D000293:Adolescent; D000328:Adult; D003416:Criminal Law; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007298:Insanity Defense; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult