title: Local Geographical Distribution of Acute Involuntary Psychiatric Admissions in Subdistricts In and Around Utrecht, the Netherlands.
abstract: BACKGROUND
  Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas.
  
  
  OBJECTIVE
  The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density.
  
  
  METHODS
  Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities.
  
  
  RESULTS
  The AIPA density (mean 4.4/10,000 inhabitants/y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of facilities of sheltered living.
  
  
  CONCLUSIONS
  The considerable AIPA density variation between subdistricts in this urban environment reflects that people who are prone to psychiatric admissions live in economically less prosperous environments. Impaired social networks and economic concerns may also contribute to an environment representing social defeat, increased demoralization, or social fragmentation.
authors.affiliation: Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands.
authors.forename: Arjan W
authors.initials: AW
authors.lastname: Braam
authors.affiliation: Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands; Palier Forensic Psychiatry, The Hague, The Netherlands.
authors.forename: Omar W H R
authors.initials: OW
authors.lastname: van Ommeren
authors.affiliation: Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands; Psychologiepraktijk Van Buuren, Barneveld, The Netherlands.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: van Buuren
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Wijnand
authors.initials: W
authors.lastname: Laan
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hugo M
authors.initials: HM
authors.lastname: Smeets
authors.affiliation: Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands; Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands.
authors.forename: Iris M
authors.initials: IM
authors.lastname: Engelhard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040561:Assisted Living Facilities / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014478:Unemployment / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: compulsory admission; emergency detention; geographical; involuntary admission; involuntary examinations