commitment of mentally ill


Summary: Legal process required for the institutionalization of a patient with severe mental problems.

Top Publications

  1. Tan J, Stewart A, Fitzpatrick R, Hope T. Attitudes of patients with anorexia nervosa to compulsory treatment and coercion. Int J Law Psychiatry. 2010;33:13-19 pubmed publisher
    ..People with anorexia nervosa appear to agree with the necessity of compulsory treatment in order to save life. The perception of coercion is complex and not necessarily related to the degree of restriction of freedom. ..
  2. Bennewith O, Amos T, Lewis G, Katsakou C, Wykes T, Morriss R, et al. Ethnicity and coercion among involuntarily detained psychiatric in-patients. Br J Psychiatry. 2010;196:75-6 pubmed publisher
    ..Regarding charges of institutional racism in psychiatry, this study highlights the importance of investigating the role of area characteristics when assessing the relationship between ethnicity and patient management. ..
  3. Fiorillo A, Giacco D, De Rosa C, Kallert T, Katsakou C, Onchev G, et al. Patient characteristics and symptoms associated with perceived coercion during hospital treatment. Acta Psychiatr Scand. 2012;125:460-7 pubmed publisher
    ..Female patients perceive more coercion in psychiatric hospital treatment. Effective treatment for positive symptoms and improving patients' global functioning may lead to a reduction in perceived coercion. ..
  4. Myklebust L, Sørgaard K, Røtvold K, Wynn R. Factors of importance to involuntary admission. Nord J Psychiatry. 2012;66:178-82 pubmed publisher
    ..Certain groups of patients are more likely to be admitted involuntarily. Increasing attention to these groups could possibly also contribute to the reduction of coercion. ..
  5. Katsakou C, Rose D, Amos T, Bowers L, McCabe R, Oliver D, et al. Psychiatric patients' views on why their involuntary hospitalisation was right or wrong: a qualitative study. Soc Psychiatry Psychiatr Epidemiol. 2012;47:1169-79 pubmed publisher
    ..This knowledge could inform the development of interventions to improve patients' views and treatment experiences. ..
  6. Georgieva I, Mulder C, Wierdsma A. Patients' preference and experiences of forced medication and seclusion. Psychiatr Q. 2012;83:1-13 pubmed publisher
    ..Our findings show that patients' preferences cannot guide the establishment of international uniform methods for managing violent behaviour. Therefore patients' individual choices should be considered. ..
  7. Shah A, Buckley L. The relationship between the use of mental health act and elderly suicide rates in England and Walls. J Inj Violence Res. 2009;1:49-53 pubmed publisher
    ..If an inverse association can be demonstrated between suicide and involuntary admissions then it has important implications for the development of mental health legislation as an adjunct to national suicide prevention strategies. ..
  8. Raboch J, Kališová L, Nawka A, Kitzlerova E, Onchev G, Karastergiou A, et al. Use of coercive measures during involuntary hospitalization: findings from ten European countries. Psychiatr Serv. 2010;61:1012-7 pubmed publisher
    ..Their use appeared to depend on diagnosis and the severity of illness, but use was also heavily influenced by the individual country. Variation across countries may reflect differences in societal attitudes and clinical traditions. ..
  9. Rugkåsa J, Dawson J. Community treatment orders: current evidence and the implications. Br J Psychiatry. 2013;203:406-8 pubmed publisher
    ..This evidence gives pause for thought about current CTO practice. Further high-quality RCTs may settle the contentious debate about effectiveness. ..

More Information


  1. Owen G, David A, Hayward P, Richardson G, Szmukler G, Hotopf M. Retrospective views of psychiatric in-patients regaining mental capacity. Br J Psychiatry. 2009;195:403-7 pubmed publisher
    ..This is the case even if initial treatment wishes are overridden. These findings moderate concerns both about surrogate decision-making by psychiatrists and advance decision-making by people with mental illness. ..
  2. Bergk J, Flammer E, Steinert T. "Coercion Experience Scale" (CES)--validation of a questionnaire on coercive measures. BMC Psychiatry. 2010;10:5 pubmed publisher
    ..Further research is needed to identify possible diagnostic, therapeutic or prognostic implications of the total score and the different subscales. Current Controlled Trials ISRCTN70589121. ..
  3. Katsakou C, Bowers L, Amos T, Morriss R, Rose D, Wykes T, et al. Coercion and treatment satisfaction among involuntary patients. Psychiatr Serv. 2010;61:286-92 pubmed publisher
    ..Interventions to reduce patients' perceived coercion might increase overall treatment satisfaction. ..
  4. Priebe S, Katsakou C, Glöckner M, Dembinskas A, Fiorillo A, Karastergiou A, et al. Patients' views of involuntary hospital admission after 1 and 3 months: prospective study in 11 European countries. Br J Psychiatry. 2010;196:179-85 pubmed publisher
    ..International differences in legislation and practice may be relevant to outcomes and inform improvements in policies, particularly in countries with poorer outcomes. ..
  5. Fiorillo A, De Rosa C, Del Vecchio V, Jurjanz L, Schnall K, Onchev G, et al. How to improve clinical practice on involuntary hospital admissions of psychiatric patients: suggestions from the EUNOMIA study. Eur Psychiatry. 2011;26:201-7 pubmed publisher
    ..The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure. ..
  6. Diseth R, Bøgwald K, Høglend P. Attitudes among stakeholders towards compulsory mental health care in Norway. Int J Law Psychiatry. 2011;34:1-6 pubmed publisher
    ..Both psychiatrists and "somatic" physicians expressed more agreement with the present legislation than the other stakeholders. The findings may have implications for the legal protection of mental health care patients. ..
  7. Giacco D, Fiorillo A, Del Vecchio V, Kallert T, Onchev G, Raboch J, et al. Caregivers' appraisals of patients' involuntary hospital treatment: European multicentre study. Br J Psychiatry. 2012;201:486-91 pubmed publisher
    ..Caregivers' appraisals of involuntary in-patient treatment are rather favourable. Their correlation with patients' symptom improvement may underline their relevance in clinical practice. ..
  8. Callaghan S, Ryan C, Kerridge I. Risk of suicide is insufficient warrant for coercive treatment for mental illness. Int J Law Psychiatry. 2013;36:374-85 pubmed publisher
  9. Loue S. The involuntary civil commitment of mentally ill persons in the United States and Romania: a comparative analysis. J Leg Med. 2002;23:211-50 pubmed
  10. Fisher W, Barreira P, Lincoln A, Simon L, White A, Roy Bujnowski K, et al. Insurance status and length of stay for involuntarily hospitalized patients. J Behav Health Serv Res. 2001;28:334-46 pubmed
    ..The data raise concerns that warrant closer scrutiny on the part of administrators and clinicians. ..
  11. Priebe S, Turner T. Reinstitutionalisation in mental health care. BMJ. 2003;326:175-6 pubmed
  12. Owen G, Szmukler G, Richardson G, David A, Hayward P, Rucker J, et al. Mental capacity and psychiatric in-patients: implications for the new mental health law in England and Wales. Br J Psychiatry. 2009;195:257-63 pubmed publisher
  13. Henderson C, Flood C, Leese M, Thornicroft G, Sutherby K, Szmukler G. Effect of joint crisis plans on use of compulsory treatment in psychiatry: single blind randomised controlled trial. BMJ. 2004;329:136 pubmed
    ..The reduction in overall admission was less. This is the first structured clinical intervention that seems to reduce compulsory admission and treatment in mental health services. ..
  14. Hiday V, Swartz M, Swanson J, Borum R, Wagner H. Criminal victimization of persons with severe mental illness. Psychiatr Serv. 1999;50:62-8 pubmed
    ..The study found a substantial rate of violent criminal victimization among persons with severe and persistent mental illness. Results suggest that substance use and homelessness make criminal victimization more likely. ..
  15. Vinkers D, de Vries S, van Baars A, Mulder C. Ethnicity and dangerousness criteria for court ordered admission to a psychiatric hospital. Soc Psychiatry Psychiatr Epidemiol. 2010;45:221-4 pubmed publisher
    ..Violence towards others and neglect of relatives are more often a reason to request court ordered admission in BME than in White persons. BME patients are more often perceived as potentially dangerous to others. ..
  16. Kisely S, Campbell L. Does compulsory or supervised community treatment reduce 'revolving door' care? Legislation is inconsistent with recent evidence. Br J Psychiatry. 2007;191:373-4 pubmed
    ..Two recent epidemiological studies in Australia (n>118 000), as well as a systematic review of all previous literature using appropriately matched or randomised controls (n=1108), suggest that it is unlikely to help. ..
  17. Swartz M, Wagner H, Swanson J, Hiday V, Burns B. The perceived coerciveness of involuntary outpatient commitment: findings from an experimental study. J Am Acad Psychiatry Law. 2002;30:207-17 pubmed
    ..The current analyses demonstrate that a consequence of OPC is increased perceptions of coercion in the treatment process, which is partially explained by the increased attention by case managers to noncompliance with treatment. ..
  18. Grudzinskas A. Commentary: the search for a formula to relate competence, coercion, and mandated treatment. J Am Acad Psychiatry Law. 2002;30:218-20 pubmed
  19. Bindman J, Tighe J, Thornicroft G, Leese M. Poverty, poor services, and compulsory psychiatric admission in England. Soc Psychiatry Psychiatr Epidemiol. 2002;37:341-5 pubmed
    ..Some indicators of service quality are independently associated with rates of detention. Variation in detention rates and its relation to service function need further explanation if the use of compulsion is to be reduced. ..
  20. Segal S, Akutsu P, Watson M. Involuntary return to a psychiatric emergency service within twelve months. Soc Work Health Care. 2002;35:591-603 pubmed
    ..We may have lost sight of the crucial role of this setting in stopping the revolving door and insuring appropriate care. ..
  21. Anand V, Ciccone J, Kashtan I, Seger A. Factors predictive of changes in the legal status of psychiatric inpatients. J Forensic Sci. 2002;47:1365-9 pubmed
    ..Patients who smoke may be applying overt and covert pressure on clinicians with regard to conversion to voluntary status to gain smoking privileges. ..
  22. Bhui K, Stansfeld S, Hull S, Priebe S, Mole F, Feder G. Ethnic variations in pathways to and use of specialist mental health services in the UK. Systematic review. Br J Psychiatry. 2003;182:105-16 pubmed
    ..There is strong evidence of variation between ethnic groups for voluntary and compulsory admissions, and some evidence of variation in pathways to specialist care. ..
  23. Horrocks J, Price S, House A, Owens D. Self-injury attendances in the accident and emergency department: Clinical database study. Br J Psychiatry. 2003;183:34-9 pubmed
    ..The clinical importance of self-injury is not mirrored by the level of psychosocial assessment and after-care provided. ..
  24. Rittmannsberger H, Sartorius N, Brad M, Burtea V, Capraru N, Cernak P, et al. Changing aspects of psychiatric inpatient treatment. A census investigation in five European countries. Eur Psychiatry. 2004;19:483-8 pubmed
    ..A considerable increase in the numbers of staff was found in Slovakia. ..
  25. Tan J, Hope T, Stewart A, Fitzpatrick R. Control and compulsory treatment in anorexia nervosa: the views of patients and parents. Int J Law Psychiatry. 2003;26:627-45 pubmed
  26. Segal S, Akutsu P, Watson M. Factors associated with involuntary return to a psychiatric emergency service within 12 months. Psychiatr Serv. 1998;49:1212-7 pubmed
  27. Poulsen H, Engberg M. Validation of psychiatric patients' statements on coercive measures. Acta Psychiatr Scand. 2001;103:60-5 pubmed
    ..The existence of a 'grey zone' between patients' and doctors' perception of coercion was confirmed. Knowledge of patients' psychopathology seems essential when considering medical, legal and ethical aspects of the use of coercion. ..
  28. Appelbaum P. Thinking carefully about outpatient commitment. Psychiatr Serv. 2001;52:347-50 pubmed
    ..Acknowledging limitations in the empirical evidence favoring outpatient commitment, the author reviews key issues for policy makers to address in considering or revising these statutes. ..
  29. Houston K, Mariotto M. Outcomes for psychiatric patients following first admission: relationships with voluntary and involuntary treatment and ethnicity. Psychol Rep. 2001;88:1012-4 pubmed
    ..Ethnic differences in placement at discharge were not supported, but involuntarily admitted patients were over-represented in the less desirable outcome categories. ..
  30. Steinert T, Lepping P, Gebhardt R. [Decisions about sectioning and medicating of schizophrenic patients in Germany and England--results of a comparative study]. Psychiatr Prax. 2003;30:114-8 pubmed
    ..001 for both). When a logistic regression was performed the country of work was the most important predictive factor in deciding whether or not to treat a patient against his will. ..
  31. Liegeois A, Eneman M. Ethics of deliberation, consent and coercion in psychiatry. J Med Ethics. 2008;34:73-6 pubmed publisher
  32. Carney T, Tait D, Richardson A, Touyz S. Why (and when) clinicians compel treatment of anorexia nervosa patients. Eur Eat Disord Rev. 2008;16:199-206 pubmed
  33. Stolker J, Nijman H, Zwanikken P. Are patients' views on seclusion associated with lack of privacy in the ward?. Arch Psychiatr Nurs. 2006;20:282-7 pubmed
    ..This finding suggests that the ward environment may have a rather large impact on how seclusion is perceived. The results underline the need for single-bed rooms in the treatment of psychiatric inpatients. ..
  34. Craw J, Compton M. Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients. Soc Psychiatry Psychiatr Epidemiol. 2006;41:981-8 pubmed
    ..Studying legal status (and the process of legal status conversion from involuntary to voluntary) and its correlates is an important topic for further research. ..
  35. Muller P, Dressing H, Salize H. [For and against: increase of compulsory admissions of psychiatric patients]. Psychiatr Prax. 2006;33:157-9 pubmed
  36. Beck N, Durrett C, Stinson J, Coleman J, Stuve P, MENDITTO A. Trajectories of seclusion and restraint use at a state psychiatric hospital. Psychiatr Serv. 2008;59:1027-32 pubmed publisher
  37. Tunde Ayinmode M, Little J. Use of seclusion in a psychiatric acute inpatient unit. Australas Psychiatry. 2004;12:347-51 pubmed
    ..As expected, the use of seclusion in an adult acute unit reflected indirect measures of illness severity. Its use needs to be carefully reviewed and monitored, representing as it does the greatest restriction on a person's freedom. ..
  38. Morgan C, Mallett R, Hutchinson G, Bagalkote H, Morgan K, Fearon P, et al. Pathways to care and ethnicity. 1: Sample characteristics and compulsory admission. Report from the AESOP study. Br J Psychiatry. 2005;186:281-9 pubmed
    ..These findings suggest that factors are operating at or prior to first presentation to increase the risk of compulsory admission among African-Caribbean and Black African patients. ..
  39. Torrey E, Zdanowicz M. Outpatient commitment: what, why, and for whom. Psychiatr Serv. 2001;52:337-41 pubmed
    ..The authors conclude by addressing eight of the most common objections to outpatient commitment by mental health professionals and civil liberties groups that oppose outpatient commitment. ..
  40. Morgan C, Mallett R, Hutchinson G, Bagalkote H, Morgan K, Fearon P, et al. Pathways to care and ethnicity. 2: Source of referral and help-seeking. Report from the AESOP study. Br J Psychiatry. 2005;186:290-6 pubmed
    ..These findings suggest that factors are operating during a first episode of psychosis to increase the risk that the pathway to care for Black patients will involve non-health professionals. ..
  41. Hirschfeld R. When to hospitalize patients at risk for suicide. Ann N Y Acad Sci. 2001;932:188-96; discussion 196-9 pubmed
    ..A person who is determined to kill himself/herself will probably prevail despite our best efforts. However, most people who are imminently suicidal at one time will feel very differently at some later time. ..
  42. Greenberg D, Mazar J, Brom D, Barer Y. Involuntary outpatient commitment: a naturalistic study of its use and a consumer survey at one community mental health center in Israel. Med Law. 2005;24:95-110 pubmed
    ..The study reflects the delicate nature of involuntary care in the community, so that in practice it is often not involuntary, not for outpatients and not a commitment. ..
  43. Kjellin L, Høyer G, Engberg M, Kaltiala Heino R, Sigurjónsdóttir M. Differences in perceived coercion at admission to psychiatric hospitals in the Nordic countries. Soc Psychiatry Psychiatr Epidemiol. 2006;41:241-7 pubmed
    ..The results from Sweden also indicate that local care traditions may account for variation among centres within countries. ..
  44. Wallsten T, Kjellin L, Lindström L. Short-term outcome of inpatient psychiatric care--impact of coercion and treatment characteristics. Soc Psychiatry Psychiatr Epidemiol. 2006;41:975-80 pubmed
    ..Coercion was not related to outcome. The way the patient perceived they had been treated by the staff was strongly related to subjective outcome. ..
  45. Papageorgiou A, King M, Janmohamed A, Davidson O, Dawson J. Advance directives for patients compulsorily admitted to hospital with serious mental illness. Randomised controlled trial. Br J Psychiatry. 2002;181:513-9 pubmed
    ..Users' advance instruction directives had little observable impact on the outcome of care at 12 months. ..
  46. Priebe S, Badesconyi A, Fioritti A, Hansson L, Kilian R, Torres Gonzales F, et al. Reinstitutionalisation in mental health care: comparison of data on service provision from six European countries. BMJ. 2005;330:123-6 pubmed
    ..General attitudes to risk containment in a society, as indicated by the size of the prison population, may be more important than changing morbidity and new methods of mental healthcare delivery. ..
  47. Monahan J, Swartz M, Bonnie R. Mandated treatment in the community for people with mental disorders. Health Aff (Millwood). 2003;22:28-38 pubmed
  48. Katsakou C, Priebe S. Outcomes of involuntary hospital admission--a review. Acta Psychiatr Scand. 2006;114:232-41 pubmed
    ..At least for this group, new approaches might have to be considered. Larger studies are required to identify predictors on which patients are likely to fall into this group. ..
  49. Preston N, Kisely S, Xiao J. Assessing the outcome of compulsory psychiatric treatment in the community: epidemiological study in Western Australia. BMJ. 2002;324:1244 pubmed
    ..No covariates were shown to be associated with changes in within pair differences in inpatient admissions or bed days. The introduction of compulsory treatment in the community does not lead to reduced use of health services. ..
  50. Haglund K, van der Meiden E, von Knorring L, von Essen L. Psychiatric care behind locked doors. A study regarding the frequency of and the reasons for locked psychiatric wards in Sweden. J Psychiatr Ment Health Nurs. 2007;14:49-54 pubmed
    ..Staff working in psychiatric care ought to reflect upon and articulate reasons for, and decisions about, locking or opening entrance doors, with the limitation of patients' freedom in mind. ..
  51. Priebe S, Katsakou C, Amos T, Leese M, Morriss R, Rose D, et al. Patients' views and readmissions 1 year after involuntary hospitalisation. Br J Psychiatry. 2009;194:49-54 pubmed publisher
    ..Patients' views of treatment within the first week are a relevant indicator for the long-term prognosis of involuntarily admitted patients. ..
  52. Gardner W, Lidz C, Hoge S, Monahan J, Eisenberg M, Bennett N, et al. Patients' revisions of their beliefs about the need for hospitalization. Am J Psychiatry. 1999;156:1385-91 pubmed
    ..Coerced patients did not appear to be grateful for the experience of hospitalization, even if they later concluded that they had needed it. ..
  53. Henderson C, Swanson J, Szmukler G, Thornicroft G, Zinkler M. A typology of advance statements in mental health care. Psychiatr Serv. 2008;59:63-71 pubmed publisher
    ..However, the relationship of advance statements to involuntary treatment is more problematic, as is their effective implementation in many mental health service settings. ..