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Involuntary psychiatric admissions have increased significantly in Ontario: study


Involuntary psychiatric hospital admissions have increased steadily from 70.7 per cent of all psychiatric admissions in 2009 to 77.1 per cent in 2013. In a new study from the Institute for Clinical Evaluative Sciences (ICES) and the Centre for Addiction and Mental Health (CAMH), researchers found nearly three-quarters of all psychiatric hospital admissions in Ontario are involuntary.

A psychiatric hospital admission is involuntary when an individual with mental illness is hospitalized against his or her will due to a perceived risk to the individual or others. While often necessary to address safety, involuntary admission is an adverse experience for many patients and, ideally, should be avoided.

“The issue with involuntary psychiatric admissions is that they can be disruptive to the patient-provider relationship and negatively impact the patient’s perception of his or her care at the time of the admission and afterward,” says Michael Lebenbaum, lead author of the study and epidemiologist at ICES.

The study published today in the British Journal of Psychiatry Open is one of the largest and most comprehensive examinations of involuntary admissions to date.

The study looked at the admission records for 115,515 patients who had been hospitalized for psychiatric care from 2009 to 2013 in Ontario. The researchers found:

  • A high and increasing prevalence of involuntary admissions (70.7 per cent in 2009, 77.1 per cent in 2013, 74.1 per cent overall).
  • Individuals with police contact in the prior week and immigrants both experienced greater likelihood of being involuntarily admitted.
  • 33.6 per cent (28,726) of individuals who were involuntarily admitted were released within 72 hours of admission and 17.1 per cent transferred to voluntary status by day three.

“We found that those who had a mental health visit in the week before admission with either a family doctor or psychiatrist were less likely to be involuntarily admitted. This indicates to us that involuntary hospitalization may, to some extent, be an avoidable event if care provided in the community settings eases the psychiatric crises that lead to involuntary hospitalization,” says Dr. Paul Kurdyak, co-author of the study, scientist at ICES and at CAMH.

“Prevalence and predictors of involuntary psychiatric hospital admissions in Ontario, Canada: a population-based linked administrative database study,” was published today in the British Journal of Psychiatry Open.

Author block: Michael Lebenbaum, Maria Chiu, Simone Vigod and Paul Kurdyak.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital and a world leading research centre in this field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental illness and addiction. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit camh.ca or follow @CAMHnews on Twitter.

For more information, please contact:

Deborah Creatura
Media Advisor, ICES
[email protected]
(o) 416-480-4780 or (c) 647-406-5996

Sean O'Malley
Media Relations, CAMH
(416) 595-6015 / [email protected]

Read the Journal Article