Mental health care needs of involuntarily admitted inpatients

Evidence-based Psychiatric Care 2015;1;59-66 Abstract Aim: This study examined the association of mental health care unmet needs with involuntary shortest-stay hospitalization in routine psychiatric practice. Method: 212 adult persons with ICD-10 mental disorders who were consecutively admitted to a 420-bed psychiatric hospital and discharged within 1-7 days were recruited. Participants were evaluated with the Camberwell Assessment of Need Scale (CANSAS-P) at discharge. Patients were grouped voluntary (VA; n=171) or involuntary (IA; n=41) admission. Results: IA persons with psychotic, neurotic, and personality disorders had a significantly lower mean number of needs (1.4 times less) and unmet needs (1.7 times less) compared to VA persons; they reported lower individual unmet needs including accommodation, food, home, self-care, physical health, treatment, company, basic education, telephone, transport, money, and welfare benefits. Four CANSAS-P domain scores were also found significantly lower in IA than VA inpatients. However, between-group differences for ‘social disability’ domain scores were unrelated to an effect of age, sex, length of stay, and diagnosis; while ‘information processing disability’, ‘emotional processing disability’, and ‘coping disability’ domain scores were found to be related to diagnoses of inpatients. Conclusion: These results provide support for the notion that involuntary admission of persons with psychotic, neurotic, and personality disorders is associated with lower or under-estimated perceived mental health care unmet needs compared to voluntary admission.