Archive 1992–2014

Objective. The need to monitor the implementation of the mental health act motivated the present attempt to verify the material concerning the admission procedures and application of direct constraint in psychiatric wards and hospitals. The main purpose of this study was to analyse the data concerning involuntary hospitalisation in 2006 taking into account the type and size of admitting institution. Additionally, the study sought to identify the sites of proceedings of the custodial court in art. 23, 24 and 28 cases and to determine the frequency of application of direct constraint on psychiatric wards.
Method. The study is based on data from 117 institutions that were monitored in 2006, including 46 psychiatric hospitals and 71 general hospitals.
Results. In 2006, 15 628 individuals were admitted involuntarily to psychiatric wards on the basis of one of four (23, 24, 28, and 29) articles of the mental health act, that is 8.7% of all admittances. Art. 23 dominates in the structure of involuntary hospitalisations, i.e., 75% of all these admissions. In 55.6% of the monitored institutions the proportion of involuntary hospitalisations did not exceed 5%o of all admissions. The level of direct constraint in both psychiatric and general hospitals was the highest since 1996. The differences in the level of involuntary hospitalisations in psychiatric hospitals and general hospitals may be due to the practices of the emergency service which prefers to transport patients to psychiatric hospitals. Another reason may be social opinion and differences in patient attitudes: patients may demonstrate more resistance during admission to a psychiatric hospital than during admission to a general hospital.
Conclusions. Psychiatric hospitals accept nearly twice as many involuntary patients as psychiatric wards in general hospitals. Dominant in this group are admissions based on art. 23 but an increasing number of admissions based on art. 24, permitting involuntary observation, can also be observed in current „admission" practice. As far as general hospitals are concerned, there is a clear relation between the size of the institution and the proportion of involuntary admissions. Whatever the institution, the custodial court case usually takes place at the hospital to which the patient was admitted.