Outcomes of administrative involuntary hospitalization: A national retrospective cohort study in Japan  

作　　者：Akihiro Shiina Aiko Sato Masaomi Iyo Chiyo Fujii 

机构地区：[1]Division of Medical Treatment and Rehabilitation,Chiba University Center for Forensic Mental Health,Chiba 2608670,Japan [2]Department of Psychiatry,Chiba University Graduate School of Medicine,Chiba 2608670,Japan [3]Department of Community Mental Health and Law,National Institute of Mental Health,Kodaira-shi 1878552,Japan

出　　处：《World Journal of Psychiatry》2019年第7期99-106,共8页世界精神病学杂志

基　　金：Supported by a grant awarded to the corresponding author from the Japanese Ministry of Health,Labour and Welfare as part of a research project entitled “Research of the inclusive care for the psychiatric patients discharged from involuntary admission by the prefectural governor’s order”

摘　　要：BACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health.Provision of adequate psychiatric treatment is important for the offender and their community.An approach used in Japan to address this issue is administrative involuntary hospitalization.Under this scheme,a person at risk for harming themselves or others because of a mental disorder can be involuntarily hospitalized in a designated psychiatric hospital.However,this scheme does not include tracking of these patients after discharge.Although some data for administrative involuntary hospitalizations are available,it remains unclear what happens to these patients after discharge.AIM To evaluate follow-up of patients under administrative involuntary hospitalization after discharge and obtain data for later comparisons with outcomes.METHODS We used a retrospective design and conducted a national survey of administrative involuntary hospitalizations.Questionnaires were distributed to 939 facilities across Japan.The questionnaire collected data for selected involuntary hospitalization cases in the hospital on June 30,2010(census date),and the prognoses of each patient on a specified date in 2011 and 2012.We also asked about the treatment provided to each patient.We stratified patients by prognosis(good or poor),and used logistic regression analysis to examine the relationship between treatment and prognosis.RESULTS We received completed questionnaires from 292 facilities(response rate 31.1%);105 facilities had no relevant patients.Our analysis included data for 394 patients with valid data.Official statistics indicated 1503 patients were under administrative involuntary hospitalization as at June 30,2012,meaning the capture rate was 27.2%.Approximately a fourth(104/394)at 1 year,and a third(137/294)at 2 years after the census had unknown prognosis.Treatment content included multi-disciplinary team meetings(78.2%of patients),counseling by public workers(59.9%),and discussion with external specialists(32.5%).Overall,116 patieBACKGROUND Treatment for offenders with mental disorders is a key concern in public mental health. Provision of adequate psychiatric treatment is important for the offender and their community. An approach used in Japan to address this issue is administrative involuntary hospitalization. Under this scheme, a person at risk for harming themselves or others because of a mental disorder can be involuntarily hospitalized in a designated psychiatric hospital. However, this scheme does not include tracking of these patients after discharge. Although some data for administrative involuntary hospitalizations are available, it remains unclear what happens to these patients after discharge.AIM To evaluate follow-up of patients under administrative involuntary hospitalization after discharge and obtain data for later comparisons with outcomes.METHODS We used a retrospective design and conducted a national survey of administrative involuntary hospitalizations. Questionnaires were distributed to939 facilities across Japan. The questionnaire collected data for selected involuntary hospitalization cases in the hospital on June 30, 2010(census date),and the prognoses of each patient on a specified date in 2011 and 2012. We also asked about the treatment provided to each patient. We stratified patients by prognosis(good or poor), and used logistic regression analysis to examine therelationship between treatment and prognosis.RESULTS We received completed questionnaires from 292 facilities(response rate 31.1%);105 facilities had no relevant patients. Our analysis included data for 394 patients with valid data. Official statistics indicated 1503 patients were under administrative involuntary hospitalization as at June 30, 2012, meaning the capture rate was 27.2%. Approximately a fourth(104/394) at 1 year, and a third(137/294) at 2 years after the census had unknown prognosis. Treatment content included multi-disciplinary team meetings(78.2% of patients), counseling by public workers(59.9%), and discussion with external specialists(

关 键 词：Involuntary HOSPITALIZATION Japan MENTAL disorders OFFENDERS Discharge OUTCOMES FOLLOW-UP 

分 类 号：R73[医药卫生—肿瘤]