Skip to main content

Advertisement

Log in

Short-term outcome of inpatient psychiatric care—impact of coercion and treatment characteristics

  • ORIGINAL PAPER
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Aims

Little is known about the outcome of brief inpatient treatment interventions in routine psychiatric practice. The aim of this article was to study if subjective and assessed outcome of brief psychiatric inpatient care are related to patient characteristics, coercion at admission and during care, and other treatment characteristics.

Method

A total of 233 involuntarily and voluntarily admitted patients were interviewed within 5 days from admission and at discharge or after 3 weeks of care. Outcome was measured as reported by patients and by change in GAF (Global Assessment Scale) scores.

Results

Predictors for a positive subjective outcome were if the patients reported that they had been well treated by the staff and had contact persons at the ward. Predictors for a GAF improvement were a low GAF score at admission and a mood disorder diagnosis.

Conclusions

Subjectively reported outcome and outcome measured by assessing change in level of functioning differed. Coercion was not related to outcome. The way the patient perceived they had been treated by the staff was strongly related to subjective outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Pijl YJ, Kluiter H, Wiersma D (2000) Change in Dutch mental health care: an evaluation. Soc Psychiatry Psychiatr Epidemiol 35:402–407

    Article  PubMed  CAS  Google Scholar 

  2. Silfverhielm H, Kamis-Gould E (2000) The Swedish mental health system. Int J Law Psychiatry 21:293–307

    Article  Google Scholar 

  3. Bülow P, Svensson T, Hansson JH (2002) Long-term consequences of the reformation of psychiatric care: a 15-year follow-up study. Nord J Psychiatry 56:15–21

    Article  PubMed  Google Scholar 

  4. Levinson D, Lerner Y, Lichtenberg P (2003) Reduction in inpatient length of stay and changes in mental health care in Israel over four decades: a national case register study. Isr J␣Psychiatry Relat Sci 40:240–247

    PubMed  Google Scholar 

  5. Clarke P, Hafner RJ, Holme G (1997) The brief admission unit in emergency Psychiatry. J Clin Psychol 53:817–823

    Article  PubMed  CAS  Google Scholar 

  6. Svensson B, Hansson L (1994) Patient satisfaction with inpatient psychiatric care. The influence of personality traits, diagnosis and perceived coercion. Acta Psychiatr Scand 90:379–384

    Google Scholar 

  7. Nicholson RA, Ekenstam C, Norwood S (1996) Coercion and the outcome of psychiatric hospitalization. Int J Law Psychiatry 19:201–217

    Article  PubMed  CAS  Google Scholar 

  8. Kjellin L, Andersson K, Candefjord IL, et al. (1997) Ethical benefits and costs of coercion in short-term inpatient psychiatric care. Psychiatric Serv 48:1567–1570

    CAS  Google Scholar 

  9. Høyer G, Kjellin L, Engberg M, et al. (2002) Paternalism and autonomy: a presentation of a Nordic study on the use of coercion in the mental health care system. Int J Law Psychiatry 25:93–108

    Article  PubMed  Google Scholar 

  10. Gardner W, Hoge S, Bennet N, et al. (1993) Two scales for measuring patients’ perception for coercion during mental hospital admission. Behav Sci Law 11:307–321

    PubMed  CAS  Google Scholar 

  11. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn. APA, Washington DC

    Google Scholar 

  12. Overall JE, Gorham DR (1962) The brief psychiatric rating scale. Psychol Rep 10:799–812

    Article  Google Scholar 

  13. Candefjord IL, Lampinen K, Ängfors G (1994) Patienters upplevelse av akut psykiatrisk vård. (Patients’ experiences of short-term inpatient psychiatric care. In Swedish). Soc Med Tidskr 71:447–453

    Google Scholar 

  14. Kjellin L, Andersson K, Bartholdson E, et al. (2004) Coercion in psychiatric care - patients’ and relatives’ experiences from four Swedish psychiatric services. Nord J Psychiatry 58:153–159

    Article  PubMed  Google Scholar 

  15. Gilbody S, House AO, Sheldon TA (2002) Outcomes research in mental health. Br J Psychiatry 181:8–16

    Article  PubMed  Google Scholar 

  16. Rogers A (1993) Coercion and “voluntary” admission: an examination of psychiatric patient views. Behav Sci 11:259–267

    Google Scholar 

  17. Monahan J, Hoge SK, Lidz C, et al. (1995) Coercion and commitment. Understanding involuntary mental hospital admission. Int J Law Psychiatry 18:249–263

    Article  PubMed  CAS  Google Scholar 

  18. Kjellin L, Westrin CG (1998) Involuntary admissions and coercive measures in psychiatric care. Int J Law Psychiatry 21:31–42

    Article  PubMed  CAS  Google Scholar 

  19. Steinert T, Schmid P (2004) Effect of voluntariness of partipation in treatment on short-term outcome of inpatients with Schizophrenia. Psychiatric Serv 55:786–791

    Article  Google Scholar 

Download references

Acknowledgements

The authors wish to thank all members of the research teams in the participating centres. The study was supported by grants from the County Councils of Kristianstad, Älvsborg, Västmanland, Västerbotten, Örebro and the National Board of Health and Welfare.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tuula Wallsten MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wallsten, T., Kjellin, L. & Lindström, L. Short-term outcome of inpatient psychiatric care—impact of coercion and treatment characteristics. Soc Psychiat Epidemiol 41, 975–980 (2006). https://doi.org/10.1007/s00127-006-0131-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-006-0131-6

Keywords

Navigation