Jonathan Bindman1, James Tighe, Graham Thornicroft, Morven Leese. 1. Section of Community Psychiatry (PRiSM), Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. j.bindman@iop.kcl.ac.uk
Abstract
BACKGROUND: Compulsory admission is a central feature of psychiatric systems internationally but the factors determining its use within different legal systems are not understood. Numbers of compulsory psychiatric admissions vary widely between areas in England. We examined the hypothesis that variation in rates of detention is related to social deprivation and also to the functioning of local mental health services. METHODS: Rates of detention under sections 2 and 3 of the Mental Health Act (1983) in 1998/9 were obtained in 34 mental health sectors in eight Trusts in England. Measures of socio-economic deprivation and measures of service function were used to conduct an ecological analysis. RESULTS: Compulsory admission is associated with measures of deprivation but there is unexplained variation. The range in rates is higher than allowed for by the resource allocation formula. Some indicators of service quality are independently associated with rates of detention. CONCLUSIONS: Variation in detention rates and its relation to service function need further explanation if the use of compulsion is to be reduced.
BACKGROUND: Compulsory admission is a central feature of psychiatric systems internationally but the factors determining its use within different legal systems are not understood. Numbers of compulsory psychiatric admissions vary widely between areas in England. We examined the hypothesis that variation in rates of detention is related to social deprivation and also to the functioning of local mental health services. METHODS: Rates of detention under sections 2 and 3 of the Mental Health Act (1983) in 1998/9 were obtained in 34 mental health sectors in eight Trusts in England. Measures of socio-economic deprivation and measures of service function were used to conduct an ecological analysis. RESULTS: Compulsory admission is associated with measures of deprivation but there is unexplained variation. The range in rates is higher than allowed for by the resource allocation formula. Some indicators of service quality are independently associated with rates of detention. CONCLUSIONS: Variation in detention rates and its relation to service function need further explanation if the use of compulsion is to be reduced.
Authors: Louk van der Post; Robert Schoevers; Vincent Koppelmans; Irene Visch; Clemens Bernardt; Niels Mulder; Aartjan Beekman; Lieuwe de Haan; Jack Dekker Journal: BMC Psychiatry Date: 2008-05-14 Impact factor: 3.630