Emergency compulsory admission in crisis situations; the Amsterdam Study of Acute

BACKGROUND: This article presents initial data from the Amsterdam Study of Acute Psychiatry (ASAP) which investigated the factors that play a role in the decision to admit a patient compulsorily to a psychiatric clinic in the Amsterdam area. AIM: To find out how socio-demographic factors, a patient's psychiatric history and pathway to care influence a patient's chance of being served with an emergency compulsory admission order during emergency consultation. METHODS: We conducted a prospective cohort study of 1970 consecutive patients who consecutively came into contact with the Psychiatric Emergency Service Amsterdam (PESA) in the period September 2004 to September 2006. RESULTS: A patient who had been admitted compulsorily once in the previous five years ran an increased risk of compulsorily admission (OR 3.9). Referral by the police or by the mental health services also implied a high risk of a compulsorily admission (OR 2.2 and OR 2.6 respectively). CONCLUSIONS: A previous compulsorily admission and referral by the police or mental health services were found to be predictors of emergency compulsory admission, irrespective of possible danger to the patient himself and others and irrespective of the patient's lack of motivation for treatment.

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