Eitanim Hospital, The Jerusalem Mental Health Center, Mobile Post Tzfon Yehuda, 90972, Israel.
Int J Law Psychiatry. 2011 Sep-Oct;34(5):368-73. doi: 10.1016/j.ijlp.2011.08.009. Epub 2011 Oct 5.
The management of individuals with mental illnesses sometimes requires involuntary hospitalization. The Israel Mental Health Act requires that cases of involuntary psychiatric hospitalization (IPH) be periodically reviewed by the district psychiatric committee. The discussion in the committee often leads to debate regarding the need for an IPH potentially depriving the patient of his freedom. Little is known about the way in which the psychiatrists and attorneys on these committees arrive at their decisions. The present study was designed to examine the views of future doctors and attorneys concerning cases of possible IPH to determine whether their decisions would be influenced by their respective professional educational backgrounds.
After compiling demographic data, we asked 170 students from each of the two disciplines what their decision would be in two hypothetical cases that dealt with the question of a prolongation of a psychiatric hospitalization. Questionnaires examining social distance and possible stigmatizing views concerning psychiatric patients were also distributed and collected.
The response rates for the medical and law students were, respectively, 90% and 85%. We found no differences between the medical and law students regarding their views on prolongation of a psychiatric hospitalization. This was consistent regardless of whether the hospitalization was against the patient's will or according to his wish and against the treating physicians' advice. We also found that the medical and law students had similar general views regarding psychiatric patients, but that the latter evidenced greater social distance than the former.
Academic background and socialization were not found to influence the decisions of students regarding IPH. Educational programs and exposure to psychiatric patients during law studies are proposed to lessen psychiatric stigma and promote better understanding between members of the two disciplines.
精神疾病患者的管理有时需要非自愿住院。《以色列精神卫生法》要求地区精神病委员会定期审查非自愿精神病住院（IPH）的病例。委员会的讨论往往会引发关于是否需要剥夺患者自由的 IPH 的辩论。对于这些委员会中的精神科医生和律师如何做出决定，人们知之甚少。本研究旨在检查未来医生和律师对可能的 IPH 病例的看法，以确定他们的决定是否会受到各自专业教育背景的影响。
在编制人口统计数据后，我们向两个学科的 170 名学生分别询问了他们在两个假设案例中的决定，这些案例涉及延长精神病住院的问题。还分发并收集了检查对精神病患者的社会距离和可能的污名化看法的问卷。
医学和法律专业学生的回复率分别为 90%和 85%。我们发现，医学和法律专业的学生在延长精神病住院的看法上没有差异。无论住院是否违背患者的意愿，是否符合他的意愿以及是否违背主治医生的建议，情况都是如此。我们还发现，医学和法律专业的学生对精神病患者有类似的一般看法，但后者比前者表现出更大的社会距离。
没有发现学术背景和社会化会影响学生对 IPH 的决定。建议在法律学习期间开展教育计划和接触精神病患者，以减少精神病的污名化并促进两个学科之间的更好理解。
