Kelly Brendan D, Emechebe Afam, Anamdi Chike, Duffy Richard, Murphy Niamh, Rock Catherine
Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland.
School of Medicine, Clinical Sciences Institute, National University of Ireland Galway, Newcastle Road, Galway, Ireland.
Int J Law Psychiatry. 2015 Jan-Feb;38:1-7. doi: 10.1016/j.ijlp.2015.01.001. Epub 2015 Jan 26.
Involuntary detention is a feature of psychiatric care in many countries. We previously reported an involuntary admission rate of 67.7 per 100,000 population per year in inner-city Dublin (January 2008-December 2010), which was higher than Ireland's national rate (38.5). We also found that the proportion of admissions that was involuntary was higher among individuals born outside Ireland (33.9%) compared to those from Ireland (12.0%), apparently owing to increased diagnoses of schizophrenia in the former group. In the present study (January 2011-June 2013) we again found that the proportion of admissions that was involuntary was higher among individuals from outside Ireland (32.5%) compared to individuals from Ireland (9.9%) (p<0.001), but this is primarily attributable to a lower rate of voluntary admission among individuals born outside Ireland (206.1 voluntary admissions per 100,000 population per year; deprivation-adjusted rate: 158.5) compared to individuals from Ireland (775.1; deprivation-adjusted rate: 596.2). Overall, admission rates in our deprived, inner-city catchment area remain higher than national rates and this may be attributable to differential effects of Ireland's recent economic problems on different areas within Ireland. The relatively low rate of voluntary admission among individuals born outside Ireland may be attributable to different patterns of help-seeking which mental health services in Ireland need to take into account in future service-planning. Other jurisdictions could also usefully focus attention not just on rates on involuntary admission among individuals born elsewhere, but also rates of voluntary admission which may provide useful insights for service-planning and delivery.
非自愿住院是许多国家精神科护理的一个特点。我们之前报告过，在都柏林市中心（2008年1月至2010年12月），非自愿住院率为每年每10万人口67.7例，高于爱尔兰全国水平（38.5例）。我们还发现，与爱尔兰本土出生的人（12.0%）相比，在爱尔兰境外出生的人（33.9%）中非自愿住院的比例更高，这显然是因为前一组精神分裂症的诊断率更高。在本研究（2011年1月至2013年6月）中，我们再次发现，与爱尔兰本土出生的人（9.9%）相比，在爱尔兰境外出生的人（32.5%）中非自愿住院的比例更高（p<0.001），但这主要是由于爱尔兰境外出生的人自愿住院率较低（每年每10万人口206.1例自愿住院；经贫困调整后的比率：158.5），而爱尔兰本土出生的人自愿住院率为（775.1例；经贫困调整后的比率：596.2）。总体而言，我们这个贫困的市中心地区的住院率仍然高于全国水平，这可能是由于爱尔兰最近的经济问题对爱尔兰不同地区产生了不同影响。爱尔兰境外出生的人自愿住院率相对较低，可能是由于求助模式不同，爱尔兰的精神卫生服务机构在未来的服务规划中需要考虑到这一点。其他司法管辖区也可以有益地不仅关注其他地方出生的人的非自愿住院率，还关注自愿住院率，这可能为服务规划和提供提供有用的见解。
