O'Donoghue Brian, Lyne John, Hill Michele, O'Rourke Linda, Daly Sally, Feeney Larkin
DETECT-Early Intervention Service for Psychosis,Avila House,Block 5,Blackrock Business Park,Carysfort Ave,Blackrock,Co Dublin,Ireland.
Cluain Mhuire Mental Health Services.
Ir J Psychol Med. 2010 Jun;27(2):66-71. doi: 10.1017/S0790966700001075.
The Mental Health Act 2001 was implemented in Ireland in 2006, however, within this new legislation there is no provision for compulsory community treatment or advance directives, which are now established practice in other countries. We aimed to determine the proportion of patients who believe that compulsory treatment may be justified, the preference for where the treatment should be delivered and factors which may influence this preference. We also sought to determine the proportion of people who would be interested in the option of having an advance directive in their future care plan.
Patients who had been admitted involuntarily in a 183 bedded psychiatric hospital in Dublin (St John of God Hospital) over a 15 month period were interviewed one year following discharge. A structured interview was used and included the Birchwood Insight Scale and Drug Attitude Inventory (DAI).
Sixty-seven patients were interviewed, which resulted in a follow-up rate of 68%. A total of 56% of participants believe that there are situations in which involuntary treatment with medication may be justified. Of the participants 59% think that the person should be admitted to hospital if they are going to be administered medication without consent. A total of 41 % of participants stated they would have preferred to have been treated at home rather than hospital and this was associated with having a diagnosis of an affective disorder or it being their first involuntary admission. Of the participants 84% expressed interest in having the option of an advance directive in their treatment care plan.
With the increasing community based provision of mental health services in Ireland a debate on compulsory community treatment orders and advance directives needs to take place amongst all stakeholders.
《2001年精神健康法》于2006年在爱尔兰实施，然而，在这项新立法中，没有关于强制社区治疗或预先指示的规定，而这在其他国家已是既定做法。我们旨在确定认为强制治疗可能合理的患者比例、对治疗地点的偏好以及可能影响这种偏好的因素。我们还试图确定对在未来护理计划中选择预先指示感兴趣的人群比例。
对都柏林一家拥有183张床位的精神病院（上帝之约翰医院）在15个月期间非自愿入院的患者在出院一年后进行访谈。采用结构化访谈，包括伯奇伍德洞察力量表和药物态度量表（DAI）。
对67名患者进行了访谈，随访率为68%。共有56%的参与者认为在某些情况下非自愿药物治疗可能合理。在参与者中，59%的人认为如果未经同意给某人用药，该人应入院治疗。共有41%的参与者表示他们更愿意在家中而非医院接受治疗，这与患有情感障碍诊断或首次非自愿入院有关。在参与者中，84%的人表示对在其治疗护理计划中有预先指示这一选择感兴趣。
随着爱尔兰基于社区的精神健康服务的增加，所有利益相关者之间需要就强制社区治疗令和预先指示展开辩论。
