Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
BC Centre for Disease Control, Vancouver, British Columbia.
Can J Psychiatry. 2023 Apr;68(4):257-268. doi: 10.1177/07067437221128477. Epub 2022 Oct 6.
Involuntary psychiatric hospitalization occurs when someone with a serious mental disorder requires treatment without their consent. Trends vary globally, and currently, there is limited data on involuntary hospitalization in Canada. We examine involuntary hospitalization trends in British Columbia, Canada, and describe the social and clinical characteristics of people ages 15 and older who were involuntarily hospitalized between 2008/2009 and 2017/2018.
We used population-based linked administrative data to examine and compare trends in involuntary and voluntary hospitalizations for mental and substance use disorders. We described patient characteristics (sex/gender, age, health authority, income, urbanity/rurality, and primary diagnosis) and tracked the count of involuntarily hospitalized people over time by diagnosis. Finally, we examined population-based prevalence over time by age and sex/gender.
Involuntary hospitalizations among British Columbians ages 15 and older rose from 14,195 to 23,531 (65.7%) between 2008/2009 and 2017/2018. Apprehensions involving police increased from 3,502 to 8,009 (128.7%). Meanwhile, voluntary admissions remained relatively stable, with a minimal increase from 17,651 in 2008/2009 to 17,751 in 2017/2018 (0.5%). The most common diagnosis for involuntary patients in 2017/2018 was mood disorders (25.1%), followed by schizophrenia (22.3%), and substance use disorders (18.8%). From 2008/2009 to 2017/2018, the greatest increase was observed for substance use disorders (139%). Over time, population-based prevalence increased most rapidly among women ages 15-24 (162%) and men ages 15-34 (81%) and 85 and older (106%).
Findings highlight the need to strengthen the voluntary care system for mental health and substance use, especially for younger adults, and people who use substances. They also signal a need for closer examination of the use of involuntary treatment for substance use disorders, as well as further research exploring forces driving police involvement and its implications.
非自愿住院治疗发生在患有严重精神障碍的人需要治疗而未经其同意的情况下。全球趋势各不相同，目前加拿大有关非自愿住院治疗的数据有限。我们检查了加拿大不列颠哥伦比亚省的非自愿住院治疗趋势，并描述了 2008/2009 年至 2017/2018 年间年龄在 15 岁及以上的非自愿住院治疗的人群的社会和临床特征。
我们使用基于人群的关联行政数据来检查和比较精神和物质使用障碍的非自愿和自愿住院治疗趋势。我们描述了患者特征（性别/性别、年龄、卫生局、收入、城市/农村和主要诊断），并按诊断随时间跟踪非自愿住院治疗人数。最后，我们按年龄和性别/性别随时间检查基于人群的患病率。
不列颠哥伦比亚省 15 岁及以上人群的非自愿住院治疗人数从 2008/2009 年的 14195 人增加到 2017/2018 年的 23531 人（65.7%）。涉及警察的逮捕从 3502 人增加到 8009 人（128.7%）。与此同时，自愿入院治疗相对稳定，从 2008/2009 年的 17651 人略有增加到 2017/2018 年的 17751 人（0.5%）。2017/2018 年非自愿患者最常见的诊断是情绪障碍（25.1%），其次是精神分裂症（22.3%）和物质使用障碍（18.8%）。从 2008/2009 年到 2017/2018 年，物质使用障碍的增幅最大（139%）。随着时间的推移，15-24 岁女性（162%）和 15-34 岁男性（81%）以及 85 岁及以上人群（106%）的人群患病率增长最快。
研究结果强调需要加强精神健康和物质使用的自愿护理系统，特别是针对年轻成年人和物质使用者。研究结果还表明，有必要进一步审查使用非自愿治疗物质使用障碍的情况，并进一步研究探索推动警察参与及其影响的因素。
