Peppou Lily Evangelia, Nikolaidi Sofia, Tsikou Kyriaki, Drakonakis Nektarios, Georgaca Eugenie, Arvaniti Aikaterini, Souliotis Kyriakos, Stylianidis Stelios, Yotsidi Vasiliki
Department of Psychology, Panteion University of Social & Political Sciences, Athens, Greece.
Association for Regional Development & Mental Health (EPAPSY), Athens, Greece.
BMC Psychiatry. 2024 Dec 2;24(1):873. doi: 10.1186/s12888-024-06300-2.
Mental health professionals' (MHPs) attitudes towards involuntary admissions have not received adequate attention in efforts to curb their rates. Thus, the present study set out to (i) explore MHP attitudes regarding involuntary hospitalisation, (ii) describe their perceived dangerousness of people with severe mental illness (SMI) and their trust in psychiatry, (iii) identify the predictors of attitudes towards compulsory admissions and (iv) gauge the contribution of perceived dangerousness versus trust in psychiatry to explaining them.
A random sample of 300 mental health professionals working in public mental health services located in the Northern part of Athens and in the two psychiatric hospitals of Attica participated in the study. Respondents had to complete a self-reported instrument garnering information about participants' attitudes towards involuntary hospitalisation (original scale), the perceived dangerousness of people with SMI (Perceived Dangerousness Scale) and their trust in psychiatry (based on the Attitudes to Mental Illness scale) as well as various socio-demographic and work-related variables.
Respondents largely accepted involuntary hospitalisations, considering them to be beneficial (72.96%) and disagreeing with the view that they adversely influence the course of illness (54.85%). Nonetheless, they believe that people with SMI should be treated in the community (89.93%), that compulsory admission should be the last therapeutic resort (84.01%) and that people with SMI should not be placed in psychiatric hospitals against their will in order to be under surveillance (90.64%). However, they acknowledge that involuntary admission is often the only treatment options(61.19%). Concomitantly, they report moderate levels of perceived dangerousness and high levels of trust in psychiatry. Trust in psychiatry had the strongest positive association with acceptance of involuntary hospitalisation among mental health professionals whereas postgraduate studies and working in outpatient settings were linked to less favourable attitudes. Interestingly, perceived dangerousness did not yield an independent effect; rather, it weakened the association between trust in psychiatry and acceptance of involuntary admissions.
Mental health professionals hold complex attitudes towards involuntary hospitalisation, which are largely explained by their trust in psychiatry. Efforts to reduce the rates of involuntary admissions should address both them and their determinants.
在控制非自愿住院率的努力中，心理健康专业人员（MHPs）对非自愿住院的态度尚未得到充分关注。因此，本研究旨在：（i）探讨心理健康专业人员对非自愿住院的态度；（ii）描述他们对严重精神疾病（SMI）患者的感知危险性以及对精神病学的信任程度；（iii）确定对强制住院态度的预测因素；（iv）评估感知危险性与对精神病学的信任在解释这些态度方面的作用。
从雅典北部公共心理健康服务机构以及阿提卡的两家精神病医院工作的300名心理健康专业人员中随机抽取样本参与研究。受访者必须完成一份自我报告工具，该工具收集有关参与者对非自愿住院的态度（原始量表）、对严重精神疾病患者的感知危险性（感知危险性量表）、对精神病学的信任程度（基于对精神疾病的态度量表）以及各种社会人口统计学和工作相关变量的信息。
受访者大多接受非自愿住院，认为其有益（72.96%），并不同意非自愿住院会对病程产生不利影响的观点（54.85%）。尽管如此，他们认为严重精神疾病患者应在社区接受治疗（89.93%），强制住院应是最后的治疗手段（84.01%），且不应违背严重精神疾病患者的意愿将其送入精神病医院进行监管（90.64%）。然而，他们承认非自愿住院往往是唯一的治疗选择（61.19%）。同时，他们报告的感知危险性水平适中，对精神病学的信任程度较高。在心理健康专业人员中，对精神病学的信任与接受非自愿住院的关联最为强烈，而研究生学历以及在门诊环境工作与不太支持的态度相关。有趣的是，感知危险性并未产生独立影响；相反，它削弱了对精神病学的信任与接受非自愿住院之间的关联。
心理健康专业人员对非自愿住院持有复杂态度，这在很大程度上由他们对精神病学的信任所解释。降低非自愿住院率的努力应针对他们及其决定因素。
