Involuntary commitment in psychiatric care: what drives the decision?

  • Vincent Lorant
  • Caroline Depuydt
  • Benoit Gillain
  • Alain Guillet
  • Vincent Dubois
ORIGINAL PAPER

DOI: 10.1007/s00127-007-0175-2

Cite this article as:
Lorant, V., Depuydt, C., Gillain, B. et al. Soc Psychiat Epidemiol (2007) 42: 360. doi:10.1007/s00127-007-0175-2

Abstract

Background

Psychiatric commitment laws have been reformed in many European countries. We assessed the relative importance of the different legal criteria in explaining involuntary commitment under the Belgian Mental Health Act of 1990.

Method

Psychiatric assessments were requested for 346 patients living in Brussels who were randomly selected from a larger group and were being considered for involuntary commitment. A retrospective study of these patients’ files was carried out.

Results

More than half of the requests for involuntary commitment were turned down. The lack of a less restrictive alternative form of care was the criterion most crucial in decisions in favour of commitment. Alternative forms of care were more likely to be unavailable for psychotic individuals, foreigners, and patients not living in a private household.

Conclusion

Involuntary commitment is mainly due to the inability of the mental health care system to provide more demanding patients with alternative forms of care.

Key words

commitment of mentally ill public health services emergency treatment fairness 

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Vincent Lorant
    • 1
  • Caroline Depuydt
    • 2
  • Benoit Gillain
    • 2
  • Alain Guillet
    • 4
  • Vincent Dubois
    • 2
    • 3
  1. 1.Public Health School, Faculty of MedicineUniversité Catholique de LouvainLouvainBelgium
  2. 2.Crisis Unit of the Saint-Luc ClinicsUniversité Catholique de LouvainLouvainBelgium
  3. 3.BrusselsBelgium
  4. 4.Institute of StatisticsUniversité Catholique de LouvainLouvainBelgium