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A prediction model for the incidence of civil detention for crisis patients with psychiatric illnesses; the Amsterdam study of acute psychiatry VII

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Abstract

Objective

Given raised numbers of civil detentions in the Netherlands and other European countries, it is important to assess the patient risk profile with respect to the incidence of those far-reaching treatment decisions. The aim of the ASAP study is to develop a comprehensive prediction model that considers all possible patient-related predictors known from earlier research.

Methods

We took a random sample of 252 from the 2,682 patients coming into contact with two psychiatric emergency teams in Amsterdam between September 2004 and September 2006. We recorded socio-demographic and clinical characteristics, aspects of social support and psychiatric history. We interviewed the patients using the Verona Service Satisfaction Scale (Verona-EU) and the Birchwood Insight Scale. During a two-year follow-up period we noted their use of mental health care facilities.

Results

Stepwise logistic regression analyses with resulted in a final prediction model (P ≤ 0.001) including preceding involuntary admission (OR 9.4, 95 % CI 3.6–24.7, P ≤ 0.001), domestic situation alone (OR 4.5, 95 % CI 1.9–11.0, P = 0.001) and VSSS score satisfactory (OR 0.2, 95 % CI 0.0–0.8, P = 0.030) as predictors of civil detention during 2 years of follow-up.

Conclusion

With the presented prediction model it will be possible to identify patients at a high risk of civil detention: patients with a history of previous involuntary admissions who live alone and are not satisfied with the mental health care they got before. This suggests the possibility that timely preventive measures can be taken comprising the adjustment or intensification of the treatment plan for this specific group of patients.

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Notes

  1. The procedure for civil detention in the Netherlands (Dutch: Inbewaringstelling) has been described elsewhere and has much in common with the procedure for emergency detention under section. 4 of the UK Mental Health Act of 1983 [5, 6].

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Acknowledgments

The authors wish to thank ARKIN Mental Health Care, Amsterdam, for financial support. The study was also supported by a grant from the Foundation for Support VCVGZ, Arnhem, Netherlands. The authors also wish to thank the patients taking part in the study and also the participating psychiatric clinicians from the Psychiatric Emergency Service Amsterdam and from the Acute Treatment Unit.

Conflict of interest

The authors report no competing interests.

Author information

Authors and Affiliations

  1. Department of Research, ARKIN Mental Health Care, Klaprozenweg 111, 1033NN, Amsterdam, The Netherlands

    Louk F. M. van der Post, Jaap Peen & Jack J. M. Dekker

  2. Department of Psychology, Faculty of Psychology and Pedagogy, Vrije Universiteit, Amsterdam, The Netherlands

    Jack J. M. Dekker

Authors
  1. Louk F. M. van der Post
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  2. Jaap Peen
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  3. Jack J. M. Dekker
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Correspondence to Louk F. M. van der Post.

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van der Post, L.F.M., Peen, J. & Dekker, J.J.M. A prediction model for the incidence of civil detention for crisis patients with psychiatric illnesses; the Amsterdam study of acute psychiatry VII. Soc Psychiatry Psychiatr Epidemiol 49, 283–290 (2014). https://doi.org/10.1007/s00127-013-0742-7

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