262065 Perceived lack of community mental health services associated with clinician recommendation of involuntary hospitalization of individuals experiencing a mental health crisis

Tuesday, October 30, 2012 : 1:10 PM - 1:30 PM

Elizabeth Lloyd McGarvey, EdD , Department of Public Health Sciences, University of Virginia, Charlottesville, VA
MaGuadalupe Leon-Verdin, MS , Department of Public Health Sciences, University of Virginia, Charlottesville, VA
Tanya N. Wanchek, PhD, JD , Department of Public Health Sciences & Weldon Cooper Center for Public Services, University of Virginia, Charlottesville, VA
Richard Bonnie, LLB , Institute of Law, Psychiatry & Public Policy, Unniversity of Virginia Law School, Charlottesville, VA
Background: Clinicians who evaluate people having a mental health crisis recommend an involuntary action in almost 50% of the cases. This study investigates the relationship between community mental health services and involuntary actions taken by clinicians following emergency evaluations of individuals during a mental health crisis. Methods: One-month survey of clinicians who evaluated individuals for mental health services when they presented with a mental health crisis. Results: In Virginia, there were 2,624 adult clients evaluated for services while experiencing a mental health crisis over a month period. Client age ranged from 18 to 95, with an average age of 40.2 (SD = 15.25), 47% are male, 67.5% are White and 27% are Black. Involuntary action was taken in 1,090 cases (41.5%). The other patients were referred for voluntary hospitalization or voluntary outpatient services or declined services altogether. Logistic regression analysis shows that some type of services or resources such as immediate assistance to client and community-based mental health treatment would have helped to better address the need of the client according to the clinicians. This study compares the characteristics and the type of resources or services needed between the clients where an involuntary action was taken and the clients where other types of voluntary actions resulted. Conclusions: This study provides evidence of the importance of available community resources/services to prevent the need for involuntary hospitalization of those experiencing a mental health crisis.

Learning Areas:
Chronic disease management and prevention
Ethics, professional and legal requirements
Other professions or practice related to public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
1. Discuss the difficulty in avoiding coercive actions resulting in involuntary commitments of individuals experiencing a mental health crisis when there are insufficint resources and services available in the community.

Keywords: Mental Health System, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted public health research and evaluation for over 20 years, and bring expertise in mental health law.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.