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

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.