Home About us Contact
|
Home About us Contact | ||
|
|
||
Involuntary Treatment (involuntary + treatment)
Selected AbstractsAddressing complex ethical issues in the treatment of children and adolescents with eating disorders: application of a framework for ethical decision-makingEUROPEAN EATING DISORDERS REVIEW, Issue 3 2001Ronald S. Manley Abstract Ethically problematic situations frequently arise in the care of children and adolescents with eating disorders. The younger person with anorexia nervosa can often deteriorate quickly, therefore the child who is in denial with respect to the seriousness of her condition and/or markedly ambivalent regarding renourishment is at grave risk. Involuntary treatment is likely to be a consideration during such a medical crisis. In this paper we outline an ethical decision-making framework that can assist the clinician in engaging the young patient and her family well in advance of a crisis, so that decisions can be made at a time when recourse to establishing incompetency or enforcing involuntary treatment are unnecessary. We have adopted a narrative approach in our application of the decision-making framework, and safety is emphasized as the central concept underlying the application of this model. Finally, a number of recommendations are made regarding application of the ethical decision-making framework with younger persons. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Violence from young women involuntarily admitted for severe drug abuseACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007T. Palmstierna Objective:, To simultaneously evaluate actuarial and dynamic predictors of severe in-patient violence among women involuntarily admitted for severe drug abuse. Method:, All patients admitted to special facilities for involuntary treatment of absconding-prone, previously violent, drug abusing women in Sweden were assessed with the Staff Observation Aggression Scale, revised. Actuarial data on risk factors for violence were collected and considered in an extended Cox proportional hazards model with multiple events and daily assessments of the Broset Violence Checklist as time-dependent covariates. Results:, Low-grade violence and being influenced by illicit drugs were the best predictors of severe violence within 24 h. Significant differences in risk for violence between different institutions were also found. Conclusion:, In-patient violence risk is rapidly varying over time with being influenced by illicit drugs and exhibiting low-grade violence being significant dynamic predictors. Differences in violence between patients could not be explained by patient characteristics. [source] Detention of the mentally ill in Europe , a reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2002Martin Zinkler Objective:,The frequency of compulsory admission varies widely across Europe. Although there has been some research on a nation-wide level, no work has been done to compare mental health legislation in different countries in relation to detention rates and to patients' perception of hospital detention. Method:,Databases and government statistics were searched for regional, national and European data. Legal frameworks were compared and reviewed in relation to patients' and professionals' views. Results:,Nearly 20-fold variations in detention rates were found in different parts of Europe. Criteria for detention of the mentally ill are broadly similar when it comes to patients at risk to themselves or others. However different rules apply for involuntary treatment in the interest of the patient's health. Conclusion:,Variations in detention rates across Europe appear to be influenced by professionals' ethics and attitudes, sociodemographic variables, the public's preoccupation about risk arising from mental illness and the respective legal framework. [source] The development of the Recovery and Prevention of Psychosis Service in Melbourne, AustraliaEARLY INTERVENTION IN PSYCHIATRY, Issue 2 2009Brendan P. Murphy Abstract Aim: To describe the establishment of a multicomponent, phase-specific, early intervention service for young people experiencing psychosis. Methods: The Recovery and Prevention of Psychosis Service commenced streamed clinical service delivery in November 2004, providing comprehensive case management for up to 3 years within Victoria's largest metropolitan health service. It delivers phase-oriented treatment focusing on early detection, recovery and relapse prevention, and minimizing disability and secondary comorbidity. The combined programme covers training and professional development, data collection and evaluation, specialist intervention services, group programme work and community development. Results: Of the first 151 clients, 70.2% were male, the average age at first presentation was 20.9 years, 15% were under 18 at first contact and 67% required inpatient admission at least once. Mean age at first contact was 20.84 years for those requiring inpatient services and 70% admitted were male. The average length of stay was 25.69 days and 23% were secluded, with an average of 2.1 seclusions. A large percentage of Recovery and Prevention of Psychosis Service clients (81%) required involuntary treatment, a significantly greater proportion of admitted patients were on Community Treatment Orders compared to those never admitted (22.5% cf. 4.1%; P = 0.04) and 92% of those admitted subsequently relapsed compared to 8% of those not admitted (P = 0.02). Conclusions: Recovery and Prevention of Psychosis Service is successfully developing a fully integrated first episode service. Recent developments include expanding the period of care up to 5 years for selected patients, the recruitment of a health promotions officer and planning for the development of a youth inpatient unit. [source] Addressing complex ethical issues in the treatment of children and adolescents with eating disorders: application of a framework for ethical decision-makingEUROPEAN EATING DISORDERS REVIEW, Issue 3 2001Ronald S. Manley Abstract Ethically problematic situations frequently arise in the care of children and adolescents with eating disorders. The younger person with anorexia nervosa can often deteriorate quickly, therefore the child who is in denial with respect to the seriousness of her condition and/or markedly ambivalent regarding renourishment is at grave risk. Involuntary treatment is likely to be a consideration during such a medical crisis. In this paper we outline an ethical decision-making framework that can assist the clinician in engaging the young patient and her family well in advance of a crisis, so that decisions can be made at a time when recourse to establishing incompetency or enforcing involuntary treatment are unnecessary. We have adopted a narrative approach in our application of the decision-making framework, and safety is emphasized as the central concept underlying the application of this model. Finally, a number of recommendations are made regarding application of the ethical decision-making framework with younger persons. Copyright © 2001 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Does fear of coercion keep people away from mental health treatment?BEHAVIORAL SCIENCES & THE LAW, Issue 4 2003Evidence from a survey of persons with schizophrenia, mental health professionals Mental health consumer advocates have long argued that involuntary treatment frightens persons with mental disorder and thus deters them from voluntarily seeking help. We surveyed 85 mental health professionals and 104 individuals with schizophrenia spectrum conditions to assess their experience with and perceptions of involuntary treatment and other treatment mandates. Of the clinicians, 78% reported that overall they thought legal pressures made their patients with schizophrenia more likely to stay in treatment. Regarding involuntary outpatient commitment, 81% of clinicians disagreed with the premise that mandated community treatment deters persons with schizophrenia from seeking voluntary treatment in the future. Of the consumer sample, 63% reported a lifetime history of involuntary hospitalization, while 36% reported fear of coerced treatment as a barrier to seeking help for a mental health problem,termed here "mandated treatment-related barriers to care." In bivariate analyses, reluctance to seek outpatient treatment associated with fear of coerced treatment (mandated treatment-related barriers to care) was significantly more likely in subjects with a lifetime history of involuntary hospitalization, criminal court mandates to seek treatment, and representative payeeship. However, experience with involuntary outpatient commitment was not associated with barriers to seeking treatment. Recent reminders or warnings about potential consequences of treatment nonadherence, recent hospitalization, and high levels of perceived coercion generally were also associated with mandated treatment-related barriers to care. In multivariable analyses, only involuntary hospitalization and recent warnings about treatment nonadherence were found to be significantly associated with these barriers. These results suggest that mandated treatment may serve as a barrier to treatment, but that ongoing informal pressures to adhere to treatment may also be important barriers to treatment. Copyright © 2003 John Wiley & Sons, Ltd. [source] Procedural justice in the context of civil commitment: an analogue study,BEHAVIORAL SCIENCES & THE LAW, Issue 6 2000Michele Cascardi Ph.D. Procedural justice theory posits that the process by which disputes are resolved influences perceptions of fairness and satisfaction with outcomes, even if the outcomes are unfavorable. Within the context of civil commitment, Tyler (1992) has suggested that enhancing respondents' perceptions of procedural justice (i.e., participation, dignity, and trust) during commitment proceedings might facilitate accommodation to an adverse judicial determination (i.e., commitment) and subsequently enhance therapeutic outcomes. The study reported here used videotapes of mock commitment hearings to examine whether patients committed for involuntary treatment are sensitive to procedural justice manipulations. Results suggest that patients are sensitive to procedural justice manipulations and, further, that such manipulations are likely to influence the patients' attitude toward psychiatric care. These findings suggest that the development of strategies to enhance patients' perceptions of procedural justice in commitment hearings may indeed have positive therapeutic implications and warrants further investigation. Copyright © 2000 John Wiley & Sons, Ltd. [source] | |||||||||||||