Perceptions of involuntary admission and risk of subsequent readmission at one-year follow-up: the influence of insight and recovery style.

ABSTRACT

BACKGROUND: Involuntary admission is one of the most ethically challenging practices in medicine, yet we are only beginning to learn more about the patient's perspective. AIMS: To investigate (i) peoples' perception of the necessity of their involuntary admission at one year after discharge (ii) readmission rates to hospital and the influence of insight and recovery style. METHODS: We interviewed individuals admitted involuntarily at one year following discharge using the Mac Arthur Admission Experience Interview, Birchwood Insight Scale, the Drug Attitude Inventory, Global Assessment of Functioning and the Recovery Style Questionnaire. RESULTS: Sixty-eight people (84%) were re-interviewed at one year and fewer (60%) reported that their involuntary admission had been necessary when compared to inception (72%). Of the 33% that changed their views, most reflected negatively on their involuntary admission. We found that insight was moderately associated with the acknowledgement that the involuntary admission was necessary. Within a year, 43% were readmitted to hospital and half of these admissions were involuntary. Individuals with a sealing over recovery style were at four times the risk of involuntary readmission. CONCLUSIONS: Peoples' perception of the necessity of their involuntary admissions is not stable over time and risk of involuntary readmission is associated with recovery style.