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Year : 2014  |  Volume : 15  |  Issue : 2  |  Page : 222-227

Discharge of patients with mental illness back into the community following involuntary admission versus voluntary admission: factor analysis

1 Consultant Psychiatrist; Manager, Medical Scientific Affairs in Clinical Research, Hyderabad, India
2 Assistant Professor of Psychiatry, Department of Psychiatry, Kakatiya Medical College, Warangal, India
3 Consultant Psychiatrist, Kakinada, India

Correspondence Address:
Srinivas Kandrakonda
Address: Plot Number 457, HMT Hills, Opposite JNTUC, Kukatpally, Hyderabad- 500085
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Source of Support: None, Conflict of Interest: None

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Background: At times, there is even a need for community involuntary treatment which may help in reducing the hospital admissions of patients with mentally illness. In India, there are very few State run psychiatric hospitals where patients get admitted and treated under section 20 of MHA 1987. There should be provisions for treating mentally ill in the community, if needed involuntarily. Detention of mentally ill for treatment during the time of florid psychosis is not a permanent solution for mental illness treatment. With the existing medicines these illnesses cannot be cured but can be controlled. So it leaves us with the option of using such detention only when no other method to treat is practicable. Such detention should best in the interest of the patient and the community. Aims: This study was an attempt to explore the practical problems in reintegrating the mentally ill back in to the community after their involuntary admission in comparison with the voluntary admission. Methods: This is a cross sectional study and data was collected from the medical records of 113 patients who were admitted in this hospital during the period of January 2010 to June 2010. Nearly 470 voluntary patients' records were analysed during the above said period but by randomization they were limited to nearly 113 to equate with the involuntary admission. Results: Median duration of total hospitalization period in involuntary admission group of patients is 108 days with a minimum of 15 days and maximum of 460 days of admission. Median duration of involuntary stay at hospital is 91 days in some patients in whose reception orders there was a clear mention of what should be done after their treatment and recovery. In comparison to this group median duration of involuntary stay in others is 113 days as there was no clear mention in their reception orders about what should be done after their treatment and recovery. Conclusion: Most of the hospitals do not have any community social worker who can liaise with the family members to address their fears and to facilitate their early reintegration back in to home. There is a need for a review board consisting judiciary and medical personnel which can revoke the reception order at any point of time to minimize through duration of involuntary hospitalization in closed wards.

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