Outcomes of involuntary hospital admission - a review

Introduction: This paper reviews studies on outcomes of involuntary hospital admissions in general adult psychiatry, and predictors of outcomes. Method: Studies assessing observer-rated clinical change and self-rated outcomes were identified. Relevant databases were searched and authors were contacted. Studies were classified according to quality criteria. Results: Eighteen studies fulfilled the inclusion criteria. Most involuntarily admitted patients show substantial clinical improvement over time. Retrospectively, between 33% and 81% of patients regard the admission as justified and/or the treatment as beneficial. Data on predictors of outcomes is limited and inconsistent. Patients with more marked clinical improvement tend to have more positive retrospective judgements. Conclusion: A substantial number of involuntary patients do retrospectively not feel that their admission was justified and beneficial. At least for this group, new approaches might have to be considered. Larger studies are required to identify predictors on which patients are likely to fall into this group.