Factors Associated with Involuntary Hospitalization among People with First-Episode Psychosis

Many people experiencing psychosis have difficulty distinguishing psychotic symptoms from reality. This means that people with first-episode psychosis may not recognize that they are suffering from a mental illness, may disagree with recommended treatment, and may not consent to hospitalization. Under the Mental Health Act in Ontario, a person with severe mental illness may be admitted to hospital on an involuntary basis if there is a high likelihood of: (i) serious harm to the patient, (ii) serious harm to another person, or (iii) mental or physical deterioration of the patient. Although involuntary hospitalization occurs under the premise that it will be beneficial to the patient, it may have negative consequences, such as distress for patients and their families, poor treatment engagement, and dissatisfaction with mental health services. These negative experiences with health services at first contact initiate patients on a particular trajectory that may impact long-term outcomes.

Given the potential adverse effects associated with involuntary hospitalization, it is important to limit its use where possible, and to understand the frequency of and factors associated with its use. This project estimated the incidence of involuntary hospitalization among patients with early psychosis in Ontario within three years of their first diagnosis. We also identified the sociodemographic, clinical, and service-level factors that increase the risk of an involuntary admission for people with first-episode psychosis.

Project participants

Funding: Ontario Mental Health Foundation

Principal Investigator: Kelly Anderson

Co-Investigators: Paul Kurdyak, Arlene MacDougall, GY Zou

Students: Rebecca Rodrigues, Adam Beswick