A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria
Background Coercive measures such as involuntary psychiatric admission are considered a last resort in the treatment of people with psychiatric disorders. So far, numerous factors have been identified that influence their use. However, the link between a pandemic – in particular, restrictions such a...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2024-01-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472423006105/type/journal_article |
| _version_ | 1827587445274705920 |
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| author | Matthäus Fellinger Thomas Waldhör Benjamin Vyssoki Michaela Amering Lisa Leutgeb Andreas Gschaider Bernhard Rappert Daniel König Gernot Fugger Philipp Knasmüller Andrea Gmeiner |
| author_facet | Matthäus Fellinger Thomas Waldhör Benjamin Vyssoki Michaela Amering Lisa Leutgeb Andreas Gschaider Bernhard Rappert Daniel König Gernot Fugger Philipp Knasmüller Andrea Gmeiner |
| author_sort | Matthäus Fellinger |
| collection | DOAJ |
| description | Background
Coercive measures such as involuntary psychiatric admission are considered a last resort in the treatment of people with psychiatric disorders. So far, numerous factors have been identified that influence their use. However, the link between a pandemic – in particular, restrictions such as lockdowns – and the use of involuntary psychiatric admission is unclear.
Aim
To examine the association between COVID-19 lockdowns and involuntary psychiatric admissions in Austria.
Method
This retrospective exploratory study assessed all involuntary psychiatric admissions and use of mechanical restraint in Austria, except for the federal state of Vorarlberg, between 1 January 2018 and 31 December 2020. Descriptive statistics and regression models were used.
Results
During the 3-year study period, 40 012 individuals (45.9% females, mean age 51.3 years) had 66 124 involuntary psychiatric admissions for an average of 10.9 days. Mechanical restraint was used during 33.9% of these admissions. In weeks of nationwide COVID-19 lockdowns (2020 v. 2018/2019), involuntary psychiatric admissions were significantly fewer (odds ratio = 0.93, P = 0.0001) but longer (11.6 (s.d.: 16) v. 10.9 (s.d.: 15.8) days). The likelihood of involuntary admission during lockdowns was associated with year (2020 v. 2018–2019; adjusted odds ratio = 0.92; P = 0.0002) but not with sex (P = 0.814), age (P = 0.310), use of mechanical restraint (P = 0.653) or type of ward (P = 0.843).
Conclusions
Restrictions such as lockdowns affect coercive measures and resulted in fewer but longer involuntary psychiatric admissions during weeks of lockdown in Austria. These results strengthen previous findings that showed the dependence of coercive measures on external factors, highlighting the need to further clarify causality and desired prevention effects when using coercive measures.
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| first_indexed | 2024-03-09T00:18:12Z |
| format | Article |
| id | doaj.art-500252d2ab0045cc8082fe17246ce77e |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-03-09T00:18:12Z |
| publishDate | 2024-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-500252d2ab0045cc8082fe17246ce77e2023-12-12T06:41:28ZengCambridge University PressBJPsych Open2056-47242024-01-011010.1192/bjo.2023.610A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in AustriaMatthäus Fellinger0https://orcid.org/0000-0003-4859-1949Thomas Waldhör1https://orcid.org/0000-0003-2043-8299Benjamin Vyssoki2Michaela Amering3Lisa Leutgeb4Andreas Gschaider5Bernhard Rappert6Daniel König7https://orcid.org/0000-0002-5741-834XGernot Fugger8Philipp Knasmüller9Andrea Gmeiner10Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaCentre for Public Health, Department of Epidemiology, Medical University of Vienna, AustriaClinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaClinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaClinic Floridsdorf, Department of General Psychiatry, Vienna Healthcare Group, Vienna, AustriaVertretungsNetz, Vienna, AustriaVertretungsNetz, Vienna, AustriaClinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaClinical Division of General Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaClinic Landstraße, Department of General Psychiatry, Vienna Healthcare Group, Vienna, AustriaClinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaBackground Coercive measures such as involuntary psychiatric admission are considered a last resort in the treatment of people with psychiatric disorders. So far, numerous factors have been identified that influence their use. However, the link between a pandemic – in particular, restrictions such as lockdowns – and the use of involuntary psychiatric admission is unclear. Aim To examine the association between COVID-19 lockdowns and involuntary psychiatric admissions in Austria. Method This retrospective exploratory study assessed all involuntary psychiatric admissions and use of mechanical restraint in Austria, except for the federal state of Vorarlberg, between 1 January 2018 and 31 December 2020. Descriptive statistics and regression models were used. Results During the 3-year study period, 40 012 individuals (45.9% females, mean age 51.3 years) had 66 124 involuntary psychiatric admissions for an average of 10.9 days. Mechanical restraint was used during 33.9% of these admissions. In weeks of nationwide COVID-19 lockdowns (2020 v. 2018/2019), involuntary psychiatric admissions were significantly fewer (odds ratio = 0.93, P = 0.0001) but longer (11.6 (s.d.: 16) v. 10.9 (s.d.: 15.8) days). The likelihood of involuntary admission during lockdowns was associated with year (2020 v. 2018–2019; adjusted odds ratio = 0.92; P = 0.0002) but not with sex (P = 0.814), age (P = 0.310), use of mechanical restraint (P = 0.653) or type of ward (P = 0.843). Conclusions Restrictions such as lockdowns affect coercive measures and resulted in fewer but longer involuntary psychiatric admissions during weeks of lockdown in Austria. These results strengthen previous findings that showed the dependence of coercive measures on external factors, highlighting the need to further clarify causality and desired prevention effects when using coercive measures. https://www.cambridge.org/core/product/identifier/S2056472423006105/type/journal_articleCoercive measuresinvoluntary admissionmental disorderslockdownsCOVID-19 |
| spellingShingle | Matthäus Fellinger Thomas Waldhör Benjamin Vyssoki Michaela Amering Lisa Leutgeb Andreas Gschaider Bernhard Rappert Daniel König Gernot Fugger Philipp Knasmüller Andrea Gmeiner A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria BJPsych Open Coercive measures involuntary admission mental disorders lockdowns COVID-19 |
| title | A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria |
| title_full | A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria |
| title_fullStr | A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria |
| title_full_unstemmed | A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria |
| title_short | A country report: impact of COVID-19 lockdowns on involuntary psychiatric treatment in Austria |
| title_sort | country report impact of covid 19 lockdowns on involuntary psychiatric treatment in austria |
| topic | Coercive measures involuntary admission mental disorders lockdowns COVID-19 |
| url | https://www.cambridge.org/core/product/identifier/S2056472423006105/type/journal_article |
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