Why are Patients Discharged by Review Boards?

• Published in: Canadian journal of psychiatry Vol. 44; no. 3; pp. 259 - 263
• Main Authors: O'Reilly, Richard L, Komer, William, Dunbar, Sandra
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-04-1999; Canadian Psychiatric Association; SAGE PUBLICATIONS, INC
• Subjects: Adolescent; Adult; Aged; Attitude of Health Personnel; Biological and medical sciences; Commitment of Mentally Ill - statistics & numerical data; Decision Making; Diagnosis-Related Groups - statistics & numerical data; Female; Humans; Male; Medical sciences; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental institutions; Mentally ill; Middle Aged; Motivation; Ontario; Organization of mental health. Health systems; Patient Discharge - statistics & numerical data; Professional Staff Committees - standards; Professional Staff Committees - statistics & numerical data; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Rights; Risk Management - methods; Risk Management - statistics & numerical data; Social psychiatry. Ethnopsychiatry; Canada; North America; Ontario; America; Ontario Canada; Review Boards; revoked certificate; Mental Health Act; Human; Psychiatric hospital; Health system; Hospital discharge; Mentally ill commitment; Motivation; Mental health; Forced hospitalization; Public health
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674379904400306

Objective:
To identify why Review Boards revoked certificates for involuntary hospitalization.
Method:
The outcome of all applications for a Review Board hearing at 2 psychiatric hospitals in Ontario were recorded from the beginning of 1987 to the end of 1996. All cases where a certificate of involuntary hospitalization was revoked were identified. For each of these cases, the clinical record, including the Review Board's written reasons for its decision, was reviewed.
Results:
During the study period, 2644 patients applied for a review of their involuntary hospitalization. Only 42% of applications reached a hearing. Of these, 9% were revoked. Several recurring reasons for overturning certificates were identified. These included the physician relying too much on hearsay evidence, relatives supporting discharge at the hearings, and the patient clearly having recovered by the time the hearing took place.
Conclusions:
Relatives or staff who observe dangerous behaviour should be encouraged to give evidence at hearings. The treatment team should take careful note of the views of patients 'families and friends and review the patients 'progress before hearings.