Trends in involuntary psychiatric hospitalization in Israel 1991-2000

BACKGROUND: Though information about involuntary psychiatric hospitalizations (IPH) is crucial for the planning of Israel's National Mental Health Care Policy, very few studies have been carried out to date on this subject. AIMS: To identify trends in first IPH to all inpatient psychiatric settings in Israel. METHOD: The sample included all admissions of adults (18 years and older) over the ten-year period, 1991-2000, according to the registration of such admissions in the National Psychiatric Case Registry. RESULTS: A 2.4-fold increase was found in first IPH over the decade studied. The typical profile of the involuntarily admitted patient was that of a native-born Jewish male, aged 18-24 or 65 and older, single, with less than 8 years of education, and with a diagnosis of schizophrenia or delusional psychosis. CONCLUSIONS: These findings suggest the need for improving the interfaces between hospital and community services, and for preparing specific guidelines to extend the use of involuntary ambulatory treatment orders. Further study is needed to explore the respective roles of involuntary inpatient and outpatient treatment.