Involuntary psychiatric hospitalisation of children and adolescents: a retrospective analysis of Athens public prosecutor's office for minors records.

Abstract

This retrospective study examines emergency involuntary psychiatric admission procedures for minors in Athens (2018-2022), using case records accessed through collaboration between the 'postgraduate Master's programme at the Medical School of Athens and the Public Prosecutor's Office for Minors Athens. Findings indicate a 37.9% increase in involuntary psychiatric examination cases post-pandemic (p <.01), though the 20.9% rise in involuntary admissions was not statistically significant (p =.140). Analysis of 2019-2021 dataset reveals that most cases handled by the prosecutor involved boys (69.4%) and minors aged ≥ 16 years (54.9%). Involuntary psychiatric examination was ordered in 92.2% of requests and conducted in Child and Adolescent Psychiatry (CAP) Units (54.7%) or Adult Psychiatry (AP) Units (45%). Involuntary admissions occurred in 44.4% of cases, significantly more in AP Units (74.4%) than CAP Units (23.8%). Psychiatric evaluation in an AP Unit (OR = 5.52, p =.001), prior contact with mental health services (OR = 2.22, p =.016), and older age (OR = 1.32, p =.005) were significantly associated with involuntary hospitalisation. Findings highlight the need to expand access to child and adolescent mental health services. Addressing systemic gaps in care could reduce reliance on judicial pathway to care and foster a more preventive and supportive approach to youth mental health.