Clinical features of patients who are admitted under different criteria of the Irish Mental Health Act 2001: a retrospective cohort study.

Objectives: To examine the criteria utilised for detaining individuals under the Irish Mental Health Act 2001 (MHA 2001) and their association with clinical features.

Methods: Demographic and clinical data of 505 involuntary admissions under the MHA 2001 between 2013 and 2023 were attained. Data included criteria utilised for detention and renewal, sociodemographic and clinical features associated with these criteria, and the use of coercive practices, such as seclusion and restraint.

Results: The majority of patients who were involuntarily admitted (61.4%), or had their admission order affirmed by tribunal (78.2%), were not judged to pose an immediate risk to themselves or others. Patients admitted under the "impaired judgement criterion" were less likely to be secluded (χ² = 15.8, p < 0.001) or restrained (χ² = 11.6, p < 0.01). Patients admitted under the "risk criterion" were younger (KW = 12.7, p = 0.02), and less likely to have a psychotic disorder (χ² = 5.9, p = <0.001) or have a previous involuntary admission (χ² = 7.7, p = 0.02). Patients who were subject to coercive care were younger (U = 12739, p < 0.001), more likely to be male (χ² = 4.6, p = 0.03), and have prolonged involuntary admissions (U = 18412, p = 0.02).

Conclusions: Currently, the majority of the involuntary care provided for patients under the MHA 2001 is not related to the risk criterion of causing immediate and serious harm to themselves or others, but rather to the criterion of impaired judgement. Patients admitted under the risk criterion are more often subjected to restrictive practices, but are less likely to suffer from psychosis, than those receiving involuntary care due to their impaired judgement.