S. Gemsa , E.O. Noorthoorn , P. Lepping , H.A. de Haan , G.J.M. Hutschemaekers
{"title":"荷兰强制护理法:对紧急非自愿入院、治疗和住院时间可能产生的影响","authors":"S. Gemsa , E.O. Noorthoorn , P. Lepping , H.A. de Haan , G.J.M. Hutschemaekers","doi":"10.1016/j.ijlp.2025.102113","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>The Special admissions Act (1994) was replaced in 2020 by the Dutch Compulsory Care Act (2018). Whereas the former law focused mainly on involuntary treatment during an inpatient admission, the Compulsory Care Act (2018) aims to reduce involuntary care and allows involuntary care in in- and outpatient settings if unavoidable. The main aim of this study is to assess the observed impact of the change in legislation on admission duration and the use of involuntary care options with a focus on medication and seclusion during acute admissions.</div></div><div><h3>Methods</h3><div>Data were collected from a large Mental Health Trust in the east of the Netherlands. We compared health care monitoring data from the years 2016 and 2017 and 2020 and 2021. The data cover involuntary treatment and the short-term law articles warranting these in both inpatient and outpatient settings.</div></div><div><h3>Results</h3><div>In the years studied the number of patients treated involuntarily and the number of short-term involuntary emergency articles were fully comparable. Involuntary medication was used more often in 2020–2021 than in 2016–17; however, seclusion was used much less. The total duration of admissions started within a short-term emergency article decreased significantly from 96 days before the change in the law to 71 days after the law change (Effect size = 0.225, <em>p</em> = 0.012). Days of involuntary inpatient stay within a short-term emergency authorization remained the same. Inpatient involuntary medication almost doubled. Involuntary outpatient care by means of medication was mainly used during and after discharge, seldom before or without admission.</div></div><div><h3>Conclusions</h3><div>After the change in the law, compulsory care was used with similar frequency and for a similar number of patients. In this study an increase in the use of medication was associated with a significant reduction in the length of inpatient admissions. Involuntary medication was used less frequently in an outpatient than in an inpatient setting, despite being possible as a means to avoid involuntary emergency admissions.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"102 ","pages":"Article 102113"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Dutch Compulsory Care Act: Possible effects on emergency involuntary admissions, treatment, and length of stay\",\"authors\":\"S. Gemsa , E.O. Noorthoorn , P. Lepping , H.A. de Haan , G.J.M. Hutschemaekers\",\"doi\":\"10.1016/j.ijlp.2025.102113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>The Special admissions Act (1994) was replaced in 2020 by the Dutch Compulsory Care Act (2018). Whereas the former law focused mainly on involuntary treatment during an inpatient admission, the Compulsory Care Act (2018) aims to reduce involuntary care and allows involuntary care in in- and outpatient settings if unavoidable. The main aim of this study is to assess the observed impact of the change in legislation on admission duration and the use of involuntary care options with a focus on medication and seclusion during acute admissions.</div></div><div><h3>Methods</h3><div>Data were collected from a large Mental Health Trust in the east of the Netherlands. We compared health care monitoring data from the years 2016 and 2017 and 2020 and 2021. The data cover involuntary treatment and the short-term law articles warranting these in both inpatient and outpatient settings.</div></div><div><h3>Results</h3><div>In the years studied the number of patients treated involuntarily and the number of short-term involuntary emergency articles were fully comparable. Involuntary medication was used more often in 2020–2021 than in 2016–17; however, seclusion was used much less. The total duration of admissions started within a short-term emergency article decreased significantly from 96 days before the change in the law to 71 days after the law change (Effect size = 0.225, <em>p</em> = 0.012). Days of involuntary inpatient stay within a short-term emergency authorization remained the same. Inpatient involuntary medication almost doubled. Involuntary outpatient care by means of medication was mainly used during and after discharge, seldom before or without admission.</div></div><div><h3>Conclusions</h3><div>After the change in the law, compulsory care was used with similar frequency and for a similar number of patients. In this study an increase in the use of medication was associated with a significant reduction in the length of inpatient admissions. Involuntary medication was used less frequently in an outpatient than in an inpatient setting, despite being possible as a means to avoid involuntary emergency admissions.</div></div>\",\"PeriodicalId\":47930,\"journal\":{\"name\":\"International Journal of Law and Psychiatry\",\"volume\":\"102 \",\"pages\":\"Article 102113\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-06-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Law and Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0160252725000469\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Law and Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0160252725000469","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
The Dutch Compulsory Care Act: Possible effects on emergency involuntary admissions, treatment, and length of stay
Purpose
The Special admissions Act (1994) was replaced in 2020 by the Dutch Compulsory Care Act (2018). Whereas the former law focused mainly on involuntary treatment during an inpatient admission, the Compulsory Care Act (2018) aims to reduce involuntary care and allows involuntary care in in- and outpatient settings if unavoidable. The main aim of this study is to assess the observed impact of the change in legislation on admission duration and the use of involuntary care options with a focus on medication and seclusion during acute admissions.
Methods
Data were collected from a large Mental Health Trust in the east of the Netherlands. We compared health care monitoring data from the years 2016 and 2017 and 2020 and 2021. The data cover involuntary treatment and the short-term law articles warranting these in both inpatient and outpatient settings.
Results
In the years studied the number of patients treated involuntarily and the number of short-term involuntary emergency articles were fully comparable. Involuntary medication was used more often in 2020–2021 than in 2016–17; however, seclusion was used much less. The total duration of admissions started within a short-term emergency article decreased significantly from 96 days before the change in the law to 71 days after the law change (Effect size = 0.225, p = 0.012). Days of involuntary inpatient stay within a short-term emergency authorization remained the same. Inpatient involuntary medication almost doubled. Involuntary outpatient care by means of medication was mainly used during and after discharge, seldom before or without admission.
Conclusions
After the change in the law, compulsory care was used with similar frequency and for a similar number of patients. In this study an increase in the use of medication was associated with a significant reduction in the length of inpatient admissions. Involuntary medication was used less frequently in an outpatient than in an inpatient setting, despite being possible as a means to avoid involuntary emergency admissions.
期刊介绍:
The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.