ROOMING-IN - AN ALTERNATIVE TO INVOLUNTARY DETENTION

Objective: To provide, via 'rooming-in', a local, less coercive and le ss frightening alternative to involuntary detention. Rooming In is the voluntary participation of so-called 'confidants', who may be chosen family members or trusted friends, in the management of acute, severe psychiatric disturbance by their providing a 24 hour vigil with the pa tient in a single, safe hospital room. Method: There were 73 admission s to the rooming-in program at the Manning Base Hospital, Taree, New S outh Wales (NSW), Australia between 5 August 1986 and 21 September 199 2. During the same period 78 patients were remitted from the hospital on an involuntary basis to urban detention centres: 'scheduled' under the NSW Mental Health Act. Demographic and diagnostic characteristics of the two populations, both of whom met identical criteria for involu ntary detention, are compared in this retrospective, case report study . These two groups constituted only 6% of total psychiatric consults c arried out at the hospital over the same 6 year period and those roome d-in represented only 12% of the psychiatric admissions. A quality ass urance study evaluated the acceptability of the program. Results: The scheduled patients were more likely to be single, of no fixed abode an d without a local family. They were more likely to have a schizophreni c disorder, compounded by polysubstance abuse, than a mood disorder. T he average inpatient stay for those roomed-in was 10 days. Seventy per cent of confidants were required for 4 days or less. The rooming-in p rogram was valued highly by nursing staff, patients and their families . Conclusion: A search of the world literature would suggest that room ing-in, as a model of care, is unique, at least in the developed world . It allows some seriously disturbed patients to be provided with a lo cal and less restrictive general hospital alternative.