COMPETENCE TO CONSENT TO VOLUNTARY PSYCHIATRIC-HOSPITALIZATION - A TEST OF A STANDARD PROPOSED BY APA

Objective: In the wake of the U.S. Supreme Court's 1990 decision in Zi nermon v. Burch, renewed attention has been given to capacities patien ts must have to be considered competent to consent to voluntary hospit alization. An American Psychiatric Association (APA) task force sugges ted that strong policy interests support the establishment of a low th reshold for competence in this situation. The study examined whether, as previous research suggested, patients would have difficulty meeting even this lenient standard. Methods: One hundred voluntarily hospital ized psychiatric patients were read two brief paragraphs, one explaini ng the purposes of psychiatric hospitalization and and the other expla ining policies for discharge. The paragraphs' readability measured abo ut eighth-grade level. After each paragraph, participants were read tw o sets of questions, one testing recall of the presented information a nd the other testing recognition of the information in a true-false fo rmat. The scores of patients grouped by selected demographic and clini cal variables were compared. Results and conclusions: The vast majorit y of patients were able to comprehend the information that the APA tas k force suggested was relevant to their decision. However, a subgroup of patients who were initially admitted involuntarily had significantl y poorer performance and may constitute a group who need special educa tional efforts focused on the consequences of voluntary admission.