Objective: To identify why Review Boards revoked certificates for involunta
ry hospitalization,
Method: The outcome of all applications for a Review Board hearing at 2 psy
chiatric hospitals in Ontario were recorded om the beginning of 1987 to the
end of 1996. All cases where a certificate of involuntary hospitalization
was revoked were identified For each of these cases, the clinical record, i
ncluding the Review Board's written reasons for its decision, was reviewed.
Results: During the study period 2644 patients applied for a review of thei
r involuntary, hospitalization. Only 42% of applications reached a hearing.
Of these, 9% were revoked. Several recurring reasons for overturning certi
ficates were identified. These included the physician relying too much on h
earsay evidence, relatives supporting discharge at the hearings, and the pa
tient clearly having recovered by the time the hearing took place.
Conclusions: Relatives or staff who observe dangerous behaviour should be e
ncouraged to give evidence at hearings. The treatment team should take care
ful note of the views of patients 'families and friends and review the pati
ents' progress before hearings.