Why are patients discharged by review boards?

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 All cases where a certificate of involuntary hospitalization was revoked were identified For each of these cases, the clinical record, i ncluding the Review Board's written reasons for its decision, was reviewed.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.