Mortality among involuntarily admitted psychiatric patients: a survival analysis

Background Only a few studies have examined mortality among committed psych iatric patients, and most of them suffer methodologically from selected pop ulations, small samples, and inappropriate methods of data analysis. The pu rpose of this study was to determine whether involuntarily admitted psychia tric inpatients are a high risk group for mortality compared to a group of voluntarily admitted psychiatric inpatients. Method: A retrospective cohort design was used with a maximum 9-year variable follow-up. A multistage sam pling procedure was used to generate the sample, which consisted of 1064 in voluntarily admitted patients and 1078 voluntarily admitted patients. Resul ts: During the follow-up period, 107 deaths were identified, 58 involuntary and 49 voluntary [chi(2)(1) = 0.9255, P = 0.336]. No significant differenc es were observed between the cohorts when survival analysis was used to exa mine survival experiences in the community. Conclusions: Compared to volunt ary patients, involuntary patients do not appear to be at a higher risk for mortality. The high standard mortality ratios observed in both cohorts, ho wever, are consistent with previous findings of high mortality among psychi atric patients in general, and support the need for intensive follow-up in the community following discharge from a psychiatric inpatient unit.