Skip to main content

Abstract

Objective:

Involuntary psychiatric treatment may parallel ethnoracial inequities present in the larger society. Prior studies have focused on restraint and seclusion, but less attention has been paid to the civil commitment system because of its diversity across jurisdictions. Using a generalizable framework, this study investigated inequities in psychiatric commitment.

Methods:

A prospective cohort was assembled of all patients admitted to an inpatient psychiatric unit over 6 years (2012–2018). Patients were followed longitudinally throughout their admission; raters recorded legal status each day. Sociodemographic and clinical data were collected to adjust for confounding variables by using multivariate logistic regression.

Results:

Of the 4,393 patients with an initial admission during the study period, 73% self-identified as White, 11% as Black, 10% as primarily Hispanic or Latinx, 4% as Asian, and 3% as another race or multiracial. In the sample, 28% were involuntarily admitted, and court commitment petitions were filed for 7%. Compared with White patients, all non-White groups were more likely to be involuntarily admitted, and Black and Asian patients were more likely to have court commitment petitions filed. After adjustment for confounding variables, Black patients remained more likely than White patients to be admitted involuntarily (adjusted odds ratio [aOR]=1.57, 95% confidence interval [CI]=1.26–1.95), as were patients who identified as other race or multiracial (aOR=2.12, 95% CI=1.44–3.11).

Conclusions:

Patients of color were significantly more likely than White patients to be subjected to involuntary psychiatric hospitalization, and Black patients and patients who identified as other race or multiracial were particularly vulnerable, even after adjustment for confounding variables.

Formats available

You can view the full content in the following formats:

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Pages: 1322 - 1329
PubMed: 35959533

History

Received: 9 June 2021
Revision received: 30 October 2021
Revision received: 19 February 2022
Accepted: 25 March 2022
Published online: 12 August 2022
Published in print: December 01, 2022

Keywords

  1. Racial-ethnic disparities
  2. Racism
  3. Inpatient treatment
  4. Involuntary commitment
  5. Law & psychiatry

Authors

Details

Timothy Shea, M.D. [email protected]
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Samuel Dotson, M.D.
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Griffin Tyree, M.D., M.A.S.
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Lucy Ogbu-Nwobodo, M.D., M.S.
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Stuart Beck, M.D.
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.
Derri Shtasel, M.D., M.P.H.
Department of Psychiatry, Massachusetts General Hospital, and Harvard Medical School, Boston.

Notes

Send correspondence to Dr. Shea ([email protected]).

Competing Interests

The authors report no financial relationships with commercial interests.

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Full Text

View Full Text

Get Access

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login
Purchase Options

Purchase this article to access the full text.

PPV Articles - Psychiatric Services

PPV Articles - Psychiatric Services

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share