Past Issues
The Characteristics of Severe Mentally
Ill Patients Who Need Forced Hospitalization
before and after the Amended Mental
Health Act in Taiwan
Ren-Yi Liu, M.D.1, Kuan-Yi Tsai, M.D., M.S.1, Frank Huang-Chih Chou, M.D., M.S., Ph.D.1,2, Wen-Wei Ho, M.D.1, Wei-Jen Chen, M.D., M.S.1,2, Cheng-Chung Chen, M.D., Ph.D.1,3
Objectives: The Amended Mental Health Act (AMHA) in Taiwan became effective
on July 4, 2008. In this research, we aimed to identify the characteristics of
severe mental illness (SMI) patients who needed forced hospitalization before and
after the implementing of the AMHA. Method: Kai-Suan Psychiatric Hospital is
the only government civilian psychiatric hospital in Kaohsiung, Taiwan. This 820-
bed hospital is accounted for about 70% of the psychiatric beds in the city of Kaohsiung.
After implementing AMHA, we used the psychiatrist-rated battery to collect
psychopathological symptoms from medical records to collect demographic
data and a psychiatric history of 146 SMI inpatients who were admitted involuntarily
for seven months. Before implementing AMHA, we also collected data from
224 SMI inpatients who were admitted in the same period in 2007 as the control
group. The collected information included patients’ nationality, educational level,
marital status, age of onset , the number of previous admissions, and the number
of forced hospitalization. Results: Compared with the control group, the involuntarily
admitted inpatients after the implementing the AMHA showed signifi cant
differences in their psychiatric symptoms, of more tension and less motor hyperactivity
(p=0.007), distractibility (p=0.006), suspiciousness (p=0.036), and grandiosity
(p=0.044). Signifi cant differences were also found in the types of violence in
more destructive behavior (p=0.008), and less verbal aggression (p=0.016). Conclusion:
The AMHA was implemented, the number of forced involuntary admissions
has been decreased by two-thirds compared to the year before. Based on this
fi nding, we suggest that stricter or different criteria are used by psychiatrists in the
AMHA.
on July 4, 2008. In this research, we aimed to identify the characteristics of
severe mental illness (SMI) patients who needed forced hospitalization before and
after the implementing of the AMHA. Method: Kai-Suan Psychiatric Hospital is
the only government civilian psychiatric hospital in Kaohsiung, Taiwan. This 820-
bed hospital is accounted for about 70% of the psychiatric beds in the city of Kaohsiung.
After implementing AMHA, we used the psychiatrist-rated battery to collect
psychopathological symptoms from medical records to collect demographic
data and a psychiatric history of 146 SMI inpatients who were admitted involuntarily
for seven months. Before implementing AMHA, we also collected data from
224 SMI inpatients who were admitted in the same period in 2007 as the control
group. The collected information included patients’ nationality, educational level,
marital status, age of onset , the number of previous admissions, and the number
of forced hospitalization. Results: Compared with the control group, the involuntarily
admitted inpatients after the implementing the AMHA showed signifi cant
differences in their psychiatric symptoms, of more tension and less motor hyperactivity
(p=0.007), distractibility (p=0.006), suspiciousness (p=0.036), and grandiosity
(p=0.044). Signifi cant differences were also found in the types of violence in
more destructive behavior (p=0.008), and less verbal aggression (p=0.016). Conclusion:
The AMHA was implemented, the number of forced involuntary admissions
has been decreased by two-thirds compared to the year before. Based on this
fi nding, we suggest that stricter or different criteria are used by psychiatrists in the
AMHA.
| Key Word | Amended Mental Health Act, severe mental illness, involuntary admission |
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