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Cited by 44Healthcare Decision-Making and RestraintsMental Health Treatment and AccessHealth, Medicine and Society

Racial and Ethnic Inequities in Inpatient Psychiatric Civil Commitment

Shea, Timothy, Dotson, Samuel, Tyree, Griffin, Ogbu-Nwobodo, Lucy, Beck, Stuart, Shtasel, Derri·2022·Psychiatric Services
DOI 10.1176/appi.ps.202100342
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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.

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  • Well-documented evidence shows that Black individuals, in particular, are disproportionately subjected to coercive practices in psychiatric settings.

    “especially in light of well-documented evidence that Black individuals, in particular, are disproportionately subjected to coercive practices in psychiatric settings [196,197].”

    From Factors Associated with Perceived Coercion in Adults Receiving Psychiatric Care: A Scoping Review (2025) · cites this paper as [196]

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Authors
Shea, T., Dotson, S., Tyree, G., Ogbu-Nwobodo, L., Beck, S., & Shtasel, D.
Affiliations
Harvard University (US)
ORCID
Venue
Psychiatric Services
Publisher
American Psychiatric Association Publishing
Published
2022-12-01
Volume
73
Issue
12
Pages
1322-1329
ISSN
  • 0022-1597 (ISSN-L)
  • 1075-2730
  • 1557-9700
DOI
10.1176/appi.ps.202100342
OpenAlex
W4297271274
Cited by
43
References
27
Citations by year
2026: 9 · 2025: 12 · 2024: 18 · 2023: 4
FWCI
7.78
Type
journal article
Language
en
Open access
closed
Locations
  • Psychiatric Services (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
Keywords
involuntary psychiatric hospitalization, civil commitment, racial and ethnic disparities, Black patients, psychiatric inpatient care, health disparities
MeSH terms
Ethnicity, Hispanic or Latino, Humans, Inpatients, Prospective Studies, Racial Groups

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