Prevalence and predictors of involuntary psychiatric hospital admissions in Ontario, Canada: a population-based linked administrative database study
Open accessAbstract
BACKGROUND: Involuntary admissions to psychiatric hospitals are common; however, research examining the trends in prevalence over time and predictors is limited. Aims To examine trends in prevalence and risk factors for involuntary admissions in Ontario, Canada. METHOD: We conducted an analysis of all mental health bed admissions from 2009 to 2013 and assessed the association between patient sociodemographics, service utilisation, pathway to care and severity characteristics for involuntary admissions using a modified Poisson regression. RESULTS: We found a high and increasing prevalence of involuntary admissions (70.7% in 2009, 77.1% in 2013, 74.1% overall). Individuals with police contact in the prior week (risk ratio (RR) = 1.20) and immigrants both experienced greater likelihood of being involuntarily admitted, regardless of control for other characteristics (RR = 1.07) (both P < 0.0001). CONCLUSIONS: We identified numerous modifiable and non-modifiable risk factors for involuntary admissions. The prevalence of involuntary admissions was high, linearly increasing over time. Declaration of interest The authors have completed the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. This study was conducted using funding entirely from public sources. P.K. has received operational support via an Ontario Ministry of Health and Long-Term Care (MOHLTC) Health Services Research Fund Capacity Award to support this project. The Institute for Clinical Evaluative Sciences (ICES) is funded by the Ontario MOHLTC. The study results and conclusions are those of the authors, and should not be attributed to any of the funding agencies or sponsoring agencies. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. All decisions regarding study design, publication, and data analysis were made independent of the funding agencies.
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Some observers have noted a correlation between increases in involuntary detainment of individuals in psychiatric crisis and limited or non-existent access to voluntary mental health treatment options, including upstream services that may prevent psychiatric crises.
“Some observers have noted a correlation between increases in involuntary detainment of individuals in psychiatric crisis and limited or non-existent access to voluntary mental health treatment options, including upstream services that may prevent psychiatric crises [12–15].”
From “Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act (2026) · cites this paper as [13]
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- Authors
- Lebenbaum, M., Chiu, M., Vigod, S., & Kurdyak, P.
- Affiliations
- University of Toronto (CA)
- Institute for Clinical Evaluative Sciences (CA)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Lebenbaum, Michael
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2018-02-22
- Volume
- 4
- Issue
- 2
- Pages
- 31-38
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC6020272
- OpenAlex
- W2789320453
- Cited by
- 70
- References
- 38
- Citations by year
- 2026: 10 · 2025: 5 · 2024: 5 · 2023: 12 · 2022: 11 · 2021: 11 · 2020: 8 · 2019: 7 · 2018: 1
- FWCI
- 7.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Institute for Clinical Evaluative Sciences
- Ontario Ministry of Health and Long-Term Care
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- psychiatric hospital admissions, prevalence trends, risk factors, police encounters, immigrants, mental health service utilization, pathways to care, Ontario
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