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The Impact of Legal Procedures on Hospital Length of Stay: Balancing Legal and Clinical Concerns
Open accessAbstract
Purpose: Psychiatric hospital length of stay (LOS) is not affected solely by socio-clinical factors but also by legal procedures. This study examined the associations between legal procedures and LOS.Methods: Data from 521 patients with psychiatric illnesses hospitalized over 2013-2015 were analyzed. Logistic regression was used to evaluate the predictors of longer (> 14 days) or prolonged (> 30) LOS with socio-clinical factors and legal procedures including court-ordered interventions (assisted outpatient treatment, medication over objection, and retention).Results: Longer LOS occurred in 246 patients and 99 had prolonged LOS. Legal procedures affected 57 patients, with 11 assisted outpatient treatments, 39 cases of medication over objection, and 16 retentions. Longer LOS was significantly associated with six factors including older age, unmarried status, non-Hispanic race, risk of violence, schizophrenia, and legal procedures. Legal procedures had the strongest association. Longer/prolonged LOS yielded qualitatively similar associations.Conclusion: Among 521 psychiatric inpatients, approximately 11% were mandated to receive interventions/procedures by the courts. Court-ordered legal procedures were strongly associated with longer LOS. Mental health providers may consider legal procedures for patients at high treatment/ medication noncompliance risk as early as patient admission to inpatient units to prevent, intervene or prepare for a longer or prolonged LOS.
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Two papers examining perceived coercion found that involuntary admission was more likely to lead to differences in perceived coercion between patients and their families.
“Two papers examining perceived coercion found that involuntary admission was more likely to lead to differences in perceived coercion between patients and their families (21,126).”
From The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review (2025) · cites this paper as [126]
The Methods describe a medical-record review, and the Results and Conclusion address court procedures and hospital length of stay, not perceived coercion. Searches for coercion and for patient–family differences after involuntary admission found no passage addressing the claimed finding. The indexed passages provide no page numbers. (LLM, conf=0.76)
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The benefits and harms of inpatient involuntary psychiatric treatment: a scoping review
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“Two papers examining perceived coercion found that involuntary admission was more likely to lead to differences in perceived coercion between patients and their families (21,126).”
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Metadata
- Authors
- Shin, J., San Gabriel, M. C. P., Ho-Periola, A., Ramer, S., Kwon, Y., & Bang, H.
- Affiliations
- Insilicogen (South Korea) (KR)
- University of California, Davis (US)
- Corresponding author
- Shin, Jinah
- ORCID
- Venue
- Journal of Korean Academy of psychiatric and Mental Health Nursing
- Published
- 2022-06-30
- Volume
- 31
- Issue
- 2
- Pages
- 181-191
- ISSN
- 1225-8482 (ISSN-L)
- 2288-4653
- PMC
- PMC9311333
- OpenAlex
- W4283715824
- Cited by
- 6
- References
- 28
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of Korean Academy of Psychiatric and Mental Health Nursing (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by-nc)
- Funders
- National Institutes of Health (UL1 TR001860)
- 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 › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- assisted outpatient treatment, involuntary psychiatric hospitalization, prolonged hospital stay, medication non-adherence, treatment non-adherence, schizophrenia, violence risk
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