Involuntary Inpatients are Satisfied Inpatients
Setting the Stage
When patients are involuntarily admitted to an inpatient psychiatric facility, intuitively it seems they may begin care with a negative outlook. This negative beginning could ultimately impact their perceived experience and indicated willingness to recommend the facility. Moreover, psychiatric providers have expressed concern over involuntary patients’ rating of providers on satisfaction surveys.
Previous studies on this topic have mixed results. The difference in findings may stem from how much control patients feel they have over their situation. Studies suggest when patients understand their rights clearly, their sense of coercion decreases, which leads to a better treatment experience [4]. Indeed, one study found a link between involuntary admission and lower patient satisfaction, but only when accounting for perceived coercion4. Data captured by MHO’s client facilities address each of these components, thus we explored in our real-world data the influence of voluntary admission status and perceived quality of informing patients of their rights on the likelihood to recommend a facility and satisfaction with psychiatrist.
Numbers Say…
Forty-six percent of 377,698 inpatient stays from 2022 to 2024 were involuntary, spanning over 100 freestanding psychiatric facilities across the United States. Data from these stays show no practical differences in voluntary and involuntary patients’ willingness to recommend the facility (“How likely would you be to recommend our facility to a friend or family member?”)[1] and that they are equally satisfied with their physician (“I was satisfied with my physician.”)[2]. However, what really mattered was whether patients felt well informed of rights (“I was informed of my rights.”)[3]. Being informed about rights was strongly linked to both likelihood of recommending the facility and physician satisfaction, where patients better informed of rights are more likely to recommend the facility and more satisfied with their physician. Interestingly, being informed of rights improved satisfaction equally for both voluntary and involuntary patients.
Wrap-up
Overall, improving communication about rights can benefit all patients equally. Regardless of whether admission is voluntary or involuntary, patients seem to feel better about their treatment when they are informed about their rights. Ultimately, it seems this translates into a higher likelihood to recommend the facility and higher satisfaction with their psychiatrist.
Interactive Figure 1. Regardless of voluntary status, being more informed of rights is associated with higher Likelihood to Recommend and Satisfaction with Physician.
Footnotes
[1] Likelihood to recommend was measured on a scale of 0 “Not at all likely” to 10 “Extremely likely”.
[2] Physician satisfaction was measured on a scale of 1 “Strongly Disagree” to 5 “Strongly Agree”.
[3] Informed of Rights was measured on a scale of 1 “Strongly Disagree” to 5 “Strongly Agree”.
References
[1] Greenwood N., Key A., Burns T., Bristow M. & Sedgwick P (1999). Satisfaction with in-patient psychiatric services. Relationship to patient and treatment factors. Br J Psychiatry, 174, 159-163.
[2] Svensson, B. & Hansson, L. (1994), Patient satisfaction with inpatient psychiatric care. Acta Psychiatrica Scandinavica, 90, 379-384.
[3] Goula A., Margetis E., Stamouli M.A., Latsou D. & Gkioka V (2021). Differences of mentally ill patients’ satisfaction degree during their involuntary or voluntary stay in a psychiatric clinic. Journal of Public Health Research, 10, 2052.
[4] Iversen, K., Høyer, G. & Sexton, H (2007). Coercion and patient satisfaction on psychiatric acute wards. International Journal of Law and Psychiatry, 30, 504-511.
