Involuntary detention: Comparison of clinical practices of psychiatry residents and faculty

Objective: The objective of this study is to study if involuntary detention criteria in legal certificates filed by psychiatry residents and faculty psychiatrists are consistent with observations in clinical documentation. Methods: Eighty-nine involuntarily hospitalized patients were retrospectively selected from medical records; eight patients were excluded due to change in involuntary status or immediate discharge on clinical grounds. Medical certificates filed by the residents and faculty psychiatrists were compared with clinical documentation of the same day for consistency in criteria for detention (substantial risk of harm to self or others and/or inability to care for self). Results: Of 81 included patients, 38.3 % lacked sufficient documentation of clinical justification for involuntary hospitalization. The rate of inconsistency of documented clinical justification showed a greater trend among psychiatry residents compared to faculty psychiatrists (p = 0.069, not statistically significant). Conclusions: Inconsistency of documented clinical justification for involuntarily detention was higher among residents compared to faculty. There is a need for structured training and supervision of psychiatry residents as well as updated training for faculty psychiatrists with regard to involuntary detention procedures.