Voluntary and Involuntary Admissions for Severe Mental Illness in China: A Systematic Review and Meta-Analysis

Abstract

Objective: The aim of this systematic review and meta-analysis was to examine the prevalence of voluntary and involuntary psychiatric admissions for severe mental illness in China and explore their associated factors.

Methods: The PubMed, Cochrane Library, PsycINFO, EMBASE, CNKI, CQVIP, and WanFang databases were systematically searched for the span since their inception to October 2018. Meta-analyses were conducted with the random-effects model.

Results: Fourteen studies with 94,305 patients were included in the analyses. The voluntary and involuntary admission rates were 30.3% (95% confidence interval [CI]=18.06% to 46.23%) and 32.3% (95% CI=10.39% to 66.21%), respectively, for severe mental illness and 19.6% (95% CI=14.09% to 26.54%) and 44.3% (95% CI=5.98% to 90.88%), respectively, for schizophrenia. Meta-regression analyses found an increase in the voluntary admission rate between 1998 and 2018.

Conclusions: The voluntary admission rate for severe mental illness has increased in China, whereas the involuntary admission rate has remained high, particularly for schizophrenia. Concerted efforts should be made to further decrease the rate of involuntary admissions.

Keywords: China; Mental health systems/hospitals; Patient rights; involuntary admission; meta-analysis; psychiatric; voluntary admission.