[A descriptive study of the procedures of psychiatric admissions at Razi hospital]
Background: The law 92-83, has established the rights of the mentally ill to respect for individual freedom and to appropriate care. However some gaps in its implementation led to the revision by Act 2004-40. aim: To study the evolution of the number of admissions with and without consent (hospitalizations at the request of a third party and compulsory hospitalizations), between 2000 and 2009. methods: Retrospective study of the archives of the mental health unit of Razi hospital. The study population included inpatients under the mode of voluntary and involuntary admission either compulsory hospitalizations or at the request of a third party. results: An increase in the number of hospitalizations without the consent from 2000 to 2009 was noted. The number of compulsory hospitalizations and the one of hospitalizations at the request of a third party rose respectively from 1,048 to 1,443 and from 22 to 1,323. So the number of free hospitalizations has decreased while the number of involuntary hospitalizations has increased, leading to a constant number of total hospitalizations. The sex ratio for compulsory hospitalizations has increased from 2.04 to 5.83 while it markedly decreased for hospitalizations at the request of a third party (from 10 to 1.7).Men, unlike women, were more likely to be hospitalized compulsorily than at the request of a third party. Conclusion: There is a larger use of hospital admissions under constraints than free ones; is it due to a concern for the respect of law or an abuse in the deprivation of freedom for some patients?
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ABSTRACT: The reality of psychiatric practices in prison has been reported in only a few studies in Tunisia. This situation is due to the constant revisions in the healthcare system on the one hand, and the judiciary system on the other. Also, the difficulties of conducting studies between the two institutions. In fact, the general trend towards deinstitutionalization, insufficient resources of public services, restrictions of patient access to community care, the onset of addictive behaviour, and finally, the general attitude marked by fear and rejection by both police and society has resulted in a good number of mental patients more frequently found in prison. In the present study, we attempted to trace the history of psychiatric practice in prison currently in the course of construction in a Tunisia undergoing total change.
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