The scope of compulsory hospitalisation in mental health care is internationally regarded as a key indicator of quality and legal protection. Despite this, there is a conspicuous lack of good and reliable data on this issue (1).
Quality indicators were introduced in the health service to give users and their families, health personnel, managers, politicians and the public information on the quality of the services provided. The last updated overview of quality indicators in adult mental health care from the Directorate of Health lists 14 indicators, which in addition to compulsory hospitalisation also include failure to meet treatment deadlines, completion of discharge summaries and waiting times (2). One indicator bears the title 'Proportion of compulsory hospitalisations in adult mental health care', another 'Compulsory hospitalisations in adult mental health care'. Both of these report the percentage proportion of sectioned patients in relation to the total number of admissions.
In a previous article, we investigated changes in emergency admissions and compulsory hospitalisations in Østfold county in the period 2000–2010 (3). We used the Directorate of Health's quality indicators for compulsory hospitalisation in mental health care. At the time, this indicator was split in two in order to measure both the percentage proportion and the rate as an expression of compulsory hospitalisations per 1000 adults in the catchment area. We found that the proportion of compulsory hospitalisations had declined due to an increase in voluntary admissions. This was caused by an increase in the total number of admissions, while the rate of compulsory hospitalisation remained unchanged from 2000 to 2010. At the time, we argued that the rate was the measure that best reflected the scope of compulsory hospitalisation in a given area. It now seems that the Directorate of Health has decided to use only the proportion as a quality indicator for compulsory hospitalisation in the mental healthcare services (2).
In this article, we investigate compulsory hospitalisations in Østfold county in 2010 and 2017, and assess the consequences that the choice of indicator entails for analyses of compulsory hospitalisation and in terms of opportunities for comparing health enterprises.
We investigate whether the number of compulsory hospitalisations in adult mental health care in Østfold county, measured in relation to the population, has changed during the period, whether the number of compulsory hospitalisations in Østfold county has changed in relation to the total number of emergency admissions, and the impact that the choice of indicator has on assessments of the use of compulsory hospitalisation.