Retrospective study of involuntary admission by order of the prefectural governor for individuals attempting self-harm and suicide

For individuals attempting suicide and self-harm, appropriate assessment and treatment interventions are essential to prevent reattempts. Patients involuntarily admitted to a psychiatric hospital by order of the prefectural governor frequently experience severe psychiatric symptoms and face several problems and difficulties. This retrospective study involved surveying 412 patients who were involuntarily admitted to our hospital from January 1, 2010 to March 31, 2022 by order of the prefectural governor for self-harm or suicide attempts. Of these, 98 patients continued treatment at our facility （“our hospital group”） and 314 patients were transferred to other psychiatric facilities （“other hospital group”）. The occurrence of suicide reattempt, readmission, administrative involuntary admission, and mortality rate associated with suicide reattempt following discharge were analyzed as prognostic factors. This study aimed to compare the prognostic factors of the two groups and evaluate their characteristics and differences. Compared with patients in the “other hospital group,” those in “our hospital group” had a significantly longer length of stay and more social services, tended to live alone or in a facility following discharge, and had a significantly higher readmission rate. Furthermore, the rate of mortality caused by suicide was lower in “our hospital group” than in the “other hospital group,” although not statistically significant. Our data did not reveal any differences in the prognosis of patients in both groups. However, despite the requirement for better adjustment to environmental conditions following discharge in “our hospital group,” the use of social services and readmission might be effective interventions. Our findings indicated that the characteristics in “our hospital group” are probably associated with improved prognosis.