Development of a Vignette-Based Instrument to Assess Psychiatric Involuntary Hospitalization Decision-Making

• DOI: 10.1891/ehpp-2024-0001
• Publication Date: 2024-08-26T13:55:17Z
• Authors: Karin R. Lavie; Kristen C. Jacobson; Lala Park; Christina Girgis; Royce Lee
• Keywords: Vignette; Clinical Decision Making

The decision to hospitalize a psychiatric patient against their will is an ethically and clinically complex problem. While there is variation in rates of involuntary hospitalization (IH) across different settings, we lack a tool to measure individual differences in IH decision-making. This study used a mixed-methods approach to develop and validate a vignette-based instrument designed to assess the decision to hospitalize psychiatric cases and confidence in IH decision-making. The instrument was tested locally inn= 31 psychiatrists, and the results were replicated in a national sample (n= 238). The results showed variation in IH rates across the eight vignettes. Mixed-effects models found significant variability in confidence ratings across both vignettes and participants, supporting the validity of this instrument to assess IH decision-making.