As hospital beds are scarce, and emergency admissions to a psychiatric ward are major life-events for children and adolescents, it is essential to have insight into the decision-making process that leads to them. To identify potentially modifiable factors, we, therefore, studied the contextual and clinical characteristics associated with the voluntary and compulsory emergency admission of minors. We used registry data (2008-2017) on 1194 outpatient emergencies involving children aged 6-18 who had been referred to the mobile psychiatric emergency service in two city areas in The Netherlands. Demographic and contextual factors were collected, as well as clinical characteristics including diagnoses, psychiatric history, Global Assessment of Functioning (GAF), and the Severity of Psychiatric Illness (SPI) scale. Logistic regression analyses were used to identify factors that predict voluntary or compulsory admission. Of 1194 consultations, 227 (19.0%) resulted in an admission, with 137 patients (11.5%) being admitted voluntarily and 90 (7.5%) compulsorily. Independently of legal status, the following characteristics were associated with admission: severity of psychiatric symptoms, consultation outside the patient's home, and high levels of family disruption. Relative to voluntary admission, compulsory admission was associated with more severe psychiatric problems, higher suicide risk, and prior emergency compulsory admission. Two potentially modifiable factors were associated with psychiatric emergency admission: the place where patients were seen for consultation, and the presence of family problems. Psychiatric emergency admissions may be reduced if, whenever possible, minors are seen in their homes and if a system-oriented approach is used.

中文翻译：

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青年患者接受精神病紧急咨询后自愿和强制性入院的预测指标。

由于病床稀缺，而精神科病房的急诊服务是儿童和青少年的主要生活事件，因此必须深入了解导致他们的决策过程。因此，为了确定潜在的可改变因素，我们研究了与未成年人自愿和强制性紧急入院相关的背景和临床特征。我们使用注册表数据（2008-2017）处理了1194个门诊紧急事件，涉及6-18岁的儿童，这些儿童在荷兰的两个城市地区都被转诊到了移动精神病学紧急服务中心。收集人口统计学和背景因素以及临床特征，包括诊断，精神病史，整体功能评估（GAF）和精神疾病严重程度（SPI）量表。使用逻辑回归分析来确定预测自愿或强制入学的因素。在1194次会诊中，有227例（19.0％）接受了入院治疗，其中137例患者（11.5％）是自愿入院的，而90例（7.5％）是强制性的。独立于法律地位，以下特征与入院相关：精神症状的严重程度，在患者家门口的咨询以及高水平的家庭破裂。相对于自愿入院，强制入院与更严重的精神病问题，更高的自杀风险以及先前的紧急强制入院有关。精神科急诊入院有两个可能可修改的因素：看病人咨询的地方和家庭问题的存在。