Compulsory admission: are there differences between migrants and natives? Data from a psychiatric emergency service of an Italian metropolitan area

BACKGROUND: As compared to natives, higher rates of involuntary admission were found among migrants in most European countries. A possible strategy to reduce this phenomenon is to develop preventive strategies targeting risk and protective factors of compulsory admission specific to the migrant population. AIMS: The first aim of the present study was to evaluate compulsory admission rates in the migrant population as compared to natives admitted for an acute mental disorder. The second aim was investigate whether sociodemographic, clinical, and care-related variables associated with compulsory admission differed between migrants and natives. Moreover, in the whole sample we assessed whether migrant status affected the risk of compulsory admission. METHODS: Retrospective single-center study on patients hospitalized in the period between January 1, 2018 and December 31, 2020 in a large metropolitan academic hospital. We compared sociodemographic, clinical, and care-related variables between migrants and natives, voluntary or compulsory admitted. We investigated the association between compulsory admission and the variables collected in the whole sample and in the migrants' and natives’ groups with a correlation analysis followed by hierarchical logistic regression models. RESULTS: The sample included 185 migrant patients and 933 native patients. The prevalence of compulsory admission was significantly higher in the migrants' group. Male gender, lower education, non-comprehension of the local language, a diagnosis of a schizophrenia spectrum disorder, and aggressive behavior were associated with compulsory admission in the migrants’ sample, partially differing from the natives. CONCLUSION: Our study highlighted how migrant status is associated with a higher risk for compulsory admission. Inclusion policies or the presence of cultural mediators in emergency settings might be preventive strategies in this context.