Nonemergent forcible medication in an acute hospital.
W. M. Greenberg and S. Attia,
Bull. Amer. Acad. Psychiatry & the Law
21(4): 465-73, 1993.
Nonemergent forcible medication is a controversial procedure that has received somewhat less study
in acute hospitals and in states where a simple in-house "treatment-driven" clinical review procedure
is followed. We reviewed the charts of all patients so medicated by the New Jersey "Rennie" process
on a large general acute adult psychiatric service, finding 43 (3%) of 1420 admitted patients so
treated. Compared with a population of next-admitted individuals, these "Rennie" patients more
frequently had previously required extended emergent forcible medication, had significantly longer
hospitalizations (70 versus 26 days), not accounted for by the duration of treatment refusal, but
improved with treatment so that almost all were discharged directly back to the community. Rennie
patients appeared more likely to be diagnosed with schizophrenia and were significantly more likely
to have a known history of assault, threatened assault, or property damage, but significantly less
likely to have a known history of suicide threat or attempt. They were also significantly less likely
to have a principal or secondary diagnosis of personality disorder or substance use disorder.