Sunday, 3 October 2010

More involuntary psychiatric admissions since smoking banned, says Canadian study

A study in Toronto that appears to be the first of its kind suggests that the smoking ban deters many patients from seeking treatment in psychiatric units. A walk-in emergency unit found it had to detain patients who needed treatment but were unwilling to submit to a no-smoking regime; other patients refused treatment but did not meet the required criteria for involuntary admission.

Involuntary treatment involves the removal of their freedom for an indefinite period. Having to give up smoking during such a period adds complications to an already upsetting if not downright traumatic experience. Many times I have wondered at the conscience of people who pick on those detained, quite probably bewildered and confused souls as targets for their conviction that the way to save humanity from itself is to stop everyone smoking. This is touched on in the article: 'what I haven't seen is the investment in resources to help these individuals when they are stable outpatients'. No: sock it to them when they are vulnerable and have no choices. Many clinical staff and academics have reservations about this.

It is clear that many of those at most risk are those outside hospital, who become aware that admission to hospital will involve them giving up smoking. (See Letters to the Department of Health.) The news that walk-in appointments are found to result in more involuntary admissions is very bad news, if it means that people are deterred even from seeking an assessment or help in an emergency.

It appears that not much work has yet been done to investigate whether people are being deterred from treatment on the grounds that they won't be able to smoke while hospitalised.

1 comment:

Michael J. McFadden said...

I have personally known two individuals who have delayed/avoided psychiatric hospitalization to their detriment because of smoking restrictions. Even before the full bans smoking "privileges" were abused by staff to keep patients in line. If the patients didn't "play nicely with others" there were limited options that staff could use to punish them and bring them into line. If the patient was a smoker however they could simply have their smoking privileges suspended.

I wonder what tricks the staff use to whip the nonsmokers into cooperation though?