Detention of children and adolescents under mental health legislation: a scoping review of prevalence, risk factors, and legal frameworks

BMC Pediatr. 2024 Jan 4;24(1):12. doi: 10.1186/s12887-023-04464-6.

Abstract

Background: For individuals with severe mental illness, involuntary assessment and/or treatment (hereafter detention) can be a necessary intervention to support recovery and may even be lifesaving. Despite this, little is known about how often these interventions are used for children and adolescents.

Methods: This global scoping review set out to: (1) map the current evidence around mental health detentions of children and adolescents (< 18 years); (2) identify the clinical, sociodemographic, and behavioural factors associated with detention; and (3) document the views of professionals and young people on the implementation of mental health legislation.

Results: After searching databases of peer-reviewed literature and citation chaining, 42 articles from 15 jurisdictions were included. About one fifth of psychiatric admissions in national register data were detentions, however trends were only available for a few high-income Western countries. The circumstances justifying detention and the criteria authorising detention varied between studies, with a mix of clinical factors and observed behaviours reported as the reason(s) warranting/precipitating a detention. Particular groups were more likely to experience detention, such as children and adolescents from minority ethnic communities and those with a documented history of abuse. There was a notable absence of qualitative research exploring the views of professionals or children and adolescents on detention.

Conclusion: Further research is needed to explore the impact of detention on those aged < 18 years, including national register-based studies and qualitative studies. This is particularly relevant in nations currently undergoing legislative reform.

Keywords: Adolescents; Children; Compulsion; Involuntary hospitalisation; Mental health detention; Mental health legislation.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Child
  • Humans
  • Involuntary Commitment*
  • Mental Disorders* / epidemiology
  • Mental Disorders* / therapy
  • Mental Health* / legislation & jurisprudence
  • Minority Groups
  • Prevalence
  • Risk Factors