Voluntary and involuntary admissions for severe mental illness in China: a systematic review and meta-analysis

Aim: The aim of this systematic review and meta-analysis was to examine the prevalence of voluntary and involuntary psychiatric admissions for severe mental illness in China and explore their associated factors. Method: PubMed, Cochrane Library, PsycINFO, EMBASE, CNKI, CQVIP and WanFang databases were systematically searched. Meta-analyses were conducted using the random-effects model. Results: Fourteen studies with 94,305 patients were included. The voluntary and involuntary admission rates for all severe mental illness were 30.3% (95%CI: 18.06-46.23%), and 32.3% (95%CI: 10.39-66.21%), respectively for severe mental illness. The corresponding figures were 19.6% (95%CI: 14.09-26.54%) and 44.3% (95%CI: 5.98-90.88%), respectively for schizophrenia. Meta-regression analyses found an increase in the voluntary admission rate over time between 1998 and 2018. Conclusion: Voluntary admission rate for severe mental illness increased in China, while involuntary admission rates remained high, especially for schizophrenia. Concerted efforts are made to further decrease the rate of involuntary admissions.