Criminal behavior prior and subsequent to involuntary commitment and detainment in adolescent psychiatric care

Purpose: To investigate the connections between young people’s criminal behavior and involuntary psychiatric treatment. Materials and methods: A registry-based follow-up study, using data of all Finnish individuals with first ever psychiatric inpatient treatment at ages 13–17 between 1996 and 2010 (n = 12,725). Information on inpatient treatment periods was extracted from the National Care Register for Health Care (HILMO) and data on criminality from the Register of Prosecutions, Sentences and Punishments maintained by Statistics Finland. The subjects were followed for 10 years after the end of the index hospital stay. Results: A criminal background before the first hospital stay was about twice as common among those committed to hospital involuntarily and those detained in involuntary treatment. Both commitment and detainment were across diagnostic groups associated with later criminal behavior in general and violent criminality in particular. In analyses stratified by sex, involuntary treatment was associated with later criminality only among females. Conclusions: Criminal behavior before admission to psychiatric treatment is a risk factor for the initiation and implementation of involuntary treatment, but the initiation and implementation of treatment through involuntary procedures are also independent predictors of later criminal behavior. In hospital care and subsequent interventions, supporting prosocial development should be a focus in addition to treating psychiatric symptoms.