Competency in adolescent inpatients.
K. C. Casimir and S. B. Billick,
Bull. Amer. Acad. Psychiatry & the Law
22(1): 19-29, 1994.
A 15-item questionnaire was used to evaluate competency to consent to hospitalization in 30
adolescent psychiatric inpatients. For competency, 17 percent of the subjects met minimal clinical
criteria, 30 percent met broad clinical criteria, and 37 percent satisfied legally oriented criteria. Only
22 percent of the adolescent subjects met combined clinical and legal criteria. When compared with
previously studied adult voluntary and adult involuntary inpatients, the data more closely resemble
those generated by involuntarily admitted adults. Consistently deficient performance on the minimal
clinical criteria indicates that adolescents may have a poor understanding of the most general
determinants of their hospitalization. Conversely, adolescents performed more favorably than
voluntary and involuntary adults on the legally oriented criteria, demonstrating their better cognitive
ability to understand such abstract concepts. Thus, specific types of judgment and insight may be
essential components in the evaluation of adolescent competency to consent to psychiatric
hospitalization.