Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries
- D. Wasserman,
- G. Apter,
- C. Baeken,
- S. Bailey,
- J. Balazs,
- C. Bec,
- P. Bienkowski,
- J. Bobes,
- M. F. Bravo Ortiz,
- H. Brunn,
- Ö. Bôke,
- N. Camilleri,
- B. Carpiniello,
- J. Chihai,
- E. Chkonia,
- P. Courtet,
- D. Cozman,
- M. David,
- G. Dom,
- A. Esanu,
- P. Falkai,
- W. Flannery,
- K. Gasparyan,
- G. Gerlinger,
- P. Gorwood,
- O. Gudmundsson,
- C. Hanon,
- A. Heinz,
- M. J. Heitor Dos Santos,
- A. Hedlund,
- F. Ismayilov,
- N. Ismayilov,
- E. T. Isometsä,
- L. Izakova,
- A. Kleinberg,
- T. Kurimay,
- S. Klæbo Reitan,
- D. Lecic-Tosevski,
- A. Lehmets,
- N. Lindberg,
- K. A. Lundblad,
- G. Lynch,
- C. Maddock,
- U.F. Malt,
- L. Martin,
- I. Martynikhin,
- N. O. Maruta,
- F. Matthys,
- R. Mazaliauskiene,
- G. Mihajlovic,
- A. Mihaljevic Peles,
- V. Miklavic,
- P. Mohr,
- M. Munarriz Ferrandis,
- M. Musalek,
- N. Neznanov,
- G. Ostorharics-Horvath,
- I. Pajević,
- A. Popova,
- P. Pregelj,
- E. Prinsen,
- C. Rados,
- A. Roig,
- M. Rojnic Kuzman,
- J. Samochowiec,
- N. Sartorius,
- Y. Savenko,
- O. Skugarevsky,
- E. Slodecki,
- A. Soghoyan,
- D. S. Stone,
- R. Taylor-East,
- E. Terauds,
- C. Tsopelas,
- C. Tudose,
- S. Tyano,
- P. Vallon,
- R. J. Van der Gaag,
- P. Varandas,
- L. Vavrusova,
- P. Voloshyn,
- J. Wancata,
- J. Wise,
- Z. Zemishlany,
- F. Öncü,
- S. Vahip
Affiliations
- D. Wasserman
- ORCiD
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
- G. Apter
- ORCiD
- French Federation of Psychiatry, Paris, France Groupe Hospitalier du Havre, Université de Rouen, Rouen, France
- C. Baeken
- ORCiD
- Flemish Association of Psychiatry, Kortenberg, Belgium Department of Psychiatry and Medical Psychiatry, Ghent University, Gent, Belgium
- S. Bailey
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France University of Central Lancashire, Preston, United Kingdom
- J. Balazs
- ORCiD
- Hungarian Psychiatric Association, Budapest, Hungary Department of Developmental and Clinical Child Psychology at the Institute Psychology Eotvos Lorand University, Budapest, Hungary
- C. Bec
- ORCiD
- National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
- P. Bienkowski
- ORCiD
- Polish Psychiatric Association, Warsaw, Poland Department of Psychiatry, Warsaw Medical University, Warsaw, Poland
- J. Bobes
- ORCiD
- Spanish Society of Psychiatry, Madrid, Spain Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
- M. F. Bravo Ortiz
- ORCiD
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
- H. Brunn
- ORCiD
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Danish Psychiatric Association, Copenhagen, Denmark Institute of regional Health Research, University of Southern Denmark, Odense, Denmark
- Ö. Bôke
- ORCiD
- Psychiatric Association of Turkey, Ankara, Turkey Ondokuz Mayıs Üniversitesi, Samsun, Turkey
- N. Camilleri
- ORCiD
- Maltese Association of Psychiatry, Attard, Malta University of Malta, Msida, Malta
- B. Carpiniello
- ORCiD
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France Italian Psychiatric Association, Roma, Italy Department of Public Health, Clinical and Molecular Medicine, Università degli studi di Cagliari, Sardinia, Italy
- J. Chihai
- ORCiD
- Society of Psychiatrists, Narcologists, Psychotherapists, and Clinical Psychologists from the Republic of Moldova, Chișinău, Moldova Department of State Medical and Pharmaceutical University “Nicolae Testemitanu”, Chișinău, Republic of Moldova
- E. Chkonia
- ORCiD
- Society of Georgian Psychiatrists, Tbilisi, Georgia Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
- P. Courtet
- ORCiD
- French Congress of Psychiatry, Paris, France University of Montpellier, CHRU Montpellier, Montpellier, France Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, Montpellier, France
- D. Cozman
- ORCiD
- Romanian Association of Psychiatry and Psychotherapy, Bucharest, Romania Medical Psychology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-NapocaRomania
- M. David
- French Federation of Psychiatry, Paris, France Fondation Bon Sauveur, Bégard, France
- G. Dom
- ORCiD
- Belgium Professional Association of Medical Specialists in Psychiatry, Brussel, Belgium Department of Psychiatry, Antwerp University (UA), Antwerpen, Belgium
- A. Esanu
- ORCiD
- Society of Psychiatrists, Narcologists, Psychotherapists, and Clinical Psychologists from the Republic of Moldova, Chișinău, Moldova Department of Psychiatry, Narcology and Medical Psychology, State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
- P. Falkai
- ORCiD
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany Clinic for Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
- W. Flannery
- College of Psychiatrists of Ireland, Dublin, Ireland Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
- K. Gasparyan
- ORCiD
- Armenian Psychiatric Association, Yerevan, Armenia Medical Psychology Department, Yerevan State Mkhitar Herats Medical University, Yerevan, Armenia
- G. Gerlinger
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany
- P. Gorwood
- French Congress of Psychiatry, Paris, France Institute of Psychiatry and Neuroscience of Paris (IPNP), University of ParisParis, France
- O. Gudmundsson
- ORCiD
- Icelandic Psychiatric Association, Kopavogur, Iceland Psychiatric Department, Landspitali, University Hospital of Iceland, Reykjavík, Iceland
- C. Hanon
- ORCiD
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Regional Resource Center of old age Psychiatry, AP-HP Centre – Université de Paris, Corentin-Celton Hospital, Paris, France
- A. Heinz
- ORCiD
- German Association for Psychiatry, Psychotherapy and Psychosomatics, Berlin, Germany Clinic for Psychiatry and Psychotherapy, Charité – Universitätsmedizin, Berlin, Germany
- M. J. Heitor Dos Santos
- Portuguese Society of Psychiatry and Mental Health, Lisbon, Portugal Institute of Environmental Health (ISAMB) of the Faculty of Medicine of the University of Lisbon (FMUL), Lisbon, Portugal
- A. Hedlund
- Swedish Psychiatry Association, Sundsvall, Sweden North Stockholm Psychiatry, Stockholm County Medical Area (SLSO), Stockholm, Sweden
- F. Ismayilov
- Azerbaijan Psychiatric Association, Baku, Azerbaijan National Mental Health Centre, Baku, Azerbaijan
- N. Ismayilov
- Azerbaijan Psychiatric Association, Baku, Azerbaijan Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
- E. T. Isometsä
- Finnish Psychiatric Association, Helsinki, Finland Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- L. Izakova
- Slovak Psychiatric Association, Bratislava, Slovakia Department of Psychiatry, Faculty of Medicine Comenius University and University Hospital, Bratislava, Slovakia
- A. Kleinberg
- Estonian Psychiatric Association, Tartu, Estonia Children Mental Health Centre of Tallinn Children Hospital, Tallinn, Estonia
- T. Kurimay
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary
- S. Klæbo Reitan
- Department of Psychiatry and Psychiatric Rehabilitation, Teaching Department of Semmelweis University, Budapest, Hungary Norwegian Psychiatric Association, Oslo, Norway Department of Mental Health, Faculty of Medicine and Health Sciences, Norweigan University of Science and Technology, Trondheim, Norway
- D. Lecic-Tosevski
- Serbian Psychiatric Association, Belgrade, Serbia Psychiatric Association of Eastern Europe and the Balkans, Athens, Greece Department of Medical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia
- A. Lehmets
- Estonian Psychiatric Association, Tartu, Estonia Psychiatric Centre of the Tallinn West Central Hospital, Tallinn, Estonia
- N. Lindberg
- Finnish Psychiatric Association, Helsinki, Finland Forensic Psychiatry, Helsinki University and Helsinki University Hospital, Helsinski, Finland
- K. A. Lundblad
- Swedish Psychiatry Association, Sundsvall, Sweden Adult Psychiatry, Stockholm County Medical Area (SLSO), Stockholm, Sweden
- G. Lynch
- Royal College of Psychiatrists, London, United Kingdom
- C. Maddock
- Royal College of Psychiatrists, London, United Kingdom
- U.F. Malt
- Norwegian Psychiatric Association, Oslo, Norway Faculty of Medicine, Psychiatry and Psychosomatic Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- L. Martin
- College of Psychiatrists of Ireland, Dublin, Ireland St Loman’s Hospital, Mullingar, Ireland
- I. Martynikhin
- Russian Society of Psychiatrists, Moscow, Russian Federation First Pavlov State Medical University of St Petersburg, Saint Petersburg, Russian Federation
- N. O. Maruta
- Association of Neurologists, Psychiatrists and Narcologists of Ukraine, Kharkiv, Ukraine Institute of Neurology, Psychiatry and Narcology of the NAMS of Ukraine State Insitution, Kharkiv, Ukraine
- F. Matthys
- Flemish Association of Psychiatry, Kortenberg, Belgium Department of Psychiatry, Universitair Ziekenhuis, Brussel, Belgium
- R. Mazaliauskiene
- Lithuanian Psychiatric Association, Vilnius, Lithuania Lithuanian University of Health Sciences, Psychiatric Clinic, Kaunas, Lithuania
- G. Mihajlovic
- Serbian Psychiatric Association, Belgrade, Serbia Clinic for Psychiatry, University of Kragujevac, Kragujevac, Serbia
- A. Mihaljevic Peles
- Croatian Psychiatric Association, Zagreb, Croatia Zagreb School of Medicine and Zagreb University Hospital Centre, Zagreb, Croatia
- V. Miklavic
- Slovenian Psychiatric Association, Ljubljana, Slovenia Ljubljana University Medical Centre, Ljubljana, Slovenia
- P. Mohr
- Czech Psychiatric Association, Prague, Czech Republic Third Faculty of Medicine, Charles University Prague, Prague, Czech Republic
- M. Munarriz Ferrandis
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain
- M. Musalek
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Institute for Social Aesthetics and Mental Health, Vienna, Austria Sigmund Freud University, Vienna, Austria
- N. Neznanov
- Russian Society of Psychiatrists, Moscow, Russian Federation St. Petersburg V.M. Bekhterev Psychoneurological Research Institute, St. Petersburg, Russian Federation
- G. Ostorharics-Horvath
- Hungarian Psychiatric Association, Budapest, Hungary
- I. Pajević
- Psychiatric Association of Bosnia-Herzegovina, Tuzla, Bosnia and Herzegovina Department of Psychiatry, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
- A. Popova
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France College Private Psychiatry of Bulgaria, Sofia, Bulgaria Nikola Shipkovenski Mental Health Centre, Sofia, Bulgaria
- P. Pregelj
- Slovenian Psychiatric Association, Ljubljana, Slovenia Department of Psychiatry, University of Ljubljana, Ljubljana, Slovenia
- E. Prinsen
- Netherlands Psychiatric Association, Utrecht, Netherlands
- C. Rados
- Austrian Society for Psychiatry and Psychotherapy, Vienna, Austria Department of Psychiatry and Psychotherapeutic Medicine, Villach State Hospital, Villach, Austria
- A. Roig
- Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain Mental Health Centre, Horta-Guinardó, Barcelona, Spain
- M. Rojnic Kuzman
- Croatian Psychiatric Association, Zagreb, Croatia Zagreb School of Medicine and Zagreb University Hospital Centre, Zagreb, Croatia
- J. Samochowiec
- Polish Psychiatric Association, Warsaw, Poland European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France Department of Psychiatry Pomeranian Medical University, Szczecin, Poland
- N. Sartorius
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
- Y. Savenko
- Independent Psychiatric Association of Russia, Moscow, Russian Federation
- O. Skugarevsky
- Belarusian Psychiatric Association, Minsk, Belarus Psychiatry and Medical Psychology Department, Belarusian State Medical University, Minsk, Belarus
- E. Slodecki
- Royal College of Psychiatrists, London, United Kingdom
- A. Soghoyan
- Armenian Psychiatric Association, Yerevan, Armenia Center of Psychosocial Recovery, Yerevan State Medical University, Yerevan, Armenia
- D. S. Stone
- National Centre for Suicide Research and Prevention of Mental-Ill Health, Karolinska Institute, Stockholm, Sweden
- R. Taylor-East
- Maltese Association of Psychiatry, Attard, Malta University of Malta, Msida, Malta
- E. Terauds
- Latvian Psychiatric Association, Riga, Latvia Department of Psychiatry and Narcology, Rīga Stradiņš University, Riga, Latvia
- C. Tsopelas
- Psychiatric Association of Eastern Europe and the Balkans, Athens, Greece Department of Psychiatry, Psychiatric Hospital of Athens, Athens, Greece
- C. Tudose
- Romanian Association of Psychiatry and Psychotherapy, Bucharest, Romania Department of Psychiatry “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- S. Tyano
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France
- P. Vallon
- Swiss Society of Psychiatry and Psychotherapy, Bern, Switzerland
- R. J. Van der Gaag
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Psychosomatics and Psychotherapy Stradina Department, University of Riga, Riga, Latvia
- P. Varandas
- Portuguese Society of Psychiatry and Mental Health, Lisbon, Portugal Casa de Saúde da Idanha and San José Psychiatric Clinic Instituto das Irmãs Hospitaleiras do Sagrado Coração de Jesus, Belas, Portugal
- L. Vavrusova
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France Slovak Psychiatric Association, Bratislava, Slovakia
- P. Voloshyn
- Association of Neurologists, Psychiatrists and Narcologists of Ukraine, Kharkiv, Ukraine Department of Neurology and Neurosurgery of Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
- J. Wancata
- Austrian Society for Psychiatry and Psychotherapy, Vienna, Austria Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- J. Wise
- European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France CNWL NHS Foundation Trust, London, United Kingdom
- Z. Zemishlany
- Israel Psychiatric Association, Ramat Gan, Israel
- F. Öncü
- Psychiatric Association of Turkey, Ankara, Turkey Forensic Psychiatry Department, Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
- S. Vahip
- European Psychiatric Association Council of National Psychiatric Associations, Strasbourg, France Department of Psychiatry, Ege University School of Medicine, Izmir, Turkey
- DOI
- https://doi.org/10.1192/j.eurpsy.2020.79
- Journal volume & issue
-
Vol. 63
Abstract
AbstractBackground.Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.Methods.The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.Results.We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.Conclusions.We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Keywords
- Awareness
- communication
- compulsory admission
- education
- ethics and human rights
- European Psychiatric Association (EPA)
- involuntary admission
- legal model
- medical model
- National Psychiatric Associations (NPAs)
- psychiatry in Europe
- stigma
