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1. Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries.

Author

Wasserman D, Apter G, Baeken C, Bailey S, Balazs J, Bec C, Bienkowski P, Bobes J, Ortiz MFB, Brunn H, Bôke Ö, Camilleri N, Carpiniello B, Chihai J, Chkonia E, Courtet P, Cozman D, David M, Dom G, Esanu A, Falkai P, Flannery W, Gasparyan K, Gerlinger G, Gorwood P, Gudmundsson O, Hanon C, Heinz A, Dos Santos MJH, Hedlund A, Ismayilov F, Ismayilov N, Isometsä ET, Izakova L, Kleinberg A, Kurimay T, Reitan SK, Lecic-Tosevski D, Lehmets A, Lindberg N, Lundblad KA, Lynch G, Maddock C, Malt UF, Martin L, Martynikhin I, Maruta NO, Matthys F, Mazaliauskiene R, Mihajlovic G, Peles AM, Miklavic V, Mohr P, Ferrandis MM, Musalek M, Neznanov N, Ostorharics-Horvath G, Pajević I, Popova A, Pregelj P, Prinsen E, Rados C, Roig A, Kuzman MR, Samochowiec J, Sartorius N, Savenko Y, Skugarevsky O, Slodecki E, Soghoyan A, Stone DS, Taylor-East R, Terauds E, Tsopelas C, Tudose C, Tyano S, Vallon P, Van der Gaag RJ, Varandas P, Vavrusova L, Voloshyn P, Wancata J, Wise J, Zemishlany Z, Öncü F, and Vahip S

Subjects
Europe, Humans, Surveys and Questionnaires, Coercion, Commitment of Mentally Ill ethics, Commitment of Mentally Ill legislation & jurisprudence, Hospitalization, Mental Disorders
Abstract

Background: 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.

Published
2020
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2. Compulsory admissions of patients with mental disorders: State of the art on ethical and legislative aspects in 40 European countries

Author

N. Neznanov, K. Gasparyan, Chris Baeken, Bernardo Carpiniello, A. Lehmets, Geert Dom, H. Brunn, William Flannery, C. Hanon, E. Prinsen, E. Slodecki, G. Ostorharics-Horvath, Peter Falkai, Przemyslaw Bienkowski, Erkki Isometsä, M. F. Bravo Ortiz, G. Lynch, Oleg Skugarevsky, T. Kurimay, Pavel Mohr, N. Camilleri, U.F. Malt, M. Rojnic Kuzman, L. Izakova, E. Terauds, Izet Pajević, Ömer Böke, Jerzy Samochowiec, V. Miklavic, A. Kleinberg, Z. Zemishlany, N. O. Maruta, P. Voloshyn, A. Popova, P. Gorwood, G. Apter, Simavi Vahip, S. Klæbo Reitan, A. Hedlund, Fuad Ismayilov, Norman Sartorius, L. Vavrusova, C. Rados, S. Tyano, Jana Chihai, Rachel Taylor-East, F. Öncü, P. Varandas, M. Musalek, N. Ismayilov, A. Mihaljevic Peles, D. S. Stone, A. Roig, Johannes Wancata, O. Gudmundsson, C. Tsopelas, F. Matthys, G. Gerlinger, Goran Mihajlović, E. Chkonia, A. Esanu, M. David, C. Tudose, P. Vallon, Dusica Lecic-Tosevski, P. Courtet, Danuta Wasserman, Andreas Heinz, L. Martin, Y. Savenko, Judit Balazs, C. Maddock, C. Bec, R. Mazaliauskiene, Doina Cozman, A. Soghoyan, M. Munarriz Ferrandis, M. J. Heitor Dos Santos, J. Wise, Nina Lindberg, S. Bailey, P. Pregelj, Julio Bobes, I. Martynikhin, R.J. van der Gaag, K. A. Lundblad, Karolinska Institutet [Stockholm], Groupe Hospitalier du Havre, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Universiteit Gent = Ghent University [Belgium] (UGENT), University of Central Lancashire [Preston] (UCLAN), Eötvös Loránd University (ELTE), Medical University of Warsaw - Poland, University of Oviedo, Hospital Universitario La Paz, Universidad Autonoma de Madrid (UAM), University of Southern Denmark (SDU), Ondokuz Mayis University, University of Malta [Malta], Universita degli Studi di Cagliari [Cagliari], University Nicolae Testemitanu [Kishinev, Moldova] (UNT), Tbilisi State Medical University (Department of Pediatrics), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Iuliu Hatieganu University of Medicine & Pharmacy, University of Antwerp (UA), Ludwig-Maximilians University [Munich] (LMU), Mater Misericordiae University Hospital [Dublin] (The Mater Hospital), Yerevan State Medical University after Mkhitar Heratsi, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Landspitali National University Hospital of Iceland, Hôpital Corentin Celton [Issy-les-Moulineaux], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Universidade de Lisboa (ULISBOA), Azerbaijan Medical University, University of Helsinki, Comenius University in Bratislava, Tallinn Children's Hospital [Tallinn, Estonia], Semmelweis University [Budapest], Serbian Academy of Sciences and Arts (SASA), Tallinn Central Hospital, Helsinki University Hospital [Helsinki, Finlande], University of Oslo (UiO), First Pavlov State Medical University of St. Petersburg [Russian Federation], Universitair Ziekenhuis [Brussels, Belgium], Lithuanian University of health Sciences [Kaunas], University of Kragujevac, University Hospital Centre Zagreb, Partenaires INRAE, University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Charles University [Prague] (CU), Sigmund Freud University (SFU), University Clinic Centre Tuzla, University of Ljubljana, Pomeranian Medical University [Szczecin, Poland] (PMU), Belarusian State Medical University (BSMU), Riga Stradins University (RSU), University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Kharkiv Medical Academy of Postgraduate Education, Medizinische Universität Wien = Medical University of Vienna, CNWL NHS Foundation Trust [London, UK] (CNWL-NHSFT), Ege university, UAM. Departamento de Psiquiatría, Repositório da Universidade de Lisboa, Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Psychiatry, Faculty of Medicine, HUS Psychiatry, and Helsinki University Hospital Area

Subjects
ASSOCIATION EPA GUIDANCE, Coercion, compulsory admission, MESH: Hospitalization, 3124 Neurology and psychiatry, 0302 clinical medicine, C848, Surveys and Questionnaires, Medicine and Health Sciences, Psychology, health care economics and organizations, involuntary admission, Medical model, education.field_of_study, education, communication, Mental Disorders, Legislature, Awareness, mental health, Europe, compulsory admission, psychiatry in Europe, 3. Good health, Europe, Hospitalization, Psychiatry and Mental health, MESH: Commitment of Mentally Ill, Education, human rights, european psychiatric asscoiation, HEALTH, Review/Meta-analyses, medicine.medical_specialty, Medicina, Population, MEDLINE, Stigma (botany), Legislation, 03 medical and health sciences, ethics and human rights, PEOPLE, HIGH-RISK STATES, medicine, Humans, QUALITY, MESH: Mental Disorders, 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, MESH: Surveys and Questionnaires, MESH: Coercion, MESH: Humans, HOSPITAL ADMISSION, National Psychiatric Associations (NPAs), 030227 psychiatry, legal model, stigma, Family medicine, PSYCHIATRIC-PATIENTS, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, Commitment of Mentally Ill, Human medicine, MESH: Europe, European Psychiatric Association (EPA), M260, medical model, 030217 neurology & neurosurgery, Legislation & jurisprudence
Abstract

© The Author(s), 2020. Published by Cambridge University Press on behalf of the European Psychiatric Association. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited., Background: 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.

Published
2020

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