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

F. Ismayilov, N. Ismayilov, E. Isometsä, L. Izakova, A. Kleinberg, T. Kurimay, S. Reitan, D. Lecic-Tosevski, A. Lehmets, N. Lindberg, K. Lundblad, G. Lynch, C. Maddock, U. Malt, L. Martin, I. Martynikhin, N. Maruta, F. Matthys, R. Mazaliauskiene, G. Mihajlovic, A. Peles, V. Miklavic,

P. Mohr, M. Ferrandis, M. Musalek, N. Neznanov, G. Ostorharics-Horvath, I. Pajević, A. Popova, P. Pregelj, E. Prinsen, C. Rados, A. Roig, M. Kuzman, J. Samochowiec, N. Sartorius, Y. Savenko, O. Skugarevsky, E. Slodecki, A. Soghoyan, D. Stone, R. Taylor-East, E. Terauds, C. Tsopelas, C. Tudose, S. Tyano, P. Vallon, R. van der Gaag, P. Varandas, L. Vavrusova, P. Voloshyn, J. Wancata, J. Wise, Z. Zemishlany, F. Öncü, S. Vahip,

2020

https://doi.org/10.1192/j.eurpsy.2020.79

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 analysed 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 stigmatisation 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.

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1. Version of Record от 2020-08-24

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Об авторах

D. Wasserman
Karolinska Institutet
G. Apter
University of Rouen
C. Baeken
Ghent University
S. Bailey
University of Central Lancashire
J. Balázs
Eötvös Loránd University
C. Bec
Karolinska Institutet
P. Bienkowski
Polish Psychiatric Association, Warsaw, Poland.; Department of Psychiatry, Warsaw Medical University, Warsaw, Poland.
J. Bobes
University of Oviedo
M. Ortiz
Autonomous University of Madrid
H. Brunn
University of Southern Denmark
Ö. Böke
Ondokuz Mayıs University
N. Camilleri
University of Malta
B. Carpiniello
University of Cagliari
J. Chihai
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
Tbilisi State Medical University
P. Courtet
University of Montpellier
D. Cozman
Iuliu Hațieganu University of Medicine and Pharmacy
M. David
French Federation of Psychiatry, Paris, France.; Fondation Bon Sauveur, Bégard, France.
G. Dom
Belgium Professional Association of Medical Specialists in Psychiatry, Brussel, Belgium.; Department of Psychiatry, Antwerp University (UA), Antwerpen, Belgium.
A. Esanu
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
Ludwig Maximilian University of Munich
W. Flannery
Mater Misericordiae University Hospital
K. Gasparyan
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
University of Paris
O. Gudmundsson
Icelandic Psychiatric Association, Kopavogur, Iceland.; Psychiatric Department, Landspitali, University Hospital of Iceland, Reykjavík, Iceland.
C. Hanon
University of Paris
A. Heinz
Charité
M. Santos
University of Lisbon
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 Medical University
E. Isometsä
University of Helsinki
L. Izakova
Comenius University in Bratislava
A. Kleinberg
Estonian Psychiatric Association, Tartu, Estonia.; Children Mental Health Centre of Tallinn Children Hospital, Tallinn, Estonia.
T. Kurimay
Semmelweis University
S. Reitan
Semmelweis University
D. Lecic-Tosevski
Serbian Academy of Sciences and Arts
A. Lehmets
Estonian Psychiatric Association, Tartu, Estonia.; Psychiatric Centre of the Tallinn West Central Hospital, Tallinn, Estonia.
N. Lindberg
University of Helsinki
K. Lundblad
Swedish Psychiatry Association, Sundsvall, Sweden.; Adult Psychiatry, Stockholm County Medical Area (SLSO), Stockholm, Sweden.
G. Lynch
Royal College of Psychiatrists
C. Maddock
Royal College of Psychiatrists
U. Malt
University of Oslo
L. Martin
College of Psychiatrists of Ireland, Dublin, Ireland.; St Loman's Hospital, Mullingar, Ireland.
I. Martynikhin
First Pavlov State Medical University of St. Peterburg
N. 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 University of Health Sciences
G. Mihajlovic
University of Kragujevac
A. Peles
University Hospital Centre Zagreb
V. Miklavic
Ljubljana University Medical Centre
P. Mohr
Charles University in Prague
M. Ferrandis
Association of Psychiatrists of Spanish Association of Neuropsychiatry, Madrid, Spain.
M. Musalek
Sigmund Freud University Vienna
N. Neznanov
St.Petersburg V.M.Bekhterev Psychoneurological Research Institute
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
University of Ljubljana
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. Kuzman
University Hospital Centre Zagreb
J. Samochowiec
Pomeranian Medical University
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 State Medical University
E. Slodecki
Royal College of Psychiatrists
A. Soghoyan
Yerevan State Medical University
D. Stone
Karolinska Institutet
R. Taylor-East
University of 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
Carol Davila University of Medicine and Pharmacy
S. Tyano
European Psychiatric Association, Committee on Ethical Issues, Strasbourg, France.
P. Vallon
Swiss Society of Psychiatry and Psychotherapy, Bern, Switzerland.
R. 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
Kharkiv Medical Academy of Postgraduate Education
J. Wancata
Medical University of Vienna
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
Ege University

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European psychiatry : the journal of the Association of European Psychiatrists

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Awareness;European Psychiatric Association (EPA);National Psychiatric Associations (NPAs);communication;compulsory admission;education;ethics and human rights;involuntary admission;legal model;medical model;psychiatry in Europe;stigma;

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