Involuntary Admission and Compulsory Treatment in Europe: An Overview

Abstract

We present epidemiologic data on compulsory admission in Europe and compare the legislations and practices on compulsory admission and treatment of psychiatric patients in the former 15-member European Union (EU-15). Rates of compulsory procedures in EU-15 nations vary from only 6 per 100,000 in Portugal to well above 200 per 100,000 in Finland. Since the introduction of new legislation aimed at reducing the rate of compulsory procedures in the respect of individual rights, the rate actually rose. The differences in legislations, combined with a number of complicated social and cultural factors, may account for this differential increase. For example, in countries with similarly structured mental health services but different legislations (e.g., Italy and the United Kingdom), actual practices of compulsory procedures differ greatly. Thus, one possible reason explaining differences in compulsory practices may reside in the criterion adopted by individual legislations, with the danger criterion tending to be associated with higher rates of compulsory procedures and the need-for-treatment criterion associated with a lower rate and more stable patterns of compulsion-related practices.