Involuntary hospitalization in contemporary mental health care. Some (still) unanswered questions

Abstract

Background: Published figures on civil commitment rates in Europe show large differences between countries. All such rates are based on public register data, and it has been questioned to what extent such data can be trusted.Aims: To present an update on our current knowledge about involuntary hospitalization, with special emphasis on research issues related to time trends in its use, the impact of legislation, and that of service structure and ideology on variations in involuntary hospitalization rates.Methods: Literature review.Results: How civil commitment rates have been computed is rarely accounted for in the literature, and rates will vary substantially according to the methods used. The quality of public register data does also vary, and few studies have looked at the quality of public registers.Conclusions: We still have insufficient knowledge about the use of involuntary hospitalization. Given the varying quality of the data, it is problematic to draw any firm conclusions about the extent, time trends and variations in the use of civil commitment. Comparison of civil commitment rates between countries should for this reason be interpreted with caution.