Lawyers' perspectives on the increased use of involuntary psychiatric treatment under the mental health act 2016, Queensland, Australia.

Anorexia Nervosa is an eating disorder typified by low body weight, restrictive eating behaviours, and body image distortion. It is associated with significant risk of medical complications, with one of the highest mortality rates of any mental illness. While the majority of patients receive treatment on a voluntary basis, a small proportion of severely ill patients refuse treatment and are treated involuntarily. The legal mechanisms used for involuntary treatment vary between jurisdictions, including mental health law, capacity-based law, guardianship, and use of inherent jurisdiction, the power of a superior court to rule on matters not included in statute. In Ireland, involuntary treatment of anorexia nervosa occurs within a legislative lacuna, not regulated by either the Mental Health Act 2001, or the Assisted Decision Making (Capacity) Act, 2015. Instead, treatment occurs under the Inherent Jurisdiction of the High Court, resulting in reliance on judicial discretion for decision-making. In this article, we explore the gaps in Ireland's current legal framework as applicable to care and treatment of anorexia nervosa, with reference to case law in England and Wales as a comparison. This includes an examination of the potential impact of the proposed changes to legislation as set out in the Mental Health Bill, 2024. We argue that these gaps mean that legislation governing the involuntary treatment of anorexia nervosa is urgently needed to safeguard the rights of this potentially vulnerable patient cohort, and ensure justice, transparency and consistency in legal approach.

The MeHPriC project in Lagos, Nigeria: a mixed methods study on policy, governance, and sustainability of mental health integration

Involuntary patients awareness of their entitlement to appeal an admission and existence of the mental health review board in South Africa.

Addressing the false dichotomy between autonomy and preservation of life: Clinical, legal, and ethical considerations in severe and longstanding anorexia nervosa.

Abstract Background Psychological health care has gradually become a way for most people to relieve social pressure and treat mental disorders. Although the current Civil Code stipulates that psychological caregivers and therapists have confidentiality obligations towards patients. However, in some special psychological disorders, patients may be at risk of self harm or harming others. Should therapists continue to maintain confidentiality in the face of multiple complex situations, or should they break their confidentiality obligations and upload reports for the sake of patient rights and the social rights of others? There is a lack of clear provisions for exceptions in current laws, so research is being conducted to investigate the attitudes of therapists and the public towards confidentiality obligations in mental health care. The purpose of the study is to identify potential challenges that psychotherapists may encounter during their practice and provide corresponding improvement suggestions. Methods A questionnaire was distributed to 36 psychotherapists in medical institutions and 620 members of the general public to investigate their perceptions and attitudes towards confidentiality, as well as their perceptions and attitudes towards confidentiality exceptions, measures, and recommendations. Simultaneously select legal professionals and hospital managers who have participated in the questionnaire survey and are interested in conducting semi-structured interviews for in-depth interviews. After the investigation, the data was organized using SPSS software and analyzed using t-test method. Results The experimental results showed that the average approval rating of the psychological therapist group for the confidentiality provisions in the Mental Health Law was 4.78 ± 0.49, and the average approval rating for the confidentiality exception provisions in the Physician Law was 4.67 ± 0.63. The attitude of the psychotherapist community towards exceptions to confidentiality obligations is as follows: for behaviors that pose a threat to national security and public safety, seriously endanger the personal safety of others, or abuse minors, the average attitudes of the psychotherapist community towards patient reporting are 4.72 ± 0.97, 4.72 ± 0.85, and 4.50 ± 1.08, respectively. The average evaluation of reporting patients' secret behavior by the general public is 4.66 ± 0.91, 4.60 ± 0.93, and 4.46 ± 0.98, respectively. It can be seen that the attitudes of the general public and psychotherapists towards confidentiality obligations and exceptions are generally consistent on most issues. Discussion A study conducted research on psychotherapists and the general public, and found that different groups have similar perceptions and attitudes towards the confidentiality obligations and exceptions of psychotherapists. In response to the issues identified in the research, it is recommended to establish systematic provisions at the legislative level regarding exceptions to the confidentiality obligations of psychotherapists, in order to clarify the situations where the confidentiality principle can be violated in specific circumstances. At the same time, it is recommended to list specific exceptions to confidentiality for psychotherapists, and to enhance their professional competence, including legal and medical literacy, to ensure that they can balance confidentiality and disclosure correctly. In future research, questionnaire questions will be expanded to focus on legal rights issues in the practice of mental health care.

Abstract Background The global population of patients with mental illness continues to expand. Their mental health is not only affected by the disease itself, but also aggravates negative emotions due to the lack of medical rights, privacy leaks, discrimination and other issues that damage their rights and interests. Existing research mostly focuses on drug and psychological intervention. Research on the application of health law in the field of mental health is relatively scattered, and its specific impact and action path on mental health have not yet been clarified. In order to fill this gap, the study will construct a health law intervention system to explore its actual impact on patients' mental health and help improve patients' mental health. Methods Stratified sampling was conducted to select 180 patients from 2 tertiary mental health institutions and 1 community health service center who met the relevant diagnostic criteria, had a disease duration of ≥1 year, and were aged 18-60 years old. Patients with cognitive impairment and severe organic diseases were excluded. Among them, 98 were male and 82 were female; 65 had depression, 58 had schizophrenia, and 57 had bipolar disorder. Implement a three-month health law intervention, covering the core rights and interests provisions of the Mental Health Law of the People's Republic of China; provide one-on-one consultation and rights protection on the online platform, and provide free legal assistance. The study used the Self-Rating Symptom Scale and the Depression Anxiety Stress Scale to collect and analyze data before, 1 month and 3 months after the intervention. Results The results show that the degree of awareness of health law is positively correlated with patients' mental health status (r = 0.45, p<.01), and the degree of legal implementation is positively correlated with patients' mental health status (r = 0.50, p<.01). In addition, the degree of legal implementation is the main factor affecting patients' mental health (β = 0.40, p<.01), followed by the degree of public awareness (β = 0.25, p<.05). The patient return rate increased from 75.3% to 91.2%, and the incidence of rights damage incidents dropped from 22.6% to 5.1%. The results show that inadequate implementation of laws and insufficient public awareness are the main negative factors affecting patients' mental health, and health law intervention can effectively improve the mental health of patients with mental illness. Discussion Research has clarified the positive impact of health law on mental health, providing patients with another way to improve mental health in addition to drug treatment and psychological intervention. Patients can improve their mental health by learning health law knowledge and proactively safeguarding their own rights and interests. At the same time, the research provides an innovative direction for mental health services to integrate medical treatment with law, proving that the implementation of health law can directly benefit patients' mental health. Future research can expand the sample coverage, extend the follow-up period, explore personalized intervention plans for patients with different types of mental illness, further deepen the integration mechanism of health law and mental health services, and promote the formation of a more complete patient rights protection and mental health promotion system.

Abstract Background As mental health issues increasingly become an important factor affecting public health and social harmony, China is gradually promoting the sinking of mental health services to grassroots communities. However, there are still fragmented, non-standard, and insufficient sustainability issues in the supply mode of mental health care services in grassroots communities, and the relevant legal and policy support system is not yet sound, which restricts service coverage and intervention effectiveness. Therefore, this study systematically sorts out the existing mental health care service models in grassroots communities, analyzes their legal and policy support status and bottlenecks, in order to provide theoretical and practical basis for building a standardized and sustainable community mental health service system. Methods The study selected 24 urban and rural communities from six provinces in eastern, central, and western China as survey subjects, covering three types of institutions: community health service centers, street social workstations, and community mental health service points. Conduct a systematic review and content analysis of community mental health related policy documents issued by the national and local governments since 2015. A questionnaire survey was conducted on 320 community mental health service providers, including general practitioners, social workers, and psychological counselors, to investigate service models, resource allocation, policy awareness, and implementation barriers. Finally, 36 policy makers, institutional managers, and service users were selected for semi-structured interviews to understand the service operation mechanism and policy implementation effectiveness. The study used SPSS 26.0 for descriptive and comparative analysis of questionnaire data, and Nvivo 12.0 for topic coding and qualitative analysis of interview texts. Results The study identified four main service models, with the "medical social collaboration" integrated service model accounting for 35.4% of the sample communities. The community health service center collaborated with community organizations to conduct psychological assessments and referrals. The "social worker led" supportive service model accounts for 29.2%, relying on community social work stations to carry out mental health education and group counseling. The "family neighborhood" mutual aid model accounts for 20.8%, based on community volunteers and neighborhood networks for psychological companionship and crisis warning. The "digital platform+" remote service model accounts for 14.6%, providing psychological assessment and counseling through online platforms. Policy analysis shows that the national level has issued the "Mental Health Law of the People's Republic of China" and relevant guidance on mental health services, but only 41.7% of communities in local supporting policies have clear service implementation guidelines and funding guarantee measures. The survey results show that 67.3% of service providers believe that the lack of specialized legal basis is the main obstacle to service development, and 71.5% reflect that the training time is less than 20 hours per year, and the standardization of services needs to be improved. Discussion The current grassroots community mental health care has formed a prototype of a diversified service model, but due to insufficient legal and policy support, lack of cross departmental collaboration mechanisms, and unsustainable resource guarantees, the overall service is still in a fragmented stage. The study provides a model reference and policy recommendations for improving the grassroots psychological service system, and further comparative research and long-term impact assessment of different regional models should be carried out in the future.

Mental health legislation across Africa has evolved significantly from colonial-era frameworks. An adapted version of the FOSTREN* (Fostering and Strengthening Approaches to Reducing Coercion in European Mental Health Services) instrument, which is a comprehensive assessment tool based on the World Health Organisation Mental Health Legislation Checklist and the United Nations Convention on the Rights of Persons with Disabilities, was used to analyse mental health laws from Nigeria, Egypt, Ghana, Cabo Verde and Kenya. The comparative analysis showed varying alignment with international human rights standards, reflecting complex interactions between global frameworks and local realities. All the mental health laws analysed show movement towards rights-based approaches, although implementation challenges related to resource constraints, service delivery capacity and cultural integration remain significant barriers. Ghana's formal integration of complementary and alternative medicine into its mental health framework, which requires cooperation between the Mental Health Authority and Traditional and Alternative Medicine Council, and the inclusion of people with lived experience of mental health conditions in review panels are examples of innovative approaches that show promise for regional adoption. While some form of supported decision-making is available, none of the countries offer advanced care directives. The study highlights that legislative reform alone is insufficient without addressing contextual factors like poverty, healthcare financing and integration of traditional healing practices in developing rights-based mental health care systems.

Mental health legislation across Africa has evolved significantly from colonial-era frameworks. An adapted version of the FOSTREN* (Fostering and Strengthening Approaches to Reducing Coercion in European Mental Health Services) instrument, which is a comprehensive assessment tool based on the World Health Organisation Mental Health Legislation Checklist and the United Nations Convention on the Rights of Persons with Disabilities, was used to analyse mental health laws from Nigeria, Egypt, Ghana, Cabo Verde and Kenya. The comparative analysis showed varying alignment with international human rights standards, reflecting complex interactions between global frameworks and local realities. All the mental health laws analysed show movement towards rights-based approaches, although implementation challenges related to resource constraints, service delivery capacity and cultural integration remain significant barriers. Ghana’s formal integration of complementary and alternative medicine into its mental health framework, which requires cooperation between the Mental Health Authority and Traditional and Alternative Medicine Council, and the inclusion of people with lived experience of mental health conditions in review panels are examples of innovative approaches that show promise for regional adoption. While some form of supported decision-making is available, none of the countries offer advanced care directives. The study highlights that legislative reform alone is insufficient without addressing contextual factors like poverty, healthcare financing and integration of traditional healing practices in developing rights-based mental health care systems.

The current research involved the analysis of awareness and current knowledge regarding the laws of mental health amongst caregivers in India, with reference to working in various rehabilitation facilities in West Bengal. The research design was a mixed-method study that was based on a combination of qualitative data collected through structured interviews and quantitative information that was gathered using a self-constructed questionnaire (reliability: 0.74). In the study, 105 caregivers were chosen using purposive and random sampling methods, and the t-tests and ANOVA were used to evaluate the quantitative data. The results showed that the caregivers were mostly aware of the importance of mental health legislation and believed that they have to continue with the training by participating in seminars and workshops. Quantitative findings showed that there was no significant difference in terms of awareness according to gender, locality or years of experience. Nonetheless, awareness levels were greatly based on the level of education and the employed individuals with the better educated and fulltime caregivers showing the better knowledge of the law. These trends were also supported by qualitative data, which revealed the fact that urban and better-educated caregivers were more certain about implementing mental health legislation. Overall, it is observed in the study that legal literacy of caregivers plays a crucial role in ethical treatment, protection of patient rights, and fostering a rights-oriented mental health care environment. The findings address the need to implement the policy-based interventions, frequent training sessions, the inclusion of the legal literacy modules in the caregiver education to reinforce the principle of informed, responsible, and humane caregiving in India.

This paper asks whether the European Court of Human Rights (ECtHR) has driven a rights-based transformation of mental-health law, or merely refined a paternalistic status quo. Using doctrinal analysis of the ECHR and close reading of leading judgments, it situates Strasbourg case law within the Council of Europe’s normative framework (European Social Charter, Oviedo Convention) and soft-law developments, read against the CRPD. Three core findings emerge. First, the Court has thickened procedural protections under Articles 5 and 3, tightening admission standards, extending review to informal and social-care placements, and recognising therapeutic neglect as ill-treatment, while Article 8 jurisprudence increasingly foregrounds bodily integrity and participation. Second, non-consensual treatment is still treated largely as an incident of lawful detention, with deference to clinical expertise and risk-based reasoning; autonomy and equal legal capacity remain weak constraints. Third, Council of Europe soft law and equality norms outpace binding doctrine, endorsing deinstitutionalisation, informed consent, and supported decision-making. The paper prescribes recalibration: analytically decoupling detention from treatment, with capacity-sensitive review under Articles 3 and 8; enforcing rigorous least-restrictive-alternative tests, and integrating Article 14 scrutiny to expose structural discrimination.

In this article, I explore how the mental health and mental capacity laws in England and Wales can be used for suicide prevention. I criticise the use of compulsion for persons diagnosed with a mental disorder who nonetheless retain decision-making capacity and argue for a greater reliance upon capacity as a distinguisher between autonomous decision-making about the end of life and the risk to life posed by symptoms of mental illness. The label of 'suicide' is also criticised as an outdated legal notion carrying pejorative meaning. Although focused on the law in England and Wales, the arguments apply much more broadly to all jurisdictions seeking to reconcile the demands of respect for life and respect for autonomy.

Mental health legislation authorises involuntary psychiatric intervention in certain circumstances. Although human rights concerns are becoming more prominent, debates among legal experts, clinicians and activists continue to swirl around people's rights to equal recognition before the law, such as described in the (United Nations Convention on the Rights of Persons with disabilities, 2006). This qualitative descriptive study aimed to better understand diverse views of people known to hold a critique of coercion in mental health services, on the practical expression of upholding human rights in the context of mental health laws. Individual semi-structured interviews were conducted with 15 key informants from five different countries and data was analysed using an inductive, thematic approach. Overall, informants characterised mental health laws as discriminatory, harmful and unjustifiable. Three themes and six sub-themes were identified. This study reports on the major themes which include: an ethical position (focusing on the present harms associated with mental health laws), strategies, (an expression of the opportunity to bring about change) and a visionary position. We explore these three features in the views of key informants as important positions in the field of abolition, and analyse each for the 'hermeneutic resources' - forms of collective interpretive resources - they provide. Abolition of mental health laws is often seen as not feasible in the context of psychiatry. However, abolition theories and practices are hermeneutic resources that need to be better understood because they offer social justice and community-led solutions beyond mental health laws and systems.

From historical foundations to contemporary structures: Tracing Qatar's mental health services from the 1950s to 2025.

Decision-making capacity (DMC) is a widely used criterion in health laws to balance respect for patient autonomy with protection from the potential consequences of treatment decisions. In 2017, lacking DMC was introduced as an additional criterion for involuntary care and treatment following comprehensive amendments to the Norwegian Mental Health Care Act. Despite the amendments aiming to reduce involuntary care and treatment rates, national health registry data indicate continued rising rates along the pre-2017 trajectory after an initial reduction in 2017. While previous studies suggesting varying DMC assessment quality, little is known about the potential factors influencing these variations. To identify factors influencing DMC assessments after introducing a capacity-based mental health law governing involuntary care and treatment. 60 purposively sampled stakeholders, including patients, families, health professionals, and lawyers, participated in semi-structured interviews and focus groups in 2018, with 26 of these participating in follow-up interviews in 2022-23. The transcribed interviews were analysed using thematic analysis. Data analysis generated four themes: 1) available resources' influence on DMC assessments; 2) health professionals' values and practices regarding involuntary care; 3) legal interpretations by supervisory bodies regarding involuntary care; and 4) political signals from the health authorities regarding involuntary care. DMC assessments appear to be influenced by several factors, including resource availability, health professionals' values and practices, legal interpretations by supervisory bodies, and political signals from health authorities. Combined with a lack of systematic training and validated tools, these factors may have raised the threshold for accessing mental healthcare beyond what systematic DMC assessments would suggest, contributing to increased illness severity among patients and rising involuntary care rates post-2017. Further research is needed to better understand the complex dynamics involved in DMC assessments and how to effectively implement capacity-based health laws.

This article begins with the question: “Why do we archive?” It reflects on art collections produced within contemporary psychiatric institutions in Portugal. It explores the ethical, bureaucratic, and political dimensions involved in the care and circulation of these works, created by people with lived experience of madness. Considering efforts to deinstitutionalize large psychiatric hospitals, the article examines specific cases of still-operational Portuguese institutions that house artistic archives. It problematises the status of these productions, which often oscillate between becoming defunct archives, being discarded, or circulating within art brut and outsider art circuits, raising questions regarding artist rights and the use of these works following the death or discharge of their creators. The analysis is structured around two main axes: first, the role of psychiatric institutions in light of the challenges posed by reforms to Mental Health Law; and second, the circulation of these artistic expressions and their contemporary discourses, with a focus on the Portuguese context. Finally, the article emphasises the urgent need to reconsider the management and preservation of these artistic archives, highlighting the tension between protecting privacy and providing access to the memory of institutionalised subjects, and questioning the current role of asylums as custodians of these cultural and human legacies.

The phenomenon of mental health disorders arising from misguided love has become an increasingly relevant social issue amidst increasing emotional stress in interpersonal relationships. This journal examines the legal position of patients with mental health disorders caused by unhealthy romantic relationships, such as obsessive, manipulative, or emotionally abusive love. This study aims to examine legal protection for individuals who experience mental disorders due to detrimental love dynamics, as well as to analyze the relationship between psychological aspects and the legal responsibilities of the parties involved. The approach method used is normative legal with a literature study of laws and regulations, jurisprudence, and relevant literature. The results of the study show that although legal protection for people with mental disorders has been regulated in the Mental Health Law and the Criminal Code, there are no specific regulations governing the legal consequences of romantic relationships that cause mental disorders. Therefore, it is necessary to formulate a legal policy that is more responsive to forms of emotional violence in romantic relationships in order to guarantee the rights and recovery of victims as a whole.

In Northern Ireland, the current main legal framework for compulsory intervention is the Mental Health (Northern Ireland) Order 1986. It is a traditional mental health law which enables detention in hospital if mental disorder and risk criteria are met. However, under Article 3(2), it states that people should not be detained "by reason only of personality disorder". There has been a process of law reform in Northern Ireland to create a non-discriminatory, comprehensive legal framework for all. This resulted in the Mental Capacity Act (Northern Ireland) 2016. The Act, when fully implemented, will replace the Order for everyone aged 16 and over, which is in contrast to most other countries where there are both mental health and mental capacity laws. Under the new Act there are no specific exclusions so, if a person is unable to make the relevant decision, including if the cause of impairment relates to issues associated with personality disorder, then compulsory intervention is allowed as long as the proposed intervention is in the person's 'best interests'. The Act was partially implemented in 2019 and currently is only used when the Order does not apply. This article explores: the development of this new legal framework; the implementation of the Act; and some of the ongoing debates, and practice complexities, related to services for people with a diagnosis of personality disorder.

Abstract This review analyse the mental healthcare systems in Gulf Cooperation Council (GCC) countries, comparing them with five developed nations to identify the gaps and barriers. The desk review was conducted to examines mental health definitions, laws, regulations, measures and insurance provisions across these countries. The findings reveal significant disparities between GCC and industrialised countries in mental health legislation, data reporting and service delivery. GCC states face challenges, including limited data availability, cultural stigma, shortage of mental health professionals, inadequate community-based programs and restricted insurance coverage. This review highlights the importance of GCC countries developing comprehensive mental health laws, enhancing data collection, expanding community-based care, increasing the mental health workforce and expanding insurance coverage. Despite overall healthcare advancements, mental health remains underdeveloped in GCC nations, requiring greater attention and resource allocation.